Cilostazol for Major Depressive Disorder After Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: A Randomized, Double-Blind, Placebo-Controlled Trial
-
Parisa Rajabi
,
Fateme TaghaviZanjani
,
Mohamadjavad Ershadmanesh
,
Faezeh Mokhtari
,
Zahra Haji Faraj Tabrizi
,
Melika Jameie
,
Saeed Nateghi
,
Mayam Mehrpooya
,
Sara Hashempour
,
Sayedeh Elham Sharafi
,
Hamed Vahidi
,
Ahmad Shamabadi
,
Ahmad Ali Noorbala
,
Shahin Akhondzadeh
Abstract
Background: Major depressive disorder (MDD) frequently occurs alongside coronary artery disease (CAD), worsening cardiovascular outcomes. Cilostazol is a phosphodiesterase 3 inhibitor used as an antiplatelet agent with potential antidepressant effects. This study evaluated the efficacy of cilostazol for treating depressive symptoms in participants with CAD.
Methods: This 6-week, double-blind, placebo-controlled clinical trial enrolled individuals with MDD and Hamilton Depression Rating Scale (HDRS) scores of 14 to 17 who had undergone percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Participants were randomly assigned to receive cilostazol (100 mg/d) or placebo. Outcomes included HDRS scores and adverse events.
Results: Baseline characteristics were similar between the groups (all P>.05). A significant time × treatment interaction effect on HDRS scores was observed (P=.037; partial η2=0.055). The cilostazol group showed greater reductions in HDRS scores through weeks 4 and 6 (P=.012 and P=.054, respectively). Adverse effects were not serious and were comparable between the groups (all P>.05).
Conclusion: Cilostazol was beneficial and safe for treating depressive symptoms in individuals who had recently undergone PCI or CABG. Further studies are needed to support broader clinical application.
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2. Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet. 2018;391(10128):1357-66.
3. Hassamal S, Spivey M, Pandurangi AK. Augmentation therapy with serial intravenous ketamine over 18 months in a patient with treatment resistant depression. Clinical neuropharmacology. 2015;38(5):212-6.
4. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American college of Cardiology. 2006;48(8):1527-37.
5. Van Melle JP, De Jonge P, Spijkerman TA, Tijssen JG, Ormel J, Van Veldhuisen DJ, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic medicine. 2004;66(6):814-22.
6. Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction: review of the evidence. Journal of general internal medicine. 2006;21:30-8.
7. Rao A, Zecchin R, Newton PJ, Phillips J, DiGiacomo M, Denniss AR, et al. The Prevalence and Impact of Depression and Anxiety in Cardiac Rehabilitation: A Longitudinal Cohort Study. European Journal of Preventive Cardiology. 2019;27(5):478-89.
8. Carney RM, Freedland KE, Veith RC, Cryer PE, Skala JA, Lynch T, et al. Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease. Biological psychiatry. 1999;45(4):458-63.
9. Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleveland Clinic journal of medicine. 2009;76(Suppl 2):S13.
10. Pitzalis MV, Iacoviello M, Todarello O, Fioretti A, Guida P, Massari F, et al. Depression but not anxiety influences the autonomic control of heart rate after myocardial infarction. American heart journal. 2001;141(5):765-71.
11. Rybakowski JK, Wykretowicz A, Heymann-Szlachcinska A, Wysocki H. Impairment of endothelial function in unipolar and bipolar depression. Biological psychiatry. 2006;60(8):889-91.
12. Rieckmann N, Gerin W, Kronish IM, Burg MM, Chaplin WF, Kong G, et al. Course of depressive symptoms and medication adherence after acute coronary syndromes: an electronic medication monitoring study. Journal of the American College of Cardiology. 2006;48(11):2218-22.
13. Meijer A, Conradi HJ, Bos EH, Anselmino M, Carney RM, Denollet J, et al. Adjusted Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: Individual Patient Data Meta-Analysis. The British Journal of Psychiatry. 2013;203(2):90-102.
14. Mutch WAC, Fransoo RR, Campbell BI, Chateau DG, Sirski M, Warrian RK. Dementia and depression with ischemic heart disease: a population-based longitudinal study comparing interventional approaches to medical management. PLoS One. 2011;6(2):e17457.
15. Carney RM, Freedland KE. Depression and coronary heart disease. Nature Reviews Cardiology. 2017;14(3):145-55.
16. Shahmansouri N, Farokhnia M, Abbasi S-H, Kassaian SE, Tafti A-AN, Gougol A, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. Journal of Affective disorders. 2014;155:216-22.
17. Pacher P, Kecskemeti V. Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns? Current pharmaceutical design. 2004;10(20):2463-75.
18. Yekehtaz H, Farokhnia M, Akhondzadeh S. Cardiovascular considerations in antidepressant therapy: an evidence-based review. The Journal of Tehran University Heart Center. 2013;8(4):169.
19. Goto S. Cilostazol: potential mechanism of action for antithrombotic effects accompanied by a low rate of bleeding. Atherosclerosis Supplements. 2005;6(4):3-11.
20. Takahashi K, Oshima A, Inoue K, Takeyoshi H, Fukuda M, Mikuni M. Novel augmentation therapy with cilostazol for the geriatric major depressive disorder patient with deep white matter hyperintensities on T2-weighted brain MRI: a case report. Pharmacopsychiatry. 2008;41(01):37-9.
21. Rezaei F, Mesgarpour B, Jeddian A, Zeionoddini A, Mohammadinejad P, Salardini E, et al. Cilostazol adjunctive therapy in treatment of negative symptoms in chronic schizophrenia: Randomized, double‐blind, placebo‐controlled study. Human Psychopharmacology: Clinical and Experimental. 2017;32(4):e2583.
22. Tai S-Y, Chen C-H, Chien C-Y, Yang Y-H. Cilostazol as an add-on therapy for patients with Alzheimer’s disease in Taiwan: a case control study. BMC neurology. 2017;17:1-6.
23. Khadivi A, Shobeiri P, Momtazmaneh S, Samsami F-S, Shalbafan M, Shirazi E, et al. Cilostazol as an adjunctive treatment in major depressive disorder: a pilot randomized, double-blind, and placebo-controlled clinical trial. Psychopharmacology. 2022;239(2):551-9.
24. Baba H, Kubota Y, Suzuki T, Arai H. Seven cases of late-life depression treated with cilostazol-augmented therapy. Journal of clinical psychopharmacology. 2007;27(6):727-8.
25. Kim YR, Kim HN, Hong KW, Shin HK, Choi BT. Anti-depressant effects of phosphodiesterase 3 inhibitor cilostazol in chronic mild stress-treated mice after ischemic stroke. Psychopharmacology. 2016;233:1055-66.
26. Zhang Y, Yang G, Wang R, Wang X, Tan X, Tang C. Cilostazol may be a better therapeutic agent for acute ischemic stroke because of its efficacy in preventing post-stroke depression. medRxiv. 2023:2023.10. 30.23297771.
27. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Journal of Pharmacology and Pharmacotherapeutics. 2010;1(2):100-7.
28. Chan A-W, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, et al. SPIRIT 2025 statement: updated guideline for protocols of randomized trials. Nature Medicine. 2025.
29. First M, Williams J, Karg R, Association SRAP. Arlington. VA, American Psychiatric Association. 2015.
30. Hamilton M. A rating scale for depression. Journal of neurology, neurosurgery, and psychiatry. 1960;23(1):56.
31. Ghazizadeh‐Hashemi F, Bagheri S, Ashraf‐Ganjouei A, Moradi K, Shahmansouri N, Mehrpooya M, et al. Efficacy and safety of sulforaphane for treatment of mild to moderate depression in patients with history of cardiac interventions: A randomized, double‐blind, placebo‐controlled clinical trial. Psychiatry and Clinical Neurosciences. 2021;75(8):250-5.
32. Bodkin JA, Amsterdam JD. Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients. American Journal of Psychiatry. 2002;159(11):1869-75.
33. Markovitz JH, Shuster JL, Chitwood WS, May RS, Tolbert LC. Platelet activation in depression and effects of sertraline treatment: an open-label study. American Journal of Psychiatry. 2000;157(6):1006-8.
34. Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, et al. Double-blind treatment of major depression with dehydroepiandrosterone. American Journal of Psychiatry. 1999;156(4):646-9.
35. Najafabadi BT, Jafarinia M, Ghamari K, Shokraee K, Tadayyon F, Akhondzadeh S. Vitamin E and ginseng combined supplement for treatment of male erectile dysfunction: A double-blind, placebo-controlled, randomized, clinical trial. Advances in Integrative Medicine. 2021;8(1):44-9.
36. Abuelezz SA, Hendawy N. Insights into the potential antidepressant mechanisms of cilostazol in chronically restraint rats: impact on the Nrf2 pathway. Behavioural Pharmacology. 2018;29(1):28-40.
37. Troubat R, Barone P, Leman S, Desmidt T, Cressant A, Atanasova B, et al. Neuroinflammation and depression: A review. European journal of neuroscience. 2021;53(1):151-71.
38. Kohler O, Krogh J, Mors O, Eriksen Benros M. Inflammation in depression and the potential for anti-inflammatory treatment. Current neuropharmacology. 2016;14(7):732-42.
39. Ono K, Tsuji M. Pharmacological potential of cilostazol for Alzheimer’s disease. Frontiers in pharmacology. 2019;10:559.
40. Ilouz R, Lev-Ram V, Bushong EA, Stiles TL, Friedmann-Morvinski D, Douglas C, et al. Isoform-specific subcellular localization and function of protein kinase A identified by mosaic imaging of mouse brain. Elife. 2017;6:e17681.
41. Xue W, Wang W, Gong T, Zhang H, Tao W, Xue L, et al. PKA-CREB-BDNF signaling regulated long lasting antidepressant activities of Yueju but not ketamine. Scientific Reports. 2016;6(1):26331.
42. Nishimura K, Ishigooka J, Imamura Y, Ihara S. Cilostazol, a cAMP phosphodiesterase 3 inhibitor, in the treatment of poststroke depression. The Journal of neuropsychiatry and clinical neurosciences. 2007;19(4):471-2.
43. Zhang Y. Cilostazol May Be a Better Therapeutic Agent for Acute Ischemic Stroke Because of Its Efficacy in Preventing Post-Stroke Depression. 2023.
44. Lee JH, Kim KY, Lee Y-K, Park SY, Kim CD, Lee WS, et al. Cilostazol prevents focal cerebral ischemic injury by enhancing casein kinase 2 phosphorylation and suppression of phosphatase and tensin homolog deleted from chromosome 10 phosphorylation in rats. Journal of Pharmacology and Experimental Therapeutics. 2004;308(3):896-903.
45. Sakurai H, Hanyu H, Sato T, Kume K, Hirao K, Kanetaka H, et al. Effects of cilostazol on cognition and regional cerebral blood flow in patients with Alzheimer's disease and cerebrovascular disease: a pilot study. Geriatrics & gerontology international. 2013;13(1):90-7.
46. Shirayama Y, Konishi T, Hashimoto K. Effects of add-on cilostazol on cognition in patients with schizophrenia: an open-label pilot trial. Journal of clinical psychopharmacology. 2011;31(5):659-61.
47. Sadeghi MA, Hemmati S, Yousefi-Manesh H, Foroutani L, Nassireslami E, Yousefi Zoshk M, et al. Cilostazol pretreatment prevents PTSD-related anxiety behavior through reduction of hippocampal neuroinflammation. Naunyn-Schmiedeberg's Archives of Pharmacology. 2024;397(1):133-44.
48. Omar MB, Toprak K, Isgandarov K, Sarı M, Alizade E, Pala S. The Effect of Cilostazol on Electrocardiographic Parameters in Patients with Peripheral Artery Disease Initiating Cilostazol Treatment. Koşuyolu Heart Journal. 2023;26(2):70-5.
49. Gamssari F, Mahmood H, Ho JS, Villareal RP, Liu B, Rasekh A, et al. Rapid ventricular tachycardias associated with cilostazol use. Tex Heart Inst J. 2002;29(2):140-2.
