Escitalopram failed to significantly improve the symptoms of depression in children aged 6–11 years, but it did appear to improve symptoms in children aged 12–17 years, wrote Dr. Karen Dineen Wagner of the University of Texas, Galveston, and her colleagues.
The study included 264 children and adolescents aged 6–17 years who had been diagnosed with major depressive disorder. The Children's Depression Rating Scale-Revised (CDRS-R) served as the primary outcome measure (J. Am. Acad. Child Adolesc. Psychiatry 2006;45:280–8).
The patients received either a placebo or 10 mg/day of escitalopram (Lexapro) for the first 4 weeks, with the option to increase dosage up to 20 mg/day for the next 4 weeks, depending on the patient's response to the medication and tolerance.
Overall, average changes in scores on the CDRS-R from baseline were not significantly different among the 102 escitalopram patients and 115 placebo patients who completed the study (−21.9 vs. −20.2). However, a later analysis that adjusted for age group revealed significant improvements in CDRS-R scores from baseline among the 77 children aged 12–17 years who took escitalopram, compared with the 80 children aged 12–17 years who took a placebo, based on observed cases (−22.3 vs. −17.8).
In addition, adolescents in the escitalopram group showed significant improvements in symptoms based on several secondary outcome measures, including the Clinical Global Impressions-Severity scale.
Headaches and abdominal pain were the only reported adverse events that occurred in more than 10% of patients in either group, and the discontinuation rate in both groups was 1.5%. The study was supported by Forest Laboratories, one of many companies from which Dr. Wagner has received research support.