Escitalopram versus serotonin noradrenaline reuptake inhibitors as second step treatment for patients with major depressive disorder: a pooled analysis

Apr 2, 2010International clinical psychopharmacology

Comparing Escitalopram and Serotonin-Noradrenaline Reuptake Inhibitors as Second-Step Treatments for Major Depression

AI simplified

Long Covid on OpenScience ↗PubMed ↗DOI ↗

Abstract

Escitalopram resulted in a 6.4-point lower depression score after 8 weeks compared to SNRIs in patients with major depressive disorder.

Patients treated with escitalopram had a clinical response rate of 73%, compared to 44% for those treated with SNRIs.
Remission rates were 62% in the escitalopram group, while 41% were observed in the SNRI group.
Escitalopram was associated with a lower withdrawal rate from the study due to all causes (9% vs. 23%).
Withdrawals due to adverse events were significantly lower in the escitalopram group (2% vs. 17%).
These findings suggest escitalopram may offer better efficacy and tolerability as a second step treatment for major depressive disorder.

AI simplified

The objective of this study was to evaluate the efficacy and tolerability of escitalopram versus serotonin and noradrenaline reuptake inhibitors (SNRIs) as second step treatment (defined operationally as poor response or intolerability to an antidepressant) for major depressive disorder (MDD). Results from all eligible head-to-head clinical trials of MDD (which excluded patients who earlier failed two or more antidepressants) sponsored by Lundbeck or Forest comparing escitalopram and SNRIs (venlafaxine and duloxetine) were pooled. A second step treatment subgroup was identified, defined as patients treated earlier with any antidepressant in the 6-month period before baseline. Data from three clinical trials were included in the analysis; 132 patients were identified in the second step treatment subgroup (66 in each of the escitalopram and SNRI groups). The primary efficacy analysis showed that the patients subsequently treated with escitalopram had significantly lower Montgomery Asberg Depression Rating Scale total scores after 8 weeks compared with those subsequently treated with SNRIs (difference = -6.4, P<0.0001). Escitalopram treatment was also associated with higher clinical response (73 vs. 44%, P=0.0004) and remission rates (62 vs. 41%, P=0.0083) compared with subsequent treatment with SNRIs. Escitalopram showed a better tolerability profile with lower all-cause withdrawals from study (9 vs. 23%, P<0.04) and lower withdrawals because of adverse events (2 vs. 17%, P<0.003). In conclusion, escitalopram is associated with a better efficacy and tolerability profile than SNRIs (duloxetine and venlafaxine) when used as a second step treatment in patients with MDD. These results should be confirmed in prospective randomized clinical trials.

Full Text

Full text is available at the source.

View full text ↗

Escitalopram versus serotonin noradrenaline reuptake inhibitors as second step treatment for patients with major depressive disorder: a pooled analysis

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the long covid brief