Anxiety is common among coronary heart disease (CHD) patients and is associated with a worse prognosis. A 12-week randomized clinical trial (UNWIND) compared exercise and escitalopram to placebo on measures of anxiety, depression, and CHD biomarkers. 

It found that treatment with escitalopram, but not exercise, caused significant reductions in anxiety and depression. At 1-year follow-up, it evaluated the participants on the Hospital Anxiety-Depression Scale-Anxiety (HADS-A) along with the HADS-Depression (HADS-D), the Beck Depression Inventory-II (BDI-II), and the Godin Leisure Time Exercise survey to assess physical activity. 

Results demonstrated that patients on escitalopram had lower scores on the HADS-A compared to those on exercise and also had less depression compared to exercise on the HADS-D and BDI-II. Furthermore, Participants on exercise reported higher levels of physical activity at 1-year compared to those randomized to placebo. 

However, despite reporting being more physically active, participants who received exercise did not have less anxiety or depression compared to placebo controls. 

Thus, escitalopram proved to be a safe and effective treatment for anxiety. Exercise provides many health benefits but may not be effective in treating anxiety.

Journal of Cardiovascular Development and Disease. 2022; 9(10):320. https://doi.org/10.3390/jcdd9100320