50. Kanlop N, Chattipakorn S, Chattipakorn N. Effects of cilostazol in the heart. Journal of cardiovascular medicine. 2011;12(2):88-95.
51. Sahin M, Alizade E, Pala S, Alici G, Ozkan B, Akgun T, et al. The effect of cilostazol on right heart function and pulmonary pressure. Cardiovascular Therapeutics. 2013;31(6):e88-e93.
2. Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet. 2018;391(10128):1357-66.
3. Hassamal S, Spivey M, Pandurangi AK. Augmentation therapy with serial intravenous ketamine over 18 months in a patient with treatment resistant depression. Clinical neuropharmacology. 2015;38(5):212-6.
4. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American college of Cardiology. 2006;48(8):1527-37.
5. Van Melle JP, De Jonge P, Spijkerman TA, Tijssen JG, Ormel J, Van Veldhuisen DJ, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic medicine. 2004;66(6):814-22.
6. Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction: review of the evidence. Journal of general internal medicine. 2006;21:30-8.
7. Rao A, Zecchin R, Newton PJ, Phillips J, DiGiacomo M, Denniss AR, et al. The Prevalence and Impact of Depression and Anxiety in Cardiac Rehabilitation: A Longitudinal Cohort Study. European Journal of Preventive Cardiology. 2019;27(5):478-89.
8. Carney RM, Freedland KE, Veith RC, Cryer PE, Skala JA, Lynch T, et al. Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease. Biological psychiatry. 1999;45(4):458-63.
9. Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleveland Clinic journal of medicine. 2009;76(Suppl 2):S13.
10. Pitzalis MV, Iacoviello M, Todarello O, Fioretti A, Guida P, Massari F, et al. Depression but not anxiety influences the autonomic control of heart rate after myocardial infarction. American heart journal. 2001;141(5):765-71.
11. Rybakowski JK, Wykretowicz A, Heymann-Szlachcinska A, Wysocki H. Impairment of endothelial function in unipolar and bipolar depression. Biological psychiatry. 2006;60(8):889-91.
12. Rieckmann N, Gerin W, Kronish IM, Burg MM, Chaplin WF, Kong G, et al. Course of depressive symptoms and medication adherence after acute coronary syndromes: an electronic medication monitoring study. Journal of the American College of Cardiology. 2006;48(11):2218-22.
13. Meijer A, Conradi HJ, Bos EH, Anselmino M, Carney RM, Denollet J, et al. Adjusted Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: Individual Patient Data Meta-Analysis. The British Journal of Psychiatry. 2013;203(2):90-102.
14. Mutch WAC, Fransoo RR, Campbell BI, Chateau DG, Sirski M, Warrian RK. Dementia and depression with ischemic heart disease: a population-based longitudinal study comparing interventional approaches to medical management. PLoS One. 2011;6(2):e17457.
15. Carney RM, Freedland KE. Depression and coronary heart disease. Nature Reviews Cardiology. 2017;14(3):145-55.
16. Shahmansouri N, Farokhnia M, Abbasi S-H, Kassaian SE, Tafti A-AN, Gougol A, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. Journal of Affective disorders. 2014;155:216-22.
17. Pacher P, Kecskemeti V. Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns? Current pharmaceutical design. 2004;10(20):2463-75.
18. Yekehtaz H, Farokhnia M, Akhondzadeh S. Cardiovascular considerations in antidepressant therapy: an evidence-based review. The Journal of Tehran University Heart Center. 2013;8(4):169.
19. Goto S. Cilostazol: potential mechanism of action for antithrombotic effects accompanied by a low rate of bleeding. Atherosclerosis Supplements. 2005;6(4):3-11.
20. Takahashi K, Oshima A, Inoue K, Takeyoshi H, Fukuda M, Mikuni M. Novel augmentation therapy with cilostazol for the geriatric major depressive disorder patient with deep white matter hyperintensities on T2-weighted brain MRI: a case report. Pharmacopsychiatry. 2008;41(01):37-9.
