Is escitalopram efficacious in severe depression?

Escitalopram retains its antidepressant efficacy when used for the treatment of severe depression.

In a study with patients with severe depression, escitalopram demonstrated superior efficacy to placebo as early as week 2 and maintained this effect until study end by week 8 (ref.1). Consistent efficacy in treating severe depression has been demonstrated when analysing the subgroup of severely depression patients (basedline MADRS score >30), where escitalopram 10–20 mg was shown to be significantly superior to both placebo and citalopram 20–40 mg, as early as week 1 (ref.2).

Superior remission rates of escitalopram 20 mg comparied to venlafaxine XR 225 mg has been demonstrated in the subgrup of patients with severe depression. Remission rates were 47% and 29% respectively (p < 0.05) (ref.3).

In a pooled analysis Kennedy et al (2006) demonstrated that the more the patients were at baseline the larger were the treatment differences between escitalopram and the comparators, in favour of escitalopram.

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References:

1. Ninar 2003

2. Gorman et al, 2002

3. Bielsky 2003