A prospective study of escitalopram in the treatment of major depressive episodes in the presence or absence of anxiety

Abstract

This open, multicenter, prospective study in France assessed the efficacy and tolerability of escitalopram in patients with depression, with or without comorbid anxiety. Escitalopram was administered over a 12-week treatment period to 790 depressed patients, including 482 patients with at least one concomitant anxiety disorder. The study was completed by 649 patients. At baseline, the mean Montgomery-Asberg Depression Rating Scale (MADRS) total score was 31.5 and decreased to 12.4 at end point (last observation carried forward [LOCF]). The MADRS score decreased by 20.5 points in patients with no anxiety disorder and by 18.3 points in patients with at least one concomitant anxiety disorder. The mean Hamilton Anxiety Rating Scale (HAM-A) total score at baseline was 25.6, which decreased to 10.8 at end point (LOCF). The HAM-A score decreased by 13.8 points in patients with no anxiety disorder and by 15.5 points in patients with at least one anxiety disorder. Adverse events were reported by 246 patients (31%). The most frequent adverse events were nausea in 65 patients (8%) and headache in 38 patients (5%); 61 patients (8%) discontinued treatment due to adverse events. Escitalopram was well tolerated and efficacious in reducing symptoms of depression in patients with or without comorbid anxiety over a 12-week treatment period.

Escitalopram for the treatment of major depression and anxiety disorders

“…This was confirmed in later analyses [63]. In addition, patients with comorbid anxiety have been described by Olié et al, who assessed the efficacy and tolerability of escitalopram in patients with depression, with or without comorbid anxiety [64]. Escitalopram was administered over a 12-week treatment Drug Profile Höschl & Švestka period to 790 depressed patients (649 completed), including 482 patients with at least one concomitant anxiety disorder.…”

The Structure of Anxiety and Depression in a Normative Sample of Younger and Older Australian Adolescents

“…Clinicians may also consider interventions designed towards general NA symptoms for cases of isolated affective disorders to potentially prevent development of future disorders as it has been shown that an anxiety disorder for example often precedes a mood disorder (Belzer and Schneier 2004). In cases of comorbid anxiety and mood disorders, clinicians may also target the nonspecific NA symptoms to improve risk of relapse (Woody et al 1998) and pharmacological treatments are considered a frontline treatment option (Gorman 1996;Olié et al 2007). With regards to the DASS-21, the clinical implications are also that this brief measure could be used as a valid screening questionnaire to identify adolescents reporting symptoms unique to depressive or anxiogenic syndromes and general NA.…”

The onset of effect for escitalopram and its relevance for the clinical management of depression

“…There are a number of exclusion criteria for patients in randomised clinical trials of major depressive disorder, such as comorbid anxiety and a range of concomitant medication, so the results from these analyses may not generalise to treatment in natural practice. Nevertheless, a good treatment effect has been reported in depressed patients with a high level of comorbid anxiety in a randomised controlled trial 29 , and in a setting with fewer inclusion restrictions 30 .…”