21. Rezaei F, Mesgarpour B, Jeddian A, Zeionoddini A, Mohammadinejad P, Salardini E, et al. Cilostazol adjunctive therapy in treatment of negative symptoms in chronic schizophrenia: Randomized, double‐blind, placebo‐controlled study. Human Psychopharmacology: Clinical and Experimental. 2017;32(4):e2583.
22. Tai S-Y, Chen C-H, Chien C-Y, Yang Y-H. Cilostazol as an add-on therapy for patients with Alzheimer’s disease in Taiwan: a case control study. BMC neurology. 2017;17:1-6.
23. Khadivi A, Shobeiri P, Momtazmaneh S, Samsami F-S, Shalbafan M, Shirazi E, et al. Cilostazol as an adjunctive treatment in major depressive disorder: a pilot randomized, double-blind, and placebo-controlled clinical trial. Psychopharmacology. 2022;239(2):551-9.
24. Baba H, Kubota Y, Suzuki T, Arai H. Seven cases of late-life depression treated with cilostazol-augmented therapy. Journal of clinical psychopharmacology. 2007;27(6):727-8.
25. Kim YR, Kim HN, Hong KW, Shin HK, Choi BT. Anti-depressant effects of phosphodiesterase 3 inhibitor cilostazol in chronic mild stress-treated mice after ischemic stroke. Psychopharmacology. 2016;233:1055-66.
26. Zhang Y, Yang G, Wang R, Wang X, Tan X, Tang C. Cilostazol may be a better therapeutic agent for acute ischemic stroke because of its efficacy in preventing post-stroke depression. medRxiv. 2023:2023.10. 30.23297771.
27. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Journal of Pharmacology and Pharmacotherapeutics. 2010;1(2):100-7.
28. Chan A-W, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, et al. SPIRIT 2025 statement: updated guideline for protocols of randomized trials. Nature Medicine. 2025.
29. First M, Williams J, Karg R, Association SRAP. Arlington. VA, American Psychiatric Association. 2015.
30. Hamilton M. A rating scale for depression. Journal of neurology, neurosurgery, and psychiatry. 1960;23(1):56.
31. Ghazizadeh‐Hashemi F, Bagheri S, Ashraf‐Ganjouei A, Moradi K, Shahmansouri N, Mehrpooya M, et al. Efficacy and safety of sulforaphane for treatment of mild to moderate depression in patients with history of cardiac interventions: A randomized, double‐blind, placebo‐controlled clinical trial. Psychiatry and Clinical Neurosciences. 2021;75(8):250-5.
32. Bodkin JA, Amsterdam JD. Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients. American Journal of Psychiatry. 2002;159(11):1869-75.
33. Markovitz JH, Shuster JL, Chitwood WS, May RS, Tolbert LC. Platelet activation in depression and effects of sertraline treatment: an open-label study. American Journal of Psychiatry. 2000;157(6):1006-8.
34. Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, et al. Double-blind treatment of major depression with dehydroepiandrosterone. American Journal of Psychiatry. 1999;156(4):646-9.
35. Najafabadi BT, Jafarinia M, Ghamari K, Shokraee K, Tadayyon F, Akhondzadeh S. Vitamin E and ginseng combined supplement for treatment of male erectile dysfunction: A double-blind, placebo-controlled, randomized, clinical trial. Advances in Integrative Medicine. 2021;8(1):44-9.
36. Abuelezz SA, Hendawy N. Insights into the potential antidepressant mechanisms of cilostazol in chronically restraint rats: impact on the Nrf2 pathway. Behavioural Pharmacology. 2018;29(1):28-40.
37. Troubat R, Barone P, Leman S, Desmidt T, Cressant A, Atanasova B, et al. Neuroinflammation and depression: A review. European journal of neuroscience. 2021;53(1):151-71.
38. Kohler O, Krogh J, Mors O, Eriksen Benros M. Inflammation in depression and the potential for anti-inflammatory treatment. Current neuropharmacology. 2016;14(7):732-42.
39. Ono K, Tsuji M. Pharmacological potential of cilostazol for Alzheimer’s disease. Frontiers in pharmacology. 2019;10:559.
