Efficacy of escitalopram in patients with severe depression: a pooled analysis

Abstract

Escitalopram is an effective, well-tolerated treatment for major depressive disorder in both primary and specialist settings. This analysis compared the efficacy of escitalopram with citalopram in the treatment of patients with severe depression [defined as a score of > or =30 Montgomery-Asberg Depression Rating Scale (MADRS)]. Data from three clinical trials were used for this pooled analysis. A total of 506 severely depressed patients were included (169 received escitalopram, 171 citalopram and 166 placebo). Mean change from baseline in MADRS total scores (primary efficacy parameter) was significantly higher in the escitalopram-treated group compared with the citalopram-treated group (p = 0.003). There was a significant difference in response between escitalopram and citalopram (56 vs. 41%, respectively, p = 0.007). Results from secondary efficacy parameters (Hamilton rating for depression and Clinical Global Impression of Improvement and Severity scales) were consistent with previous results. The benefits in severe depression of escitalopram vs. citalopram were so demonstrated.

Escitalopram in a working population: results from an observational study of 2378 outpatients in Austria

“…Initially, patients were moderately-to markedly-ill, and ended with having mild or no symptoms at all. This decrease was comparable with the therapeutic efficacy of escitalopram reported in several randomized, controlled, clinical trials (Burke et al, 2002;Gorman et al, 2002;Auquier et al, 2003;Lepola et al, 2003;Stahl et al, 2003;Goodman et al, 2005;Kasper et al, 2005;Llorca et al, 2005;Moore et al, 2005;Wade et al, 2005b;Kennedy et al, 2006). The study population consisted of a large, heterogeneous group of patients including 2% elderly patients and patients with psychiatric disorders, for which escitalopram is not officially registered.…”

“…Escitalopram has been termed a serotonin dual action antidepressant as it binds to both the primary site of the serotonin transporter and to the allosteric site, which increases the reuptake inhibition (Chen et al, 2005). The efficacy of escitalopram has been shown in controlled clinical trials in primary care and in specialist settings, for the treatment of depression (Burke et al, 2002;Gorman et al, 2002;Auquier et al, 2003;Lepola et al, 2003;Llorca et al, 2005;Moore et al, 2005;Wade et al, 2005b;Kasper et al, 2006;Kennedy et al, 2006) and anxiety disorders (Stahl et al, 2003;Goodman et al, 2005;Kasper et al, 2005).…”

Escitalopram in major depressive disorder: a multicenter, randomized, double-blind, fixed-dose, parallel trial in a Chinese population

“…Our study confirms that escitalopram is effective in the treatment of depression and is well tolerated [Burke et al, 2002;Lepola et al, 2003Lepola et al, , 2004Llorca et al, 2005;Moore et al, 2005]. Escitalopram 10 mg/day had comparable efficacy to fluoxetine 20 mg/day, based on the primary and secondary efficacy measurements (improvement in HAM-D-17 and MADRS total scores).…”

Getting the balance right: Established and emerging therapies for major depressive disorders

“…58 The drug was shown to be more efficacious than placebo and as least as effective or better than citalopram, 22,[66][67][68][69] with an early onset of efficacy. 22,59 Differences between the two SSRIs seem to depend on the initial severity of the depressive symptomatology, given that escitalopram has shown superior antidepressive efficacy in severely depressed patients. 60,70 Nevertheless, opposite findings were also reported, suggesting methodologic flaws as a cause for the difference in efficacy between the two drugs.…”