Safety Of Escitalopram Research Articles

CYP2C19 polymorphisms on escitalopram treatment outcome in South Indian population with major depressive disorder

Various CYP2C19-mediated metabolizer groups may arise as a result of inter-individual variability, which potentially influences the efficacy and safety of escitalopram. Hence, it is crucial to establish a comprehensive collection of information relevant to each phenotype regarding the efficacy and tolerability of therapy. This will enable psychiatrists to make optimal decisions for individual patients. The aim of the study: The aim of this study is to classify MDD patients into various CYP2C19 metabolizer groups and to determine the association between phenotype and treatment outcome. Materials and Methods: The study enrolled 119 escitalopram monotherapy-treated MDD patients aged 18–58. MADRS, HDRS-17, and CGI were used to measure efficacy at baseline, weeks 4, 8, and 12. Safety and tolerability outcomes were examined from occurring ADRs. Clinical outcomes were compared among phenotypes based on changes in HDRS-17 and CGI scores from week 4 to week 12. Results: Subjects were categorized by CYP2C19 genotype: 20 poor (PM), 64 intermediate (IM), 24 extensive (EM), and 11 ultra-rapid (UM) metabolizers. Response and remission occurred in 67.2 % and 26.8 % of the 119 subjects at the end of the 12th week of the study. The response rate in PM was much lower (21.6 %) compared to EM. There were 312 adverse drug reactions (ADRs), and 88 (73.94 %) individuals had at least one. In safety data, nervousness was the most common ADR among the four groups 66 (55.4 %), followed by decreased appetite 48 (40.3 %). There were no severe ADRs. Men had more ADRs than women. Conclusion: CYP2C19 genotyping may help personalize escitalopram medication. The study found that the reduced ability of PM to metabolize escitalopram is probably associated with the decreased efficacy and tolerance shown in PM compared to EM and IM. The relationship between metabolizer status and treatment response followed the anticipated direction. Our findings should guide future clinical studies that include pharmacokinetic assessments

Efficacy and Safety of Escitalopram, Desvenlafaxine, and Vortioxetine in the Acute Treatment of Anxious Depression: A Randomized Rater-blinded 6-week Clinical Trial

Anxious depression is associated with greater chronicity, higher severity of symptoms, more severe functional impairment, and poor response to drug treatment. However, evidence for first-choice antidepressants in patients with anxious depression is limited. This study aimed to compare the efficacy and safety of escitalopram, desvenlafaxine, and vortioxetine in the acute treatment of anxious depression. Patients (n = 124) with major depressive disorder and high levels of anxiety were randomly assigned to an escitalopram treatment group (n = 42), desvenlafaxine treatment group (n = 40), or vortioxetine treatment group (n = 42) in a 6-week randomized rater-blinded head-to-head comparative trial. Changes in overall depressive and anxiety symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA), respectively. Patients demonstrated similar baseline-to-endpoint improvement in scores and similar response and remission rates for HAMD and HAMA. Analysis of the individual HAMD items revealed that desvenlafaxine significantly reduced anxiety somatic scores (p = 0.013) and hypochondriasis scores (p = 0.014) compared to escitalopram. With respect to the individual HAMA items, desvenlafaxine treatment showed significantly lower scores for respiratory symptoms (p = 0.013) than escitalopram treatment and cardiovascular symptoms (p = 0.005) than vortioxetine treatment. The treatments were well tolerated, with no significant differences. Our results indicated no significant differences in the efficacy and tolerability of escitalopram, desvenlafaxine, and vortioxetine in this subtype of patients with anxious depression during the acute phase of treatment.

Effectiveness, safety and adherence to therapy with Elicea Q-Tab in real clinical practice

To evaluate the effectiveness and safety of escitalopram in the form of oral dispersible tablets (Elicea Q-Tab) in real-life clinical practice in patients with depressive and anxiety disorders. The study included 1.892 outpatient patients, 1.860 of whom completed participation in accordance with the protocol and entered the statistical analysis. Most patients were diagnosed with depressive and anxiety disorders of varying severity, as a rule, these diagnoses were established for the first time. The drug was most often prescribed at a dosage of 10 mg/day. The patients were monitored for 90 days and at each of the 3 visits, scales were used to assess the clinical condition (CGI-S and CGI-I), scales «Interaction with people, maintaining relationships (social functioning)» and «Availability of work, task completion, school attendance (professional functioning)», scales satisfaction with the convenience of admission/appointment and the effectiveness of treatment, various indicators of quality of life (autonomy, social and professional functioning, hobbies and hobbies), as well as the severity of cognitive disorders were measured. Patients treated with escitalopram in the form of oral tablets dispersible in the oral cavity (Elicea Q-Tab) showed an improvement in their clinical condition (a decrease in CGI-S scores from 3.65 at visit 1 to 2.63 by visit 3, by 28%; a decrease in CGI-I scores from 2.39 at visit 1 to 1.57 to visit 3, by 34%), as well as improving the quality of life, social (from 2.74 points on 1 visit to 4.32 on 2 visits, by 58%) and professional functioning (from 2.81 on 1 visit to 4.35 on 2 visits, by 55%), the level of concentration (from 3.28 points on 1 visit up to 4.5 on 3 visits, by 37%). Doctors and patients noted high satisfaction with the effectiveness and convenience of using the drug, the frequency of adverse events was low. The study showed that escitalopram in the form of oral tablets dispersible in the oral cavity (Elicea Q-Tab) is an efficient and safe treatment for depressive and anxiety disorders in real-world clinical settings. Patients and physicians have evaluated the drug positively and it can be considered as an effective agent in psychiatric practice.

