Safety and efficacy of oral escitalopram as continuation treatment of intravenous citalopram in patients with major depressive disorder.
The objective of this open-label, multicentre study was to evaluate the safety and efficacy of treatment with escitalopram (10 or 20 mg/day) for 6 weeks following a switch from intravenous citalopram treatment (20 or 40 mg/day) in patients presenting with a major depressive episode. A total of 173 patients were included, 147 (85%) of whom completed the study. The mean Montgomery-Asberg Depression Rating Scale (MADRS) total score at inclusion (last citalopram dose) was 31.6 +/- 9.9. The MADRS score decreased to 23.4 +/- 10.5 after 3 days of oral treatment with escitalopram and was 12.7 +/- 9.3 at the end of the study. The scores on the Clinical Global Impression (CGI) and Patient Global Evaluation scales also improved: at the end of the study, the response rates were 67% on the MADRS (defined as >or=50% decrease from MADRS baseline score) and 68% on the CGI-I (defined as CGI-I <or=2). More than half of the patients were in remission (MADRS score <or=12). Overall, the switch from intravenous citalopram to escitalopram was well tolerated. In all, 57 patients (33%) reported at least 1 adverse event, and 7 patients (4%) were withdrawn due to an adverse event. The most frequently reported adverse events were probably linked to residual depressive symptoms (anxiety: 9%; insomnia: 5%). In conclusion, escitalopram was well tolerated as a continuation treatment after switching from intravenous citalopram and reduced depressive symptoms in patients with a moderate to severe major depressive episode.
Schmitt
Laurent
L
Service de Psychiatrie et Psychologie Médicale, Hôpital Casselardit, CHU Toulouse, Toulouse, France. schmitt.1@chu-toulouse.fr
Tonnoir
Brigitte
B
Arbus
Christophe
C
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D015283:Citalopram / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram