IMPROVEMENT IN MOOD, PHYSICAL SYMPTOMS, AND FUNCTION WITH NORTRIPTYLINE FOR DEPRESSION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Although recent epidemiologic studies have established that patients w ith chronic medical illness and depressed mood are more disabled than euthymic patients, detailed data on the benefits and risks of antidepr essant treatment in medically high-risk patients have been slow to acc umulate. The authors have examined multiple outcome indicators in pati ents with disabling chronic obstructive pulmonary disease and comorbid depression. Thirty patients completed a 12-week, randomized controlle d trial of nortriptyline. Nortriptyline was clearly superior to placeb o for treatment of depression. Nortriptyline treatment was accompanied by marked improvements in anxiety, certain respiratory symptoms, over all physical confort, and day-to-day function; placebo effects were ne gligible. Physiological measures reflecting pulmonary insufficiency we re generally unaffected by treatment. These data provide impetus for r enewed efforts to improve recognition and treatment of mood disorders in even severely disabled medical patients.