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已发表论文
艾司西酞普兰缓解 COPD 患者抑郁和焦虑症状的有效性和安全性：一项随机双盲安慰剂对照试验
Authors Gao Z, Tang S, Zhang W , Zhang M, Wei Z, Long Z, Wang B, Qin H, Qian H , Yin Y , Wang G, He B
Received 8 October 2025
Accepted for publication 29 January 2026
Published 7 February 2026 Volume 2026:21 572465
DOI https://doi.org/10.2147/COPD.S572465
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Prof. Dr. Richard Russell
Zhan Gao,1,* Shasha Tang,1,* Wen Zhang,1 Mingzhou Zhang,1 Zhenghua Wei,1 Zhou Long,1 Bin Wang,1 Heng Qin,1 Hang Qian,1 Yan Yin,2,* Guansong Wang,1 Binfeng He1,3
1Institute of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400037, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China; 3Department of General Practice, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400037, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Binfeng He, Email ldhbf@tmmu.edu.cn Guansong Wang, Email wanggs@tmmu.edu.cn
Purpose: Depression and anxiety negatively impact COPD prognosis, yet evidence for psychopharmacological interventions remains limited. This study evaluated the efficacy and safety of low-dose escitalopram for managing these comorbidities in COPD patients.
Patients and methods: In this double-blind, placebo-controlled trial, 150 COPD patients with moderate-to-severe anxiety and/or depression were randomized (1:1) to receive escitalopram (5– 10 mg/day) or placebo for 4 weeks, followed by an 11-month observational follow-up without maintenance study medication. Primary endpoints were changes in HAMA-14 and HAMD-17 scores at Month 1. Secondary outcomes included CAT scores, mMRC ratings, and lung function (FEV1% predicted) through Month 12.
Results: At Month 1, escitalopram demonstrated significantly greater reductions in HAMA-14 (− 9.25 [95% CI − 9.67 to − 8.82] vs − 2.20 [− 2.46 to − 1.95]) and HAMD-17 (− 7.37 [− 7.74 to − 7.01] vs − 1.37 [− 1.72 to − 1.01]) compared to placebo (p < 0.01). These improvements were sustained at Month 12 (p < 0.01). CAT scores improved significantly more in the escitalopram group (− 6.20 [− 6.68 to − 5.72]) versus placebo (− 2.79 [− 3.02 to − 2.55]) over the 12-month observational period (p < 0.01). No significant differences were observed for mMRC or FEV1% predicted. Adverse events were mild and comparable between groups.
Conclusion: Short-term treatment with low-dose escitalopram significantly alleviates depression and anxiety in COPD patients. Notably, this brief intervention initiated a sustained positive clinical trajectory over 12 months. Combined with a favorable safety profile, these findings support its potential integration into comprehensive COPD management protocols, pending multicenter validation.
Trial Registration: ChiCTR1800017338 (https://www.chictr.org.cn/). Registered 25-July-2018.
Keywords: anxiety, CAT score, COPD, depression, escitalopram
1Institute of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400037, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China; 3Department of General Practice, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400037, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Binfeng He, Email ldhbf@tmmu.edu.cn Guansong Wang, Email wanggs@tmmu.edu.cn
Purpose: Depression and anxiety negatively impact COPD prognosis, yet evidence for psychopharmacological interventions remains limited. This study evaluated the efficacy and safety of low-dose escitalopram for managing these comorbidities in COPD patients.
Patients and methods: In this double-blind, placebo-controlled trial, 150 COPD patients with moderate-to-severe anxiety and/or depression were randomized (1:1) to receive escitalopram (5– 10 mg/day) or placebo for 4 weeks, followed by an 11-month observational follow-up without maintenance study medication. Primary endpoints were changes in HAMA-14 and HAMD-17 scores at Month 1. Secondary outcomes included CAT scores, mMRC ratings, and lung function (FEV1% predicted) through Month 12.
Results: At Month 1, escitalopram demonstrated significantly greater reductions in HAMA-14 (− 9.25 [95% CI − 9.67 to − 8.82] vs − 2.20 [− 2.46 to − 1.95]) and HAMD-17 (− 7.37 [− 7.74 to − 7.01] vs − 1.37 [− 1.72 to − 1.01]) compared to placebo (p < 0.01). These improvements were sustained at Month 12 (p < 0.01). CAT scores improved significantly more in the escitalopram group (− 6.20 [− 6.68 to − 5.72]) versus placebo (− 2.79 [− 3.02 to − 2.55]) over the 12-month observational period (p < 0.01). No significant differences were observed for mMRC or FEV1% predicted. Adverse events were mild and comparable between groups.
Conclusion: Short-term treatment with low-dose escitalopram significantly alleviates depression and anxiety in COPD patients. Notably, this brief intervention initiated a sustained positive clinical trajectory over 12 months. Combined with a favorable safety profile, these findings support its potential integration into comprehensive COPD management protocols, pending multicenter validation.
Trial Registration: ChiCTR1800017338 (https://www.chictr.org.cn/). Registered 25-July-2018.
Keywords: anxiety, CAT score, COPD, depression, escitalopram