title: Effects of escitalopram on stress-related relapses in women with multiple sclerosis: an open-label, randomized, controlled, one-year follow-up study.
abstract: A growing body of evidence supports the association between Stressful Life Events (SLEs) and increased risk for relapse in Multiple Sclerosis (MS). In this open-label, randomized, controlled, one-year prospective study we investigated the effects of escitalopram on stress-related relapses in 48 women with relapsing-remitting MS. Patients were randomly assigned either to receive escitalopram 10mg/day (e-group, N=24) or to continue with treatment as usual, as a control group (c-group, N=24). SLEs were documented weekly in self-report diaries and were classified afterwards as short- or long-term depending on their psychological impact as this was subjectively felt by the patient. The cumulative risk for relapse was 2.9 times higher for controls than for escitalopram-treated patients (95% CI=1.7-5.1, p<0.001) and it was influenced only by long-term SLEs. In the e-group only 3 or more long-term SLEs were associated with a significant increase of the risk of a relapse during the following 4 weeks, and this risk was 4 times lower compared to the c-group. Our study shows preliminary evidence that escitalopram may constitute an effective and well-tolerated treatment option for the prevention of stress-related relapses in women with MS.
authors.affiliation: First Department of Psychiatry, Athens University Medical School, Eginition Hospital, Halandri-Athens, Greece. ectorcenter@yahoo.gr
authors.forename: Charalampos I
authors.initials: CI
authors.lastname: Mitsonis
authors.forename: Iannis M
authors.initials: IM
authors.lastname: Zervas
authors.forename: Constantin M
authors.initials: CM
authors.lastname: Potagas
authors.forename: Panagiotis A
authors.initials: PA
authors.lastname: Mitropoulos
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Dimopoulos
authors.forename: Constantin A
authors.initials: CA
authors.lastname: Sfagos
authors.forename: George N
authors.initials: GN
authors.lastname: Papadimitriou
authors.forename: Demetrios C
authors.initials: DC
authors.lastname: Vassilopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008016:Life Change Events; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000517:prevention & control*; D055502:Secondary Prevention; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors