Abstract | OBJECTIVE: METHODS: A total of 405 patients who were 65 years or older with a primary diagnosis of MDD received 12 week, open-label escitalopram 10 or 20 mg/day. Patients in remission (MADRS ≤12) at Week 12 were randomized to 24 weeks of double-blind treatment with either placebo or escitalopram (fixed dose from Week 6). RESULTS: After randomization of 312 patients in remission, patients whose dose had been increased to 20 mg escitalopram after 2 weeks of open-label treatment had a high escitalopram relapse rate (16.7%) and a placebo relapse rate of 32.5% with a hazard ratio (HR) of 2.2, whereas patients titrated to 20 mg escitalopram at Weeks 4 or 6 had a high placebo relapse rate (41.2%) and an escitalopram relapse rate of 5.7% with a HR = 8.9. A high placebo relapse rate was also observed for patients with a baseline MADRS below median, while low escitalopram relapse rates were characteristic of patients who had achieved remission by Week 6 or 8 (HR = 8.9), had a current depressive episode length below median, baseline MADRS below median (HR = 11.8), or received 10 mg for 12 weeks (HR = 6.3). A key limitation of the study was that some analyses were post-hoc and that none of the comparisons between complementary subgroups had nominal p-values <0.05. CONCLUSIONS: In this post-hoc analysis of elderly patients with MDD, several factors, including female gender, early remission, low baseline MADRS score, major depressive episode ( MDE) duration, and escitalopram dosage, significantly affected the relapse rate after randomization to escitalopram or placebo.
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Authors | Ornah Dolberg, Sara Larsson Lönn, Kajsa Kvist |
Journal | Current medical research and opinion
(Curr Med Res Opin)
Vol. 30
Issue 7
Pg. 1301-7
(Jul 2014)
ISSN: 1473-4877 [Electronic] England |
PMID | 24628498
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antidepressive Agents, Second-Generation
- Citalopram
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Topics |
- Aged
- Aged, 80 and over
- Ambulatory Care
- Antidepressive Agents, Second-Generation
(therapeutic use)
- Citalopram
(therapeutic use)
- Depressive Disorder, Major
(drug therapy)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Female
- Humans
- Male
- Quality of Life
- Recurrence
- Treatment Outcome
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