Efficacy and tolerability of escitalopram versus citalopram in major depressive disorder: A 6-week, multicenter, prospective, randomized, double-blind, active-controlled study in adult outpatients

Yevtushenko, Valery Y.; Belous, A.; Yevtushenko, Yevgenia G.; Gusinin, Sergei E.; Бузик, О. Ж.; Agibalova, T. V.

doi:10.1016/j.clinthera.2007.11.014

Cited by 61 publications

(85 citation statements)

References 32 publications

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“…In previous studies, Escitalopram has shown comparable or superior efficacy and better tolerability compared to other SSRI's. [6][7][8][9][10] It was also found to be non inferior and significantly better tolerated than the two SNRIs, Venlafexine and Duloxetine. [11][12][13] Milnacipran is the most balanced SNRI which blocks the reuptake of both serotonin and norepinephrine equally.…”

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confidence: 99%

Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression

Shinde

Reddy

Kulmi

et al. 2018

Int J Basic Clin Pharmacol

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Background: The present prospective, open labelled study was designed to evaluate the efficacy and tolerability of escitalopram, selective serotonin reuptake inhibitors (SSRI) in comparison with milnacipran, dual serotonin and noradrenaline reuptake inhibitors (SNRI) in the treatment of major depressive disorder.Methods: Outpatients (N=120) with an ongoing/newly diagnosed ICD-10 major depressive episode and having a minimum score of 8 on the 21-item Hamilton Depression Rating Scale (HDRS) were assigned to escitalopram, 10–20 mg/day (54 patients) and milnacipran 50-100mg (66 patients), for an 8 week treatment period with follow up at 2nd, 4th and 8th week. The parameters for efficacy were improvement (decrease in HDRS scores at 8 weeks from baseline values), response (decrease of ≥50% in the HDRS scores) and remission (HDRS score of ≤7). Tolerability was assessed by comparing the frequency of adverse effects and drop out rate due to the same at the end of 2nd, 4th and 8th week in both the groups.Results: Improvement, Response rate and Remission rates at the end of eight weeks were 71.11%, 83.33% and58.33% for escitalopram and 59.35%, 34.14% and75.6% for milnacipran respectively. Adverse experiences were reported by 14% of patients in escitalopram group and 79.2% patients in milnacipran group at 8 weeks. Additionally, there were significantly lesser dropouts due to adverse events in escitalopram (3.70%) than in milnacipran group (30%).Conclusions: Escitalopram, the Senantiomer of citalopram, is a safe and effective antidepressant with potentially superior tolerability and comparable efficacy to the dual reuptake inhibitor, Milnacipran.

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confidence: 99%

Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression

Shinde

Reddy

Kulmi

et al. 2018

Int J Basic Clin Pharmacol

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“…10 Supporting the assumption that antidepressants do not act merely by means of a placebo effect, depressed patients were treated with drugs, including central stimulants, barbiturates, opiates and antipsychotics, but without satisfactory effect, 30 even before the serendipitous discovery of the first antidepressants, imipramine and iproniazide; 31 had drug treatment of depression been merely a matter of a psychological placebo response, these compounds should have appeared just as effective as imipramine or iproniazide. Moreover, a large number of trials have revealed significant differences between two antidepressants (or putative antidepressants) in trials including no placebo arm; [32][33][34][35][36] had the superiority of antidepressants over placebo in controlled trials been merely the result of the patient realizing that he/she has not been given active treatment, such an outcome would be difficult to explain given that the participants in these trials knew that they were not at risk of receiving placebo. The present data, suggesting that antidepressants do not act merely by means of a placebo effect, are well in line with these observations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

et al. 2017

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It has been suggested that the superiority of antidepressants over placebo in controlled trials is merely a consequence of side effects enhancing the expectation of improvement by making the patient realize that he/she is not on placebo. We explored this hypothesis in a patient-level post hoc-analysis including all industry-sponsored, Food and Drug Administration-registered placebocontrolled trials of citalopram or paroxetine in adult major depression that used the Hamilton Depression Rating Scale (HDRS) and included a week 6 symptom assessment (n = 15). The primary analyses, which compared completers on active treatment without early adverse events to completers on placebo (with or without adverse events) with respect to reduction in the HDRS depressed mood item showed larger symptom reduction in patients given active treatment, the effect sizes being 0.48 for citalopram and 0.33 for paroxetine. In actively treated subjects reporting early adverse events, who also outperformed those given placebo, the severity of the adverse events did not predict response. Several sensitivity analyses, for example, including (i) those using change of the sum of all HDRS-17 items as effect parameter, (ii) those excluding all subjects with adverse events (that is, also those on placebo) and (iii) those based on the intention-to-treat population, were all in line with the primary analyses. The finding that both paroxetine and citalopram are clearly superior to placebo also when not producing adverse events, as well as the lack of association between adverse event severity and response, argue against the theory that antidepressants outperform placebo solely or largely because of their side effects.

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“…Most randomized clinical trials (RCT) compared citalopram to escitalopram and none of them showed any significant difference between the two regarding safety. However, escitalopram was significantly more effective in 3 studies [18][19][20] while no significant difference was found in 2 studies [21,22]. Two of the 3 studies comparing escitalopram with paroxetine showed the superiority of escitalopram with respect to both safety and efficacy [3,23,24].…”

Section: Introductionmentioning

confidence: 93%

“…The superiority of escitalopram over other SSRIs has been demonstrated in head to head efficacy trials and meta-analyses [18][19][20]22,23,[32][33][34]. Escitalopram is the most specific SSRI, because of its unique pharmacological property: selected serotonin reuptake inhibition [11].…”

Section: Discussionmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors, are They All Equal? A Pharmacoepidemiological Study

Peron¹,

JB²

2016

Adv Pharmacoepidemiol Drug Saf

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Introduction: According to the French health authorities' guidelines relative to depression and anxiety disorder treatments, six Selective Serotonin Reuptake Inhibitors are available for prescription as a first-line of treatment. The guidelines suggest equivalence between these treatment options, but studies diverge regarding efficacy and safety profiles. Moreover, conditions in clinical trials are strictly controlled and do not truly reflect real life utilization. The objective of this study was to evaluate differences in efficacy and/or safety between these six selective serotonin reuptake inhibitors in real conditions of use.

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Efficacy and tolerability of escitalopram versus citalopram in major depressive disorder: A 6-week, multicenter, prospective, randomized, double-blind, active-controlled study in adult outpatients

Cited by 61 publications

References 32 publications

Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression

Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

Selective Serotonin Reuptake Inhibitors, are They All Equal? A Pharmacoepidemiological Study

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