Abstract
<p>The effect of lovastatin plus fluoxetine on depression has been investigated in many studies, but ignoring other effective factors has decreased the accuracy of the results. The aim of this study was to assess the simultaneous effect of lovastatin plus fluoxetine on depression while controlling a large number of potential covariates using penalized linear mixed model in a longitudinal study. 60 patients with major depressive disorder according to DSM-IV diagnostic criteria were enrolled. The sample was randomly allocated into fluoxetine (up to 40 mg/day) plus lovastatin (30 mg/day) group and fluoxetine (up to 40 mg/day) plus placebo group. Hamilton depression rating scale was used to measure the depression score at baseline, week 2, and week 6. We used linear mixed model (LMM) with least absolute shrinkage and selection operator (LASSO) penalty. Among 60 patients, 39 (65%) were female with a mean age of 31.93 (9.8) years; 51.7% of the patients were married, a majority (73%) lived in village, and 45% of them had high school education. Both groups showed a significant decrease in depression score using Hamilton Depression scale. However, depression score in the treatment group decreased more than the placebo group (Mean=12.8(SD=6.3) vs. Mean=8.2(SD=4.0), t=3.4, P&lt;.001).The proposed model revealed that in the presence of the other covariates, lovastatin plus fluoxetine could play a key role in the reduction of depression. It was also shown that all of the covariates except blood pressure had a significant effect on depression. Linear mixed model with LASSO penalty revealed that sex, age, education, physical illness had the most significant effect on depression.</p>results demonstrated that the masters’ students were possessed of less spiritual growth, indicating the need for more accurate planning towards improving students’ health-promoting lifestyles. So, it was recommended that more attention be paid to the improvement of health-promoting lifestyles, especially in terms of spiritual growth.<p> </p>
Highlights
Depression is a major public health problem, with a substantial morbidity, mortality and health-care cost related to it
The effect of lovastatin plus fluoxetine on depression has been investigated in many studies, but ignoring other effective factors has decreased the accuracy of the results
The aim of this study was to assess the simultaneous effect of lovastatin plus fluoxetine on depression while controlling a large number of potential covariates using penalized linear mixed model in a longitudinal study. 60 patients with major depressive disorder according to DSM-IV diagnostic criteria were enrolled
Summary
Depression is a major public health problem, with a substantial morbidity, mortality and health-care cost related to it. The estimated lifetime prevalence of major depression ranges between 10% and 20% (Patten, 2003). Disability from major depressive disorder (MDD) is greater than that for subclinical or mild and moderate depression because of its greater prevalence, and associated increased risk of mortality and coronary heart disease. Many randomized clinical trials have examined the effectiveness of the existing treatments for major depression. The detection of new methods for the management of depressive disorders is considerable. Statins are primarily used for the treatment of depression and have been recommended to be used for primary prevention of some problems in patients with psychiatric disorders (Andrade, 2013). Many studies have shown the relationship between statins and depression, but there are contradictory results about its effect on depression (Judd et al, 2014; Morales et al, 2006; Otte, Zhao, & Whooley, 2012)
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