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How long should a trial of escitalopram treatment be in patients with major depressive disorder, generalised anxiety disorder or social anxiety disorder? An exploration of the randomised controlled trial database

How long should a trial of escitalopram treatment be in patients with major depressive disorder, generalised anxiety disorder or social anxiety disorder? An exploration of the randomised controlled trial database
How long should a trial of escitalopram treatment be in patients with major depressive disorder, generalised anxiety disorder or social anxiety disorder? An exploration of the randomised controlled trial database
Objective: to extend the knowledge of course of improvement in patients with major depressive disorder (MDD), social anxiety disorder (SAD) or generalised anxiety disorder (GAD) participating in randomised placebo-controlled trials (RCTs) and to infer the optimal duration of initial escitalopram treatment in clinical practice, after which intervention might be reasonable in case of non-response.

Methods: post hoc analysis of pooled clinical trial database for escitalopram in MDD (14 studies), GAD (4 studies) and SAD (2 studies). Onset of action was defined as a 20% or more decrease from baseline score in disorder-specific psychopathological rating scales: response as a 50% or more decrease from baseline score.

Results: in MDD, the probability of responding at week 8 if no onset was apparent at week 2 was 43%; in patients with an onset of effect the probability was nearly 80%. Similar patterns were observed in GAD and SAD. The chance of responding beyond week 4 in MDD, GAD and SAD was 20% or less if no effect had occurred by week 2.

Conclusions: the pattern of response in these RCTs suggests that in patients with MDD, GAD or SAD in wider clinical practice, a period of at least 4 weeks is worthwhile before considering further intervention.
treatment, response, escitalopram, onset of action
0885-6222
269-275
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Stein, Dan J.
07cf0cbd-837d-49ac-aceb-1c393a2f3e00
Dolberg, Ornah T.
a39524fa-c5b6-40da-a674-d9fb280ebe2d
Bandelow, Borwin
2fbbae21-629e-4d76-b5d0-7dff1282d64d
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Stein, Dan J.
07cf0cbd-837d-49ac-aceb-1c393a2f3e00
Dolberg, Ornah T.
a39524fa-c5b6-40da-a674-d9fb280ebe2d
Bandelow, Borwin
2fbbae21-629e-4d76-b5d0-7dff1282d64d

Baldwin, David S., Stein, Dan J., Dolberg, Ornah T. and Bandelow, Borwin (2009) How long should a trial of escitalopram treatment be in patients with major depressive disorder, generalised anxiety disorder or social anxiety disorder? An exploration of the randomised controlled trial database. Human Psychopharmacology: Clinical and Experimental, 24 (4), 269-275. (doi:10.1002/hup.1019).

Record type: Article

Abstract

Objective: to extend the knowledge of course of improvement in patients with major depressive disorder (MDD), social anxiety disorder (SAD) or generalised anxiety disorder (GAD) participating in randomised placebo-controlled trials (RCTs) and to infer the optimal duration of initial escitalopram treatment in clinical practice, after which intervention might be reasonable in case of non-response.

Methods: post hoc analysis of pooled clinical trial database for escitalopram in MDD (14 studies), GAD (4 studies) and SAD (2 studies). Onset of action was defined as a 20% or more decrease from baseline score in disorder-specific psychopathological rating scales: response as a 50% or more decrease from baseline score.

Results: in MDD, the probability of responding at week 8 if no onset was apparent at week 2 was 43%; in patients with an onset of effect the probability was nearly 80%. Similar patterns were observed in GAD and SAD. The chance of responding beyond week 4 in MDD, GAD and SAD was 20% or less if no effect had occurred by week 2.

Conclusions: the pattern of response in these RCTs suggests that in patients with MDD, GAD or SAD in wider clinical practice, a period of at least 4 weeks is worthwhile before considering further intervention.

Full text not available from this repository.

More information

Published date: June 2009
Keywords: treatment, response, escitalopram, onset of action

Identifiers

Local EPrints ID: 148041
URI: https://eprints.soton.ac.uk/id/eprint/148041
ISSN: 0885-6222
PURE UUID: f8093b66-a896-4b4c-b53a-c9e20a8defc6

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Date deposited: 27 Apr 2010 09:45
Last modified: 17 Jul 2019 00:03

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