A randomized, double-blind, 6-week prospective pilot study on the efficacy and safety of dose escalation in non-remitters in comparison to those of the standard dose of escitalopram for major depressive disorder.
J Affect Disord
; 259: 91-97, 2019 12 01.
Article
em En
| MEDLINE
| ID: mdl-31445345
ABSTRACT
BACKGROUND:
Escalating doses of selective serotonin reuptake inhibitors are often used to treat patients with a suboptimal response to the standard dose. This study assessed the efficacy and safety of dose escalation of escitalopram, up to 30â¯mg, in non-remitters with major depressive disorder (MDD) after treatment with the standard dose.METHOD:
We recruited 98 patients with MDD (aged 18-65 years). After 4 weeks of open-label treatment with 10-20â¯mg of escitalopram per day, non-remitters [Montgomery-Åsberg Depression Rating Scale (MADRS) score > 10] were randomized 11 for double-blind treatment with either escitalopram (30â¯mg per day) or escitalopram (20â¯mg per day) plus placebo for 6 weeks. The primary efficacy outcome was a change in the total MADRS score.RESULTS:
After 4 weeks of open-label treatment, 12 patients achieved remission, and 36 dropped out, leaving 50 non-remitters, of whom 44 (88%) completed the double-blind study. The primary outcome measure, the least-squares mean (standard error) change in the total MADRS score at week 6 was significantly different (pâ¯=â¯0.046) between the groups [-8.0 (1.2) in the placebo dose-escalation and -11.8 (1.2) in the escitalopram dose-escalation]. The dose escalation of escitalopram was well tolerated. However, the response and remission rates and quality of life showed no significant differences.LIMITATIONS:
Small sample size and short follow-up periodCONCLUSION:
This study suggests that dose escalation of escitalopram up to 30â¯mg per day may be beneficial for the treatment of depressive symptoms in non-remitters after standard (10-20â¯mg/day) treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Citalopram
/
Inibidores Seletivos de Recaptação de Serotonina
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Transtorno Depressivo Maior
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article