Escitalopram therapy for major depression and anxiety disorders

BACKGROUND: Randomized controlled clinical trials have demonstrated that escitalopram is efficacious in a range of mood and anxiety disorders, but the individual trials are insufficiently large to allow a full exploration of its tolerability.

OBJECTIVE: To assess the tolerability and safety of escitalopram through analysis of all randomized controlled clinical trials in major depressive disorder and anxiety disorders.

METHODS: Analyses of tolerability were based on data from all available randomized, double-blind, controlled studies completed by December 2006 in which escitalopram was compared with placebo or active compounds (citalopram, fluoxetine, paroxetine, sertraline, venlafaxine). Adverse events (AEs) that occurred more frequently with escitalopram than with placebo were listed, and tolerability and safety were evaluated.

RESULTS: Nausea was the only AE with an incidence greater than or equal to 10% and 5 percentage points greater than with placebo during short-term, treatment. In general, AEs were mild to moderate in severity. AEs related to I sexual dysfunction were similarly frequent with escitalopram and citalopram, but were higher with paroxetine. No suicide occurred among escitalopram-treated patients, and there were no significant differences between escitalopram and placebo in incidence of suicidal behavior, measured by self-harm and suicidal thoughts. The 8 week withdrawal rate due to AEs was higher with escitalopram than with placebo (7.3% vs 2.8%; p = 65 y of age) or those with hepatic dysfunction.

CONCLUSIONS: Based on data from randomized controlled trials involving more than 4000 escitalopram-treated patients, escitalopram (10-20 mg/day) is safe and well tolerated in short- and long-term treatment

serotonin-reuptake inhibitors, double-blind, controlled trial, long-term treatment, tolerability, primary-care patients, randomized clinical-trial, suicide, adverse events, tricyclic antidepressants, disorders, sexual dysfunction, exploration, risk, clinical-trial, paroxetine, venlafaxine, 10 mg, pregnancy, placebo, escitalopram, major depressive disorder, day, controlled-trial, major depression, efficacy, extended-release

1060-0280

1583-1592

http://bjp.rcpsych.org/cgi/content/abstract/186/3/...

Baldwin, D.S.

1beaa192-0ef1-4914-897a-3a49fc2ed15e

Reines, E.H.

e586fd19-a710-4198-af4e-c6a83debc440

Guiton, C.

7705c89b-9c17-4805-adb0-97dcc189d585

Weiller, E.

014a34ff-c58b-4dad-b8e7-e6c511185056

2007

Baldwin, D.S.

1beaa192-0ef1-4914-897a-3a49fc2ed15e

Reines, E.H.

e586fd19-a710-4198-af4e-c6a83debc440

Guiton, C.

7705c89b-9c17-4805-adb0-97dcc189d585

Weiller, E.

014a34ff-c58b-4dad-b8e7-e6c511185056

Baldwin, D.S., Reines, E.H., Guiton, C. and Weiller, E. (2007) Escitalopram therapy for major depression and anxiety disorders. The Annals of Pharmacotherapy, 41 (10), 1583-1592.

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Published date: 2007

Keywords: serotonin-reuptake inhibitors, double-blind, controlled trial, long-term treatment, tolerability, primary-care patients, randomized clinical-trial, suicide, adverse events, tricyclic antidepressants, disorders, sexual dysfunction, exploration, risk, clinical-trial, paroxetine, venlafaxine, 10 mg, pregnancy, placebo, escitalopram, major depressive disorder, day, controlled-trial, major depression, efficacy, extended-release