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More Evidence of Escitalopram's Superiority

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Yeah, I'm a broken record, I know. But fewer side effects and higher efficacy make escitalopram increasingly look like the king of the antidepressants.

 

Encephale. 2012 Feb;38(1):86-96. Epub 2011 Dec 10.

[Clinical efficacy and achievement of a complete remission in depression: Increasing interest in treatment with escitalopram].

[Article in French]

Favré P.

Source

 

EPS Ville-Evrard, secrétariat 93G16, 202, avenue J.-Jaurès, 93332 Neuilly-sur-Marne cedex, France.

Abstract

 

Such a prevalent disease as Major Depressive Disorder (MDD), associated with prominent impairment in physical and social functioning, implies as well an increased morbidity and mortality. Long-term treatments are required due to the frequent occurrence of relapses. Patient compliance is a core factor in both acute and continuation treatment, closely related to tolerability issues. We have partially reviewed the literature published on PubMed since 2004 which assess the relative antidepressant efficacy of escitalopram and comparator antidepressants in adult patients who met DSM-IV criteria for major depressive disorder (MDD). Clinically important differences exist between commonly prescribed antidepressants. These analyses are in favor of a superior efficacy and tolerability of long-term escitalopram treatment (10 to 20mg/day) compared with active controls, including selective serotonin re-uptake inhibitors (SSRIs) (paroxetine, citalopram, bupropion, fluoxetine, fluvoxamine, sertraline), serotonin/noradrenaline reuptake inhibitors (SNRIs) (venlafaxine, milnacipran and duloxetine) and noradrenergic and specific serotonergic antidepressants (NaSSAs) (mirtazapine). Cipriani et al. (2009) have performed a network meta-analysis of 12 new generation antidepressants. They have shown that clinically important differences exist between commonly prescribed antidepressants for both efficacy and acceptability in favor of escitalopram and sertraline in acute treatment, defined as 8-week treatment. Kasper et al. (2009) conducted a post-hoc pooled analysis of data from two 6-month randomized controlled trials that revealed superior efficacy and tolerability of escitalopram when compared with paroxetine. The pooled analysis of four randomized, double-blind, active comparator, 6-month trials in MDD, by Wade et al. (2009), showed that short-term outcomes may predict long-term treatment compliance and outcomes. A higher probability of achieving remission was associated with responding after 8 weeks and with completing 6 months of treatment. Furthermore, Week 24 complete remission (MADRS≤5) was significantly (P

 

Copyright © 2011 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

 

PMID:

22381728

[PubMed - in process]

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An elderly friend of mine recently switched from escitalopram (about 4 years of use) to fluoxetine.

Overnight her chronic problems with constipation and GERD pain around an esophageal hernia have vanished.

She loves being free of abdominal pain for the first time in years.

 

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I had to get off of escitalopram. It worked well, but I was getting to the point where I was worried about falling asleep at the wheel.

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