Escitalopram Prevents Mental Stress-Induced Myocardial Ischemia in Patients with Coronary Artery Disease


Escitalopram REMIT TrialOn May 29, 2013 the researchers from Duke Medicine revealed new findings about the benefits of the antidepressant Escitalopram CAS# 128196-01-0. Known as the brand name Lexapro, Escitalopram has long been touted as an efficacious and safe treatment for clinical depression. The latest findings regarding Escitalopram, reported in The Journal of the American Medical Association, showed supporting evidence that this SSRI helps to reduce mental stress-induced myocardial ischemia, also known as MSIMI. Myocardial ischemia is a common problem among patients with coronary disease, with exercise induced ischemia being documented in studies most often. However, recent findings have not only suggested that MSIMI occurs in a larger number of patients than doctors originally thought, often triggering new or additional cardiac events.

EscitalopramDefined as a decreased heart muscle blood flow, ischemia that stems from mental stress is often a silent ischemia. Cardiac patients were previously assumed to be at little or no risk of myocardial ischemia if they performed well on an exercise induced stress test, but this is not always the case. In fact, studies published in the Journal of the American College of Cardiology as far back as 2006 proved that patients without exercise induced or chemically induced ischemia still showed mental induced ischemia in stressful situations. One particular study, led by David S. Sheps, M.D., M.S.P.H. from the University of Florida and the Malcom Randall Veterans Administration Medical Center in 2006 followed 29 patients with coronary artery disease without known ischemia. The patients in this study were administered chemical injections designed to put stress on their heart blood flow, along with exercise and treadmill tests. Neither the chemical injection nor the strenuous exercises were documented to cause ischemia in these 29 patients when imaging via a radioactive tracer was completed. These same patients were then placed in a role playing style experience designed to create stress and mental anguish. One minute into the role playing exercise in which the patients were giving a stressful speech, over 20 percent of the participants displayed ischemia that was visible via the radionuclide imaging. With none of these participants experiencing chest pain or any outward signs of ischemia, this study provided the backbone for the documentation of MSIMI within this patient population.

escitalopramThe REMIT, or Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment study, which involved 127 patients, took place in roughly four years between July of 2007 and August of 2011. This randomized and double blind study was placebo-controlled. Results were positive, indicating that the patients involved who had stable coronary artery disease and were administered escitalopram had a lower rate of MSIMI as compared to patients who received a placebo. With six weeks of treatment of escitalopram, at the end of 6 weeks the participants who took escitalopram had an absence of MSIMI during the 3 mental stressor tests, unlike the group of patients who received the placebo.  Knowledge and a greater awareness of mental stress-induced ischemia have highlighted the need for research and development of treatments like escitalopram to help prevent MSIMI. LGM Pharma provides escitalopram for research and development purposes. Clients can be assured of quality API products and continuous support throughout the R&D process.

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