Evalution of the effect of Escitalopram vs. placebo on changing the temperament traits of neuroticism

Introduction: Neuroticism is a personality trait that is most related to the mental health challenges. Escitalopram is the selective serotonin reuptake inhibitors (SSRIS) that are usually used in the treatment of depression and anxiety disorders. The aim of this study was to evaluate the efficacy and safety of escitalopram on improving the temperament traits on the neurotic patients. Methods: In this randomized placebo controlled trial, 172 residents in three hospitals in Ahvaz, Iran were randomly assigned to receive esitalopram 20 mg/daily/ orally (No=86, 29.9 ± 6.4 years with a range of 20 to 48 years old) or placebo (N=86, 29.8+6.3 years, ranged 21-47 years old) for 4 weeks.. At the beginning of the treatment the neuroticism and deoression scores were measured using NEO-60 and HAM-D questionnaires, and the patients were re-evaluated every two weeks during the treatment. The changes of temperament traits of neuroticism and depression in the two groups were analyzed using SPSS software. Results: Administration of escitalopram in the treatment group reduced the neuroticism score 5.84 % and 13.3% after 2 and 4 weeks, respectively, compared with placebo group (P<0.01). The changes in neuroticism temperament traits were not significant in placebo group during 4 weeks (P<0.05).

Discussion on Safety of Escitalopram and Paroxetine in the Treatment of Senile Depression to Improve Clinical Efficacy

Discussion on Safety of Escitalopram and Paroxetine in the Treatment of Senile Depression to Improve Clinical Efficacy

Comparative efficacy and safety of escitalopram, desvenlafaxine, and vortioxetine in the acute treatment of anxious depression: A randomized rater-blinded, 6-week clinical trial

IntroductionThis study is about the clinical uses of three antidepressants( escitalopram, desvenlafaxine, vortioxetine) in the treatment of anxioun depression.ObjectivesThe purpose of this study was to compare the efficacy and safety of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in the acute treatment of anxious depression.Methods Patients (n=189) with DSM5 major depression and high levels of anxiety were evenly randomized to escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in a six-week, randomized, rater-blinded, head to head comparative trial. Changes in overall depressive and anxiety symptoms were assessed.Results Patients demonstrated similar baseline-to-endpoint improvement in HAMD and HAMA total scores. Patients also demonstrated similar response rate and remission rate in HAMD and HAMA. In analysis of individual HAMD and HAMA items, desvenlafaxine had greatly reduced scores for anxiety somatic (p=0.013), hypochondriasis (p=0.014), cardiovascular symptoms (p=0.005), respiratory symptoms (p=0.013) compared to escitalopram or vortioxetine. Each treatment were well tolerated with no significant differences.ConclusionsThese results showed no significant differences in efficacy and tolerability of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in this subtype of patients with anxious depression during the acute phase treatment.DisclosureNo significant relationships.

Impact of gender, depression severity and type of depressive episode on efficacy and safety of escitalopram: an observational study on major depressive disorder patients in southern India

BackgroundAntidepressant response is a complex trait influenced by clinical, demographic and genetic factors.ObjectivesTo explore the influences of baseline depression severity, gender and type of depressive episode on efficacy and safety of escitalopram (10–20 mg/day) in South Indian patients with major depressive disorder (MDD).MethodsThe study was conducted on 18–65-year-old patients (n = 151) suffering from a first or recurrent episode of MDD with a 17-item Hamilton Depression Rating Scale (HDRS-17) score of ≥ 18 at baseline. Efficacy assessments were done using HDRS-17, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression (CGI) at baseline and weeks 4, 8 and 12. Patients were monitored for adverse drug reactions (ADRs). Clinical outcomes were compared among various groups based on gender, type of depressive episode (first or recurrent episode) and baseline HDRS-17 scores (moderate depression—score between 17 and 23; severe depression—score ≥ 24).ResultsAmong the 148 subjects who completed the 12-week study, 43.9% and 42.6% achieved response and remission, respectively. The decline in HDRS-17 and MADRS scores from baseline was significant (p value < 0.05) at all follow-up visits and a similar pattern was seen with CGI. Efficacy outcomes were better in the moderate baseline depression group compared with severe depression. There were no associations of efficacy with gender and type of depressive episode. A total of 247 adverse drug reactions (ADR) were reported and 119 (80.41%) subjects experienced at least one ADR during the study period. No serious ADR was reported. Male patients experienced more ADRs compared with females. The safety profile of escitalopram was similar across various groups based on baseline depression severity and type of depressive episode.ConclusionThe study revealed that escitalopram is efficacious in south Indian MDD patients with a favourable safety profile. The efficacy was influenced by baseline depression severity whereas more ADRs were reported by male patients.

Clinical efficacy and safety of escitalopram in the treatment of depressed elderly patients with insomnia

Objective To investigate the clinical efficacy and safety of escitalopram in the treatment of depressed elderly patients with insomnia. Methods According to the digital table, 60 depressed elderly patients with insomnia were selected and randomly divided into the control group and the observation group, 30 cases in each group.The control group was treated by citalopram, the observation group was treated by escitalopram, the two groups were treated for 8 weeks.The depression and sleep quality were tested by HAMD and PSQI before and after treatment, and the incidence of adverse reactions and the total clinical efficacy were compared between the two groups in the same time. Results Compared with pre-treatment, the HAMD scores in the control group and observation group were decreased from (26.76±3.47)points and (26.53±3.44)points to (13.48±1.36)points and (18.25±2.15)points respectively; the PSQI scores were decreased from (26.76±3.47)points and (26.53±3.44)points to (13.48±1.36)points and (18.25±2.15)points respectively, and the differences were statistically significant(all P<0.05). After treatment, compared with the control group, the HAMD score(t=10.270, P=0.000) and PSQI score(t=-7.712, P=0.000) in the observation group were significantly lower.The incidence rate of adverse effects was lower(χ2=0.425, P=0.935) and the total effective rate was higher, but without statistically significant differences(χ2=2.785, P=0.426). Conclusion Escitalopram can improve the depression of elderly depression patients with insomnia, improve sleep quality with high safety. Key words: Depressive disorder; Sleep initiation and maintenance disorders; Escitalopram; Middle aged; Aged

Efficacy and Safety of Escitalopram in First Episode of Major Depressive Disorder - A Tertiary Care Indian Center Experience

Context: Major Depressive Disorder (MDD) is the most prevalent psychiatric illness and escitalopram is one of the most commonly used selective serotonin reuptake inhibitors (SSRI) for its treatment. Aim: To study efficacy and safety of escitalopram in patients with first episode of MDD. Materials and methods: This was a prospective, open label, eight weeks follow-up study. Eighty-four patients with first episode of MDD were selected using simple random sampling. Depression was diagnosed using DSM-5 diagnostic criteria for MDD. Montgomery-Asberg Depression Rating Scale (MADRS) was used to assess the severity of depression. Clinical Global Impression Severity (CGI-S) and Clinical Global Impression Improvement (CGI-I) were used to measure illness severity and global improvement. The Antidepressant Side-Effect Checklist (ASEC) was used to measure adverse reactions to antidepressants. Results: The mean of MADRS total score at baseline was 32.08 which was decrease in subsequent follow up and at 8-week score was 11.24. 77% of patients responded (≥50% or more reduction of MADRS total score) and 64.9% remitted (≤12 score of MADRS) at 8 weeks. 22.9% of patients reported side effects during the 8-week treatment. 94.2% of patients got significant improvement with 10 mg dose of escitalopram. The common side effects were constipation (5.4%), nausea (5.4%), dry mouth (4.1%) and yawning (4.15%). Conclusion: Escitalopram treatment was efficacious and well tolerated in patients with first episode of MDD. Nearly two third patients achieved remission at the end of eight week.

Comparison of efficacy and safety of escitalopram and vilazodone in major depressive disorder

Background: Major depressive disorder (MDD) is a worldwide prevalent psychiatric ailment associated with significant morbidity and mortality. Escitalopram is an effective selective serotonin reuptake inhibitor (SSRI), and vilazodone is a newer SSRI and partial serotonin receptor agonist approved for MDD. Aims and Objectives: The aim was to evaluate and compare the efficacy and safety of escitalopram and vilazodone in patients of MDD. Materials and Methods: The present, randomized study was conducted in a tertiary care teaching institute, and 50 patients between 18 and 55 years of either sex diagnosed with MDD based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria were included in the study. Patients were assigned randomly into two groups to receive orally either escitalopram (10 mg) or vilazodone (20 mg) and baseline scores of Hamilton Anxiety Scale (HAM–A) and Hamilton Depression Rating Scale (HAM-D) were recorded. These were then assessed at 6 weeks for post-drug scores and compared with baseline using Mann–Whitney and Wilcoxon signed-rank test statistical analytic method. Intergroup comparison was also done. Results: Average age of the patients taken was 39.74 ± 8.6 years with a male:female ratio of 19:31. The HAM-D score was significantly lowered by both escitalopram and vilazodone (P < 0.0001). HAM-A score was also similarly lowered by escitalopram (P < 0.0001) and vilazodone (P < 0.0001). On intergroup comparison, escitalopram was found to cause more lowering of HAM-D score and HAM-A score than vilazodone (P < 0.0001). Biochemical profile (blood sugar, serum urea, creatinine, hemoglobin, and total leukocyte counts) was not altered with either of the drugs over 6 weeks. No significant adverse drug reactions were noted with the drugs. Conclusion: Both drugs are effective in decreasing depression and anxiety scores in patients of MDD. On comparison, escitalopram was found better than vilazodone.

Paroxetine versus Venlafaxine and Escitalopram in Korean Patients with Major Depressive Disorder: A Randomized, Rater-blinded, Six-week Study.

ObjectiveThe purpose of this study was to compare the efficacy and safety of escitalopram, paroxetine and venlafaxine in Korean patients with major depressive disorder (MDD).MethodsA total of 449 Korean MDD patients were recruited in a six-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to paroxetine, venlafaxine, or escitalopram treatment.ResultsWhen comparing the mean difference for the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HDRS) total scores during six weeks, paroxetine (−6.4±0.4, and −5.4±0.4, respectively) was found to be significantly superior to escitalopram (−3.7±0.5 and −3.1±0.4, respectively). Venlafaxine had a significantly lower MADRS total score (−5.4±0.4) than escitalopram. When adjusting baseline variables, the response, according to the MADRS and HDRS scores, in the paroxetine group was greater than that for the escitalopram group (odds ratio [OR]=2.43, 95% confidence interval [CI]=1.42–4.16 for MADRS; and OR=2.32, 95% CI=1.35–3.97 for HDRS) and the venlafaxine group (OR=1.94, 95% CI=1.17–3.21 for MADRS; and OR=1.71, 95% CI=1.03–2.83 for HDRS). Despite that the overall tolerability was high and similar among the three groups, a total of 268 subjects (59.7%) prematurely discontinued treatment, representing the main limitation of the present study.ConclusionAlthough a low study completion rate limits generalizability, our findings suggest that paroxetine might be superior to escitalopram in Korean MDD patients. Further studies should be conducted to draw a definite conclusion.

Effect and safety of escitalopram in the treatment of depressive disorder in patients with myocardial infarction: A prospective study

Background: The top two contributors to the worldwide burden of disease are predicted to be ischemic heart disease (IHD) and major depression. Patients with established IHD are at risk to develop depression. Major depression is common among patients recovering from myocardial infarction (MI). As depression can worsen the prognosis of cardiac patients, it might be possible to improve the prognosis by treating the depression with antidepressants. Aim: The index study aimed to find the prevalence of depressive disorder in adult patients with MI admitted to the cardiology unit and to examine the outcome as regards to the effect and safety of escitalopram as per the treatment regime routinely followed for the treatment of depression in such patients. Methods: One hundred consecutive patients with an established diagnosis of MI admitted to the Department of Cardiology constituted the study sample. Patients who qualified for the major depressive disorder were then treated with escitalopram. Results: The overall prevalence of depression in patients with MI is 22%. The study highlights that depression in the post-MI period is common and responds well to antidepressant treatment. Escitalopram could be an effective and safe antidepressant for the treatment of depression in patients with MI. Conclusion: The study highlights that depression in post MI period is common and escitalopram seems to be an effective and safe antidepressant for the treatment of depression in MI patients.

THE SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI) AS TREATMENT OF DEPRESSION IN PATIENTS WITH EPILEPSY

The current possibilities of treatment of depression in epilepsy were represented. Depression is one of the most frequent psychiatric comorbidities in epilepsy. The prevalence of depression ranges from 10 to 80%, and most often found in patients with focal epilepsy resistant to antiepileptic therapy. Depression in patients with epilepsy are not often diagnosed and therefore not treated. A number of common epilepsy and depression pathogenetic mechanisms, such as impaired metabolism of certain neurotransmitters in the central nervous system, especially serotonin was descripted. Based on this, the most promising drugs in the treatment of depression in epilepsy are now the selective serotonin reuptake inhibitor (SSRI), such as escitalopram. Objective. The primary objectives were to evaluate the efficacy and safety of escitalopram in treating depressive symptoms