Investigators have reported that adding simvastatin to escitalopram did not improve depression symptoms in adults with obesity, although the statin significantly reduced cholesterol and inflammation markers.

Researchers enrolled 160 adults diagnosed with major depressive disorder and a body mass index (BMI) of 30 or higher into the 12-week randomized controlled trial. Participants received either escitalopram plus simvastatin or escitalopram plus placebo to assess whether simvastatin could enhance the antidepressant effects of escitalopram.

Depression severity was measured using the Montgomery-Åsberg Depression Rating Scale (MADRS). Both groups showed similar improvements over 12 weeks. MADRS scores decreased by 13.97 points in the simvastatin group and 13.50 points in the placebo group, a difference that was not statistically significant. Self-reported symptoms, measured using the Beck Depression Inventory II, also improved in both groups, with no meaningful difference observed.

Researchers also evaluated response and remission rates, quality of life, and global functioning. None of these secondary outcomes differed significantly between groups.

Although simvastatin had no effect on depressive symptoms, it did improve metabolic markers. Participants in the simvastatin group experienced significant reductions in low-density lipoprotein (LDL) cholesterol, total cholesterol, and C-reactive protein (CRP), an inflammatory marker. LDL levels dropped by 40.37 mg/dL in the simvastatin group vs 3.78 mg/dL in the placebo group; CRP levels also declined with simvastatin but increased slightly in the placebo group.

Participants ranged in age from 18 to 65 years and were enrolled across nine academic centers in Germany. Most were female (79%), with a mean age of 39. At baseline, participants had moderate depression and elevated cardiometabolic risk: over 70% had hypertension and 65% had CRP levels above 3 mg/L.

The trial retention rate exceeded 95%. Serious adverse events were rare and occurred at similar rates in both groups. The most commonly reported side effects were headache and nausea.

While simvastatin improved lipid and inflammation profiles, it did not enhance the antidepressant effects of escitalopram. The findings contribute to ongoing research evaluating statins as adjunctive treatments for mood disorders.

The study was funded by the German Ministry of Education and Research and registered at ClinicalTrials.gov (NCT04301271).

Full disclosures can be found in the published study. 

Source:  JAMA Psychiatry