Antidepressants in the Treatment of Sinusitis

Greg Davis, MD MPH – Otolaryngology/Head and Neck Surgery

Summary: Depression has been shown to amplify the severity of symptoms in several chronic conditions. My previous research showed that the rates of depression and somatization (psychological distress from the perception of body dysfunction) are common in patients with chronic sinusitis (25% and 31%, respectively). This study also showed that both depression and somatization are independent predictors for worse symptoms after sinus surgery.

Aim: To test if antidepressants improve chronic sinusitis symptoms.

Hypothesis: Patients treated with antidepressants will report greater improvement in symptoms compared to those treated with placebo.

Methods: All patients presenting to the UWMC Sinus clinic with a diagnosis of chronic sinusitis will be screened for depression. Patients screening positive for depression will be eligible for the study. Regardless of whether patients are treated with medical management (generally antibiotics and oral steroids) or surgery, subjects will be randomized to receive either an antidepressant or placebo. After baseline assessment and data acquisition, subjects will be followed for one year with well validated subjective and objective outcome measures. The antidepressant cohort will be compared to the placebo cohort based on quality of life outcome measures.

Implications: The addition of an antidepressant to the standard medical armamentarium may directly improve symptom severity and benefit the quality of life of patients with chronic sinusitis.

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