Efficacy of Escitalopram Monotherapy in the Treatment of Major Depressive Disorder: A Pooled Analysis of 4 Chinese Clinical Trials

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2017 Sep 28

PMID 28953649

Citations 9

Authors

Guanjun Li

Yifeng Shen

Jianfeng Luo

Huafang Li

Affiliations

Soon will be listed here.

Abstract

This study aimed to evaluate the efficacy of escitalopram monotherapy in the treatment of major depressive disorder (MDD) on the basis of pooled data analysis of 4 Chinese clinical trials.A total of 649 outpatients with MDD score of ≥18 at the 17-item Hamilton Depression Rating Scale (HAMD17) were included across 4 eligible studies. Patients were treated with 10 mg/day escitalopram for 2 weeks, and then 20 mg/day escitalopram was administered if the clinical response was poor.The change in total HAMD17 score was significantly greater in moderate MDD group than in other subgroups (P < .001), but the proportion of responders and remission rate in moderate MDD group were markedly lower than in mild MDD group. As compared to patients with concomitant anxiety, anxiety free patients showed significant improvement in total HAMD17 score at days 14 and 28 (P < .05). However, there was no significant difference in the change of total HAMD17 score at day 7 and the end of study. According to clinical global impression (CGI) score, the total response rate (very much improved and much improved) was 86.7%. There were 479 adverse events (AEs), but serious AEs were not observed. A total of 3.39% (22/649) of patients withdrew from these studies due to AEs. The most common (incidence ≥2.0%) AEs were nausea, dry mouth, somnolence, dizziness, fatigue, dyspepsia, liver dysfunction, and loss of appetite.Escitalopram monotherapy is effective and safe in the treatment of MDD in Chinese patients, and therapeutic efficacy is dependent on the severity of MDD. Further study is needed to identify better predictors of therapeutic responses.

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References

Nierenberg A, Greist J, Mallinckrodt C, Prakash A, Sambunaris A, Tollefson G . Duloxetine versus escitalopram and placebo in the treatment of patients with major depressive disorder: onset of antidepressant action, a non-inferiority study. Curr Med Res Opin. 2007; 23(2):401-16. DOI: 10.1185/030079906X167453. View

Lam R, Lonn S, Despiegel N . Escitalopram versus serotonin noradrenaline reuptake inhibitors as second step treatment for patients with major depressive disorder: a pooled analysis. Int Clin Psychopharmacol. 2010; 25(4):199-203. DOI: 10.1097/YIC.0b013e32833948d8. View

Gelenberg A . A review of the current guidelines for depression treatment. J Clin Psychiatry. 2010; 71(7):e15. DOI: 10.4088/JCP.9078tx1c. View

Baldwin D, Reines E, Guiton C, Weiller E . Escitalopram therapy for major depression and anxiety disorders. Ann Pharmacother. 2007; 41(10):1583-92. DOI: 10.1345/aph.1K089. View

Zhong H, Haddjeri N, Sanchez C . Escitalopram, an antidepressant with an allosteric effect at the serotonin transporter--a review of current understanding of its mechanism of action. Psychopharmacology (Berl). 2011; 219(1):1-13. DOI: 10.1007/s00213-011-2463-5. View

Montgomery S, Andersen H . Escitalopram versus venlafaxine XR in the treatment of depression. Int Clin Psychopharmacol. 2006; 21(5):297-309. DOI: 10.1097/00004850-200609000-00008. View

Lieberman J, Greenhouse J, Hamer R, Krishnan K, Nemeroff C, Sheehan D . Comparing the effects of antidepressants: consensus guidelines for evaluating quantitative reviews of antidepressant efficacy. Neuropsychopharmacology. 2005; 30(3):445-60. DOI: 10.1038/sj.npp.1300571. View

Bech P, Andersen H, Wade A . Effective dose of escitalopram in moderate versus severe DSM-IV major depression. Pharmacopsychiatry. 2006; 39(4):128-34. DOI: 10.1055/s-2006-946702. View

Bandelow B, Andersen H, Dolberg O . Escitalopram in the treatment of anxiety symptoms associated with depression. Depress Anxiety. 2006; 24(1):53-61. DOI: 10.1002/da.20141. View

10.

Pigott T, Prakash A, Arnold L, Aaronson S, Mallinckrodt C, Wohlreich M . Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder. Curr Med Res Opin. 2007; 23(6):1303-18. DOI: 10.1185/030079907X188107. View

11.

Montgomery S, Hansen T, Kasper S . Efficacy of escitalopram compared to citalopram: a meta-analysis. Int J Neuropsychopharmacol. 2010; 14(2):261-8. DOI: 10.1017/S146114571000115X. View

12.

Kasper S, Baldwin D, Lonn S, Boulenger J . Superiority of escitalopram to paroxetine in the treatment of depression. Eur Neuropsychopharmacol. 2009; 19(4):229-37. DOI: 10.1016/j.euroneuro.2008.12.003. View

13.

Braestrup C, Sanchez C . Escitalopram: a unique mechanism of action. Int J Psychiatry Clin Pract. 2014; 8 Suppl 1:11-3. DOI: 10.1080/13651500410005496. View

14.

Sicras-Mainar A, Navarro-Artieda R, Blanca-Tamayo M, Gimeno-de la Fuente V, Salvatella-Pasant J . Comparison of escitalopram vs. citalopram and venlafaxine in the treatment of major depression in Spain: clinical and economic consequences. Curr Med Res Opin. 2010; 26(12):2757-64. DOI: 10.1185/03007995.2010.529430. View

15.

Llorca P, Azorin J, Despiegel N, Verpillat P . Efficacy of escitalopram in patients with severe depression: a pooled analysis. Int J Clin Pract. 2005; 59(3):268-75. DOI: 10.1111/j.1742-1241.2005.00440.x. View

16.

Baldwin D . Escitalopram: efficacy and tolerability in the treatment of depression. Hosp Med. 2002; 63(11):668-71. DOI: 10.12968/hosp.2002.63.11.1912. View

17.

Si T, Wang G, Yang F, Fang Y, Fang M, Li J . Efficacy and safety of escitalopram in treatment of severe depression in Chinese population. Metab Brain Dis. 2017; 32(3):891-901. DOI: 10.1007/s11011-017-9992-5. View

18.

Lepola U, Loft H, Reines E . Escitalopram (10-20 mg/day) is effective and well tolerated in a placebo-controlled study in depression in primary care. Int Clin Psychopharmacol. 2003; 18(4):211-7. DOI: 10.1097/00004850-200307000-00003. View

19.

Kennedy S, Andersen H, Thase M . Escitalopram in the treatment of major depressive disorder: a meta-analysis. Curr Med Res Opin. 2009; 25(1):161-75. DOI: 10.1185/03007990802622726. View

20.

Boulenger J, Hermes A, Huusom A, Weiller E . Baseline anxiety effect on outcome of SSRI treatment in patients with severe depression: escitalopram vs paroxetine. Curr Med Res Opin. 2010; 26(3):605-14. DOI: 10.1185/03007990903482467. View