Escitalopram treatment of depression in human immunodeficiency virus/acquired immunodeficiency syndrome: a randomized, double-blind, placebo-controlled study.
Depression can be a chronic and impairing illness in people with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Large randomized studies of newer selective serotonin reuptake inhibitors such as escitalopram in the treatment of depression in HIV, examining comparative treatment efficacy and safety, have yet to be done in HIV-positive patients. This was a fixed-dose, placebo-controlled, randomized, double-blind study to investigate the efficacy of escitalopram in HIV-seropositive subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, major depressive disorder. One hundred two participants were randomly assigned to either 10 mg of escitalopram or placebo for 6 weeks. An analysis of covariance of the completers found that there was no advantage for escitalopram over placebo on the Montgomery-Asberg Depression Rating Scale (p = 0.93). Sixty-two percent responded to escitalopram and 59% responded to placebo on the Clinical Global Impression Scale. Given the relatively high placebo response, future trials in this area need to be selective in participant recruitment and to be adequately powered.
*Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; †Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa; and ‡School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Jacqueline
J
Hoare
Paul
P
Carey
John A
JA
Joska
Henri
H
Carrara
Katherine
K
Sorsdahl
Dan J
DJ
Stein
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000523:psychology; D000328:Adult; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D016896:Treatment Outcome; D055815:Young Adult
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors