Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: MAIN OUTCOME MEASURES: The primary outcome measure was the treatment difference in Montgomery-Asberg Depression Rating Scale (MADRS) total score at week 8. Secondary outcome measures were response and remission (MADRS total score < or = 12) rates. RESULTS: Individual patient data (N = 4549) from 16 randomized controlled trials were included in the analyses ( escitalopram n = 2272, SSRIs n = 1750, SNRIs n = 527). Escitalopram was significantly more effective than comparators in overall treatment effect, with an estimated mean treatment difference of 1.1 points on the MADRS (p < 0.0001), and in responder (63.7 vs. 58.3%, p < 0.0001) and remitter (53.1 vs. 49.4%, p < 0.0059) analyses. Escitalopram was significantly superior to SSRIs, with an estimated difference in response of 62.1 vs. 58.4% and remission of 51.6 vs. 49.0%. In comparison to SNRIs, the estimated difference in response was 68.3 vs. 59.0% (p = 0.0007) and for remission the difference was 57.8 vs. 50.5% (p = 0.0088). These results were similar for severely depressed patients (baseline MADRS > or = 30). Sensitivity analyses were performed with data from articles reporting Hamilton Rating Scale for Depression (HAMD) scores. The 8-week withdrawal rate due to adverse events was 5.4% for escitalopram and 7.9% for the comparators (p < 0.01). This difference was accounted for by statistically significant higher attrition rates in the SNRI comparisons. This work may be limited by the clinical methodology underlying meta-analytic studies, in particular, the exclusion of trials that fail to meet predetermined criteria for inclusion. CONCLUSIONS:
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Authors | Sidney H Kennedy, Henning F Andersen, Michael E Thase |
Journal | Current medical research and opinion
(Curr Med Res Opin)
Vol. 25
Issue 1
Pg. 161-75
(Jan 2009)
ISSN: 1473-4877 [Electronic] England |
PMID | 19210149
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antidepressive Agents, Second-Generation
- Serotonin Uptake Inhibitors
- Citalopram
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Topics |
- Antidepressive Agents, Second-Generation
(adverse effects, therapeutic use)
- Citalopram
(adverse effects, therapeutic use)
- Depressive Disorder, Major
(drug therapy)
- Humans
- Selective Serotonin Reuptake Inhibitors
(adverse effects, therapeutic use)
- Treatment Outcome
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