ISTANBUL — The more severe a patient's baseline depression, the greater the efficacy displayed by escitalopram in a large observational Greek study.
Escitalopram (Lexapro) also proved exceptionally well tolerated in this 3,931-patient, 186-site naturalistic study, with a mere 7.8% discontinuation rate for any reason, Dr. Vasiliki Lagari reported at the annual congress of the European College of Neuropsychopharmacology.
The mean duration of the current episode of major depression among study participants was 1.8 years. For 62%, this was their first episode of major depressive disorder, according to Dr. Lagari of the Tripolis (Greece) Psychiatric Hospital.
At enrollment in the open-label 3-month study, 16% of patients were classified as having mild depression based upon a Clinical Global Impression of Severity (CGI-S) score of 3 on the 7-point scale. Fifty-four percent had moderate depression as defined by a CGI-S score of 4, and 30% had severe depression. The mean baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score was 26.7.
The mean reduction in MADRS score from baseline through 3 months was 22.6 points in the group with severe depression. That was a significantly greater improvement than in the moderately depressed group, which had a mean 17.7-point improvement, and this, in turn, was a significantly greater reduction than the 13.5-point decrease in patients with mild depression.
The same pattern of greater improvement in patients with more severe depression was seen in terms of CGI-S scores. However, the remission rate as defined by a CGI-S score of 2 or less approached 90% in patients with mild depression at baseline, a rate more than twice that of the severely depressed group, Dr. Lagari continued.
One or more adverse events were reported by 6.5% of patients on escitalopram only. The rate was three-fold higher in those on concomitant therapy.
The study was funded by a grant from Lundbeck, the manufacturer of escitalopram.