Escitalopram and suicidality in adult depression and anxiety.
The escitalopram clinical trial database, consisting of all placebo-controlled and relapse prevention trials within major depressive disorder (MDD) and anxiety disorders, was analysed for specific adverse events indicative of suicidal behaviour (fatal suicide, non-fatal self-harm or suicidal thoughts) in relation to treatment. The number of events was low, with no fatal suicides in the first 2 weeks of treatment. There was one fatal suicide during the full treatment period on placebo (incidence 0.1%; rate 0.003), and none on escitalopram. None of these figures were significantly different between escitalopram (n=2277) and placebo (n=1814) patients. There was no indication that escitalopram provokes suicidal behaviour compared to placebo in either MDD or anxiety disorders. Based on efficacy ratings (Montgomery-Asberg Depression Rating Scale, item 10), escitalopram was more efficacious versus placebo in lowering suicidal thoughts from weeks 1 through 8 in the treatment of patients with MDD.
Pedersen
Anders Gersel
AG
Drug Development, H. Lundbeck A/S, Copenhagen, Denmark. agpe@lundbeck.com
D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D016208:Databases, Factual; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D016728:Self-Injurious Behavior / Q000188:drug therapy / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram