Journal
INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY
Volume 18, Issue 4, Pages 211-217Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00004850-200307000-00003
Keywords
antidepressant; citalopram; efficacy; enantiomer; escitalopram; flexible dose; MADRS; major depressive disorder; SSRI
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Escitalopram was compared to placebo in moderately to severely depressed patients in primary care with citalopram as the active reference. Patients were randomized to receive flexible doses of 10-20 mg/day escitalopram (n = 155), 20-40 mg/day citalopram (n = 160), or placebo (n = 154) over an 8-week double-blind period. The primary efficacy parameter was the change from baseline to last assessment in the Montgomery-Asberg Depression Rating Scale total score. Escitalopram produced a statistically significant therapeutic difference of 2.9 points (P = 0.002) compared to placebo, and escitalopram was consistently and statistically significantly more efficacious than placebo from week 1 onwards. Analysis of Clinical Global Impression-Severity and Clinical Global Impression-improvement confirmed the primary efficacy results. By week 8, significantly more patients had responded to treatment with escitalopram than with citalopram (P = 0.021) or placebo (P = 0.009). Escitalopram was as well tolerated as citalopram and had a similar adverse event profile. Both escitalopram- and citalopram-treated patients had placebo-level adverse event withdrawal rates (3% and 4%, respectively). This study demonstrates the consistent antidepressant efficacy and excellent tolerability of escitalopram 10-20 mg/day in primary care patients with major depressive disorder. Int Clin Psychopharmacol 18:211-217 (C) 2003 Lippincott Williams Wilkins.
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