Safety of Anti-Depressant for Chronic Obstructive Pulmonary Disease (SAD-COPD)

Safety of Anti-Depressant for Chronic Obstructive Pulmonary Disease

Objective: Determine whether treatment of perceived stress, anxiety, and depression with anti-depressant therapy improves dyspnea scores, 6-minute walk (6MW) distance and quality of life (QoL) in patients with Chronic Obstructive Pulmonary Disease (COPD) and ILD (Interstitial Lung Disease) undergoing pulmonary rehab.

The study is a prospective, randomized, double-blinded, placebo-controlled study to assess the effect of an SSRI on 6MW, dyspnea scores, and QoL in COPD and ILD patients undergoing pulmonary rehab. Thirty subjects that carry an ICD-9 code diagnosis of COPD and/or ILD and CES-D (Center for Epidemiologic Studies Depression) score of > 16 will be recruited from Duke Pulmonary Rehab.

Multivariable regression models will be constructed to evaluate the relationship between perceived stress, anxiety, and depression with adjustments by race, gender, age, BMI and GOLD score. A multivariable regression model will be constructed to assess whether treatment of perceived stress, depression, and anxiety with antidepressant therapy (sertraline) is an effect modifier on 6MW distance and dyspnea scores in patients with COPD or ILD who are enrolled in pulmonary rehab.

Descriptive statistics will be used to examine the socio-demographic characteristic data. Student t-tests will be performed to assess group differences in continuous data. Categorical variables will be examined using the Pearson's Chi-Squared test.

Inclusion Criteria:

• Male or female with an ICD-9 code diagnosis of COPD and/or ILD
• Mild, moderate, or severe major depression symptoms based on Center of Epidemiologic Studies Depression (CES-D) score > 16.
• Able to complete informed consent†
• Read and write in English

Exclusion Criteria:

• Current treatment with antidepressants
• Current treatment with anti-psychotics
• Severe physical disability that would interfere with lung assessment
• History of major psychiatric illness, including bipolar disorder, psychoses, and/or severe personality disorder.
• Active suicidal ideations
• Serious cognitive problems (dementia syndrome) or cognitive impairment defined as MMSE < 22
• Recent loss of spouse within 6 weeks of study enrollment.
• History of alcohol or drug dependence in the last 6 months.
• Pregnant women or nursing mothers
• Poorly controlled concomitant conditions that pose additional procedure risk as determined by the investigator.