40. Ilouz R, Lev-Ram V, Bushong EA, Stiles TL, Friedmann-Morvinski D, Douglas C, et al. Isoform-specific subcellular localization and function of protein kinase A identified by mosaic imaging of mouse brain. Elife. 2017;6:e17681.
41. Xue W, Wang W, Gong T, Zhang H, Tao W, Xue L, et al. PKA-CREB-BDNF signaling regulated long lasting antidepressant activities of Yueju but not ketamine. Scientific Reports. 2016;6(1):26331.
42. Nishimura K, Ishigooka J, Imamura Y, Ihara S. Cilostazol, a cAMP phosphodiesterase 3 inhibitor, in the treatment of poststroke depression. The Journal of neuropsychiatry and clinical neurosciences. 2007;19(4):471-2.
43. Zhang Y. Cilostazol May Be a Better Therapeutic Agent for Acute Ischemic Stroke Because of Its Efficacy in Preventing Post-Stroke Depression. 2023.
44. Lee JH, Kim KY, Lee Y-K, Park SY, Kim CD, Lee WS, et al. Cilostazol prevents focal cerebral ischemic injury by enhancing casein kinase 2 phosphorylation and suppression of phosphatase and tensin homolog deleted from chromosome 10 phosphorylation in rats. Journal of Pharmacology and Experimental Therapeutics. 2004;308(3):896-903.
45. Sakurai H, Hanyu H, Sato T, Kume K, Hirao K, Kanetaka H, et al. Effects of cilostazol on cognition and regional cerebral blood flow in patients with Alzheimer's disease and cerebrovascular disease: a pilot study. Geriatrics & gerontology international. 2013;13(1):90-7.
46. Shirayama Y, Konishi T, Hashimoto K. Effects of add-on cilostazol on cognition in patients with schizophrenia: an open-label pilot trial. Journal of clinical psychopharmacology. 2011;31(5):659-61.
47. Sadeghi MA, Hemmati S, Yousefi-Manesh H, Foroutani L, Nassireslami E, Yousefi Zoshk M, et al. Cilostazol pretreatment prevents PTSD-related anxiety behavior through reduction of hippocampal neuroinflammation. Naunyn-Schmiedeberg's Archives of Pharmacology. 2024;397(1):133-44.
48. Omar MB, Toprak K, Isgandarov K, Sarı M, Alizade E, Pala S. The Effect of Cilostazol on Electrocardiographic Parameters in Patients with Peripheral Artery Disease Initiating Cilostazol Treatment. Koşuyolu Heart Journal. 2023;26(2):70-5.
49. Gamssari F, Mahmood H, Ho JS, Villareal RP, Liu B, Rasekh A, et al. Rapid ventricular tachycardias associated with cilostazol use. Tex Heart Inst J. 2002;29(2):140-2.
50. Kanlop N, Chattipakorn S, Chattipakorn N. Effects of cilostazol in the heart. Journal of cardiovascular medicine. 2011;12(2):88-95.
51. Sahin M, Alizade E, Pala S, Alici G, Ozkan B, Akgun T, et al. The effect of cilostazol on right heart function and pulmonary pressure. Cardiovascular Therapeutics. 2013;31(6):e88-e93.
| Files | ||
| Issue | Vol 21 No 3 (2026) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/rhythm.v21i3.22566 | |
| Keywords | ||
| Combination Drug Therapy Heart Myocardial Infarction Neuroimmunomodulation Randomized Controlled Trial Drug Repositioning | ||
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How to Cite
1.
Rajabi P, TaghaviZanjani F, Ershadmanesh M, Mokhtari F, Haji Faraj Tabrizi Z, Jameie M, Nateghi S, Mehrpooya M, Hashempour S, Sharafi SE, Vahidi H, Shamabadi A, Noorbala AA, Akhondzadeh S. Cilostazol for Major Depressive Disorder After Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: A Randomized, Double-Blind, Placebo-Controlled Trial. Res Heart Yield Transl Med. 2026;21(3):231-242.
