The UNWIND randomized clinical study found that treatment with Escitalopram for 12 weeks was more effective at reducing anxiety in nervous coronary heart disease (CHD) patients than either exercise training or a placebo. It was unknown whether or not a treatment for anxiety would have any long-term advantages. Patients were randomly assigned to receive either Escitalopram (up to 20 mg) for the full 12 weeks, Exercise (3 times per week), or a placebo tablet. Following the completion of treatment, the participants were monitored for 6 months to determine whether or not the treatment continued to be effective in reducing the primary anxiety endpoint as measured by the Hospital Anxiety and Depression Scale-Anxiety scale (HADS-A). Additionally, the participants were monitored for up to 6 years to ascertain the impacts of treatment on major adverse cardiac events. 120 out of 128 participants who were initially randomized were available for follow-up, which is a 94% success rate. The HADS-A scores of participants who were randomly assigned to the Escitalopram condition were lower (3.9 [3.1, 4.7]) compared to those who were randomly assigned to the Exercise condition (5.5 [4.6, 6.3]) (P=.007) and those who were randomly assigned to the Placebo condition (5.3 [4.1, 6.5]) (P=.053). There were 29 adverse events over 3.2 years (interquartile range: 2.3–4.5 years) of follow-up, but there were no significant differences between the groups. In the UNWIND experiment, a therapy of Escitalopram for 12 weeks was successful in lowering anxiety levels. These positive effects persisted for 6 months after treatment had been completed. Patients diagnosed with coronary heart disease did not benefit from exercise as a treatment for their anxiety, even though moderate or vigorous physical activity had a lot of positive effects on health.
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