Cilostazol for Major Depressive Disorder After Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: A Randomized, Double-Blind, Placebo-Controlled Trial

Authors

  • Parisa Rajabi Psychosomatic Medicine Ward, Psychosomatic Medicine Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Fateme Taghavi Zanjani Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohamadjavad Ershadmanesh Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Faezeh Mokhtari Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Zahra Haji Faraj Tabrizi Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Melika Jameie Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Saeed Natheghi Cardiology Ward, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Maryam Mehrpouya Cardiology Ward, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  • Sara Hashempour Psychosomatic Medicine Ward, Psychosomatic Medicine Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Sayedeh Elham Sharafi Psychosomatic Medicine Ward, Psychosomatic Medicine Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Hamed Vahidi Cardiology Ward, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Ahmad Shamabadi Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Ahmad-Ali Noorbala Psychosomatic Medicine Ward, Psychosomatic Medicine Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Shahin Akhondzadeh Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI:

https://doi.org/10.18502/rhythm.v21i3.22566

Keywords:

Combination Drug Therapy; Heart; Myocardial Infarction; Neuroimmunomodulation; Randomized Controlled Trial; Drug Repositioning

Abstract

Background: Major depressive disorder (MDD) frequently occurs alongside coronary artery disease (CAD), worsening cardiovascular outcomes. Cilostazol is a phosphodiesterase 3 inhibitor used as an antiplatelet agent with potential antidepressant effects. This study evaluated the efficacy of cilostazol for treating depressive symptoms in participants with CAD.

Methods: This 6-week, double-blind, placebo-controlled clinical trial enrolled individuals with MDD and Hamilton Depression Rating Scale (HDRS) scores of 14 to 17 who had undergone percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Participants were randomly assigned to receive cilostazol (100 mg/d) or placebo. Outcomes included HDRS scores and adverse events.

Results: Baseline characteristics were similar between the groups (all P>.05). A significant time × treatment interaction effect on HDRS scores was observed (P=.037; partial η2=0.055). The cilostazol group showed greater reductions in HDRS scores through weeks 4 and 6 (P=.012 and P=.054, respectively). Adverse effects were not serious and were comparable between the groups (all P>.05).

Conclusion: Cilostazol was beneficial and safe for treating depressive symptoms in individuals who had recently undergone PCI or CABG. Further studies are needed to support broader clinical application

Published

2026-09-08

Issue

Volume (21) issue (3)

Section

Articles