Source: DGNews  |  Posted 5 years ago

By Fran Lowry

MIAMI, F.L. -- March 27, 2006 -- Escitalopram prevents relapse in patients with anxiety or depression, according to a review of 3 double-blind, placebo-controlled studies presented at the 26[^]th[] Annual Conference of the Anxiety Disorders Association of America (ADAA).

The risk of relapse was statistically significantly lower in patients treated with escitalopram than with placebo across the spectrum of affective disorders studied, said presenter Anjana Bose, PhD, executive director, Central Nervous System Department, Forest Laboratories, Inc., New York, New York, United States. These included generalized anxiety disorder (GAD), social anxiety disorder (SAD), and major depressive disorder (MDD).

These conditions tend to be chronic and have a high tendency to relapse. and the results of these trials support the concept of maintenance treatment up to 6 months? duration, Dr. Bose said.

?Selective serotonin reuptake inhibitors [SSRIs] have become first-line treatment options for GAD, SAD and MDD,? Dr. Bose said. ?They have excellent efficacy and tolerability, and this makes them ideal for long-term therapy. Escitalopram is the most selective SSRI currently available.?

Escitalopram is approved by the FDA for long-term use only in MDD. Therefore, the GAD and SAD studies were conducted in Europe. The MDD study was conducted in the US, Dr. Bose said.

In each study, patients who responded to short (8-12 weeks) open-label treatment with escitalopram at 10-20 mg/day were then eligible to enter a randomized, double-blind placebo-controlled treatment phase. The primary outcome for all three studies was time to relapse during the double-blind treatment phase.

The GAD study randomized 187 patients to escitalopram at a dose of 20 mg/day and 188 patients to placebo for up to 76 weeks. The SAD study randomized 190 patients to 10-20 mg/day escitalopram and 181 patients to placebo for 24 weeks. The MDD study randomized 181 patients to 10-20 mg/day escitalopram and 93 patients to placebo for 36 weeks.

In each study, escitalopram maintenance treatment significantly reduced the risk of relapse compared to placebo, Dr. Bose reported. In GAD patients, time to relapse was significantly longer and the proportion of patients who relapsed was lower in the escitalopram group compared to placebo (19% vs. 56%, P <.001); hazard ratio (HR) = 4.04).

In SAD patients, escitalopram was effective in preventing relapse compared to placebo (22% vs. 50%, P <.001; HR = 2.83). In MDD patients, time to relapse was significantly longer with escitalopram, and the cumulative risk of relapse significantly was also lower in escitalopram-treated patients than in placebo-treated patients (26% vs. 40%, P =.013; HR = 1.79).

Escitalopram was well tolerated, Dr. Bose said. Most adverse events were mild to moderate and included headache, dizziness, rhinitis, upper respiratory tract infection and increased sweating.

[Presentation title: Escitalopram Prevents Relapse Across Anxiety Disorders and Major Depression. Abstract 380]