Escitalopram in the treatment of major depressive disorder in primary-care settings: an open-label trial.
BACKGROUND
The present trial was designed to assess the efficacy and safety of escitalopram prescribed to patients seeking treatment of major depressive disorder (MDD) in a Canadian primary-care setting.


METHODS
Investigators (mainly primary-care physicians) enrolled patients with MDD from their daily practice. Patients were treated with escitalopram (flexible dose 10-20 mg/day) for up to 24 weeks. Efficacy assessments included the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression-Improvement and -Severity scales (CGI-I, CGI-S), the Patient Global Evaluation (PGE), and the Medical Outcome Study 36-item Short Form (SF-36).


RESULTS
Out of the 647 patients enrolled, 461 (71%) completed 24 weeks of treatment. The most common reason for discontinuation was adverse events (10%). The mean MADRS score decreased from 30.7 at baseline to 10.9 at the end of 24 weeks (last observation carried forward, LOCF). Remission (MADRS<or=12) was achieved by 65.5% of patients (LOCF). Symptom improvements were confirmed by global ratings of improvement made by physicians (CGI-I) as well as patients PGE. There was improvement on all dimensions of the SF-36, suggesting an overall improvement in quality of life.


CONCLUSIONS
Escitalopram was well tolerated, safe, and efficacious. Escitalopram can be used with confidence to treat patients with MDD in Canadian primary-care settings.
Chokka
Pratap
P
Grey Nuns Community Hospital, Edmonton, Canada. pchokka@shaw.ca
Legault
Mark
M
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram