Escitalopram versus sertraline in the treatment of major depressive disorder

A randomized clinical trial

Daniel Ventura, Edward P Armstrong, Grant H. Skrepnek, M. Haim Erder

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective. This trial was conducted to compare the efficacy and tolerability of a fixed dose of escitalopram 10mg/day with sertraline optimally dosed within its recommended dose range (50-200 mg/day) for the treatment of major depressive disorder. Methods. In this multicenter trial, depressed patients (DSM-IV defined; baseline Montgomery-Asberg Depression Rating Scale [MADRS] ≥ 22) aged 18-80 years were randomly assigned to 8 weeks of double-blind treatment with escitalopram (10 mg/day) or sertraline (50-200 mg/day) following a 1-week single-blind placebo lead-in period. There was no placebo comparison arm. Sertraline was initiated at 50 mg/day, and could be increased by 50 mg/day at weekly intervals based on clinical need and tolerability at the lower dose level. The blind was maintained with matching double-blind placebo capsules for the escitalopram group. Change from baseline to endpoint in MADRS total score (last observation carried forward) was the primary efficacy measure. Results. A total of 212 patients received double-blind medication. At week 8, the mean sertraline dosage was 144 mg/day (median = 150mg/day). Mean changes from baseline to endpoint in MADRS scores were -19.1 and -18.4 for the escitalopram and sertraline groups, respectively. At endpoint, 75% and 70% of escitalopram- and sertraline-treated patients, respectively, were responders (≥ 50% improvement from baseline in mean MADRS scores). Both treatments were generally well tolerated; only 2% and 4% of patients prematurely discontinued escitalopram and sertraline treatment respectively, due to adverse events. Conclusion: No differences in efficacy were observed for fixed-dose escitalopram 10mg/day and sertraline flexibly dosed from 50-200 mg/day. At these doses, both escitalopram and sertraline were generally well tolerated.

Original languageEnglish (US)
Pages (from-to)245-250
Number of pages6
JournalCurrent Medical Research and Opinion
Volume23
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Sertraline
Citalopram
Major Depressive Disorder
Randomized Controlled Trials
Depression
Therapeutics
Placebos
Diagnostic and Statistical Manual of Mental Disorders
Multicenter Studies
Capsules
Observation

Keywords

  • Clinical trial
  • Dose-response relationship
  • Double-blind
  • Escitalopram
  • Major depressive disorder
  • Sertraline

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Escitalopram versus sertraline in the treatment of major depressive disorder : A randomized clinical trial. / Ventura, Daniel; Armstrong, Edward P; Skrepnek, Grant H.; Erder, M. Haim.

In: Current Medical Research and Opinion, Vol. 23, No. 2, 02.2007, p. 245-250.

Research output: Contribution to journalArticle

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abstract = "Objective. This trial was conducted to compare the efficacy and tolerability of a fixed dose of escitalopram 10mg/day with sertraline optimally dosed within its recommended dose range (50-200 mg/day) for the treatment of major depressive disorder. Methods. In this multicenter trial, depressed patients (DSM-IV defined; baseline Montgomery-Asberg Depression Rating Scale [MADRS] ≥ 22) aged 18-80 years were randomly assigned to 8 weeks of double-blind treatment with escitalopram (10 mg/day) or sertraline (50-200 mg/day) following a 1-week single-blind placebo lead-in period. There was no placebo comparison arm. Sertraline was initiated at 50 mg/day, and could be increased by 50 mg/day at weekly intervals based on clinical need and tolerability at the lower dose level. The blind was maintained with matching double-blind placebo capsules for the escitalopram group. Change from baseline to endpoint in MADRS total score (last observation carried forward) was the primary efficacy measure. Results. A total of 212 patients received double-blind medication. At week 8, the mean sertraline dosage was 144 mg/day (median = 150mg/day). Mean changes from baseline to endpoint in MADRS scores were -19.1 and -18.4 for the escitalopram and sertraline groups, respectively. At endpoint, 75{\%} and 70{\%} of escitalopram- and sertraline-treated patients, respectively, were responders (≥ 50{\%} improvement from baseline in mean MADRS scores). Both treatments were generally well tolerated; only 2{\%} and 4{\%} of patients prematurely discontinued escitalopram and sertraline treatment respectively, due to adverse events. Conclusion: No differences in efficacy were observed for fixed-dose escitalopram 10mg/day and sertraline flexibly dosed from 50-200 mg/day. At these doses, both escitalopram and sertraline were generally well tolerated.",
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N2 - Objective. This trial was conducted to compare the efficacy and tolerability of a fixed dose of escitalopram 10mg/day with sertraline optimally dosed within its recommended dose range (50-200 mg/day) for the treatment of major depressive disorder. Methods. In this multicenter trial, depressed patients (DSM-IV defined; baseline Montgomery-Asberg Depression Rating Scale [MADRS] ≥ 22) aged 18-80 years were randomly assigned to 8 weeks of double-blind treatment with escitalopram (10 mg/day) or sertraline (50-200 mg/day) following a 1-week single-blind placebo lead-in period. There was no placebo comparison arm. Sertraline was initiated at 50 mg/day, and could be increased by 50 mg/day at weekly intervals based on clinical need and tolerability at the lower dose level. The blind was maintained with matching double-blind placebo capsules for the escitalopram group. Change from baseline to endpoint in MADRS total score (last observation carried forward) was the primary efficacy measure. Results. A total of 212 patients received double-blind medication. At week 8, the mean sertraline dosage was 144 mg/day (median = 150mg/day). Mean changes from baseline to endpoint in MADRS scores were -19.1 and -18.4 for the escitalopram and sertraline groups, respectively. At endpoint, 75% and 70% of escitalopram- and sertraline-treated patients, respectively, were responders (≥ 50% improvement from baseline in mean MADRS scores). Both treatments were generally well tolerated; only 2% and 4% of patients prematurely discontinued escitalopram and sertraline treatment respectively, due to adverse events. Conclusion: No differences in efficacy were observed for fixed-dose escitalopram 10mg/day and sertraline flexibly dosed from 50-200 mg/day. At these doses, both escitalopram and sertraline were generally well tolerated.

AB - Objective. This trial was conducted to compare the efficacy and tolerability of a fixed dose of escitalopram 10mg/day with sertraline optimally dosed within its recommended dose range (50-200 mg/day) for the treatment of major depressive disorder. Methods. In this multicenter trial, depressed patients (DSM-IV defined; baseline Montgomery-Asberg Depression Rating Scale [MADRS] ≥ 22) aged 18-80 years were randomly assigned to 8 weeks of double-blind treatment with escitalopram (10 mg/day) or sertraline (50-200 mg/day) following a 1-week single-blind placebo lead-in period. There was no placebo comparison arm. Sertraline was initiated at 50 mg/day, and could be increased by 50 mg/day at weekly intervals based on clinical need and tolerability at the lower dose level. The blind was maintained with matching double-blind placebo capsules for the escitalopram group. Change from baseline to endpoint in MADRS total score (last observation carried forward) was the primary efficacy measure. Results. A total of 212 patients received double-blind medication. At week 8, the mean sertraline dosage was 144 mg/day (median = 150mg/day). Mean changes from baseline to endpoint in MADRS scores were -19.1 and -18.4 for the escitalopram and sertraline groups, respectively. At endpoint, 75% and 70% of escitalopram- and sertraline-treated patients, respectively, were responders (≥ 50% improvement from baseline in mean MADRS scores). Both treatments were generally well tolerated; only 2% and 4% of patients prematurely discontinued escitalopram and sertraline treatment respectively, due to adverse events. Conclusion: No differences in efficacy were observed for fixed-dose escitalopram 10mg/day and sertraline flexibly dosed from 50-200 mg/day. At these doses, both escitalopram and sertraline were generally well tolerated.

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