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Escitalopram Helps Prevent Relapse of Obsessive-Compulsive Disorder Symptoms: Presented at APA

By Danny Kucharsky

TORONTO, CANADA -- May 25, 2006 -- Escitalopram 10 mg/day or 20 mg/day significantly reduces the risk of relapse in patients with obsessive-compulsive disorder (OCD), according to a study presented here at the American Psychiatric Association Annual Meeting (APA).

The study found escitalopram at both doses had an anti-OCD effect during 16 weeks of open-label treatment and a significant relapse-preventing effect during continued treatment up to 24 weeks, said investigator Naomi Fineberg, MD, professor of psychiatry, Postgraduate Medical School, University of Hertfordshire, Hatfield, United Kingdom.

The study was a multinational, randomized, double-blind, placebo-controlled, flexible to fixed dose relapse prevention study in 2 phases: a 16-week, open-label period followed by a 24-week, double-blind, placebo-controlled period and a 1-week taper period.

Patients who responded to treatment by the end of the 16 week open-label period were eligible for randomization.

Of the 468 patients entering the open-label period, 94 withdrew, and of the remaining 374, 320 were randomized to double-blind treatment -- 163 to escitalopram and 157 to placebo.

Patients withdrew if they relapsed or if the patient or doctor decided to discontinue treatment.

"With an open-label phase you are going to get more people who withdraw," Dr. Fineberg said in her presentation on May 23^rd.

Twenty-eight of the withdrawals were for adverse events, most of which were mild to moderate. One patient was withdrawn due to suicidal thoughts.

During the 24-week, double-blind period, the overall withdrawal rate, excluding relapses, was comparable for both treatments: 7.9% for escitalopram-treated patients (n = 13) and 8.9% for placebo-treated patients (n = 14). Escitalopram "was reasonably well tolerated and most patients did well," Dr. Fineberg said.

Time to relapse of OCD over 24 weeks showed a significant advantage for patients treated with escitalopram compared with patients treated with placebo (P <.001; log-rank test). The proportion of patients who relapsed was significantly higher in the placebo group than in the escitalopram group (52% vs 24%, P <.001).

The risk of relapse was 2.74 times higher for placebo-treated patients than for escitalopram-treated patients. Both the 10-mg and 20-mg escitalopram subgroups were significantly superior to the corresponding placebo subgroups in the analysis of time to relapse.


The study was sponsored by H. Lundbeck A/S.


[Presentation title: Escitalopram in Relapse Prevention in Patients With Obsessive-Compulsive Disorder (OCD). Abstract NR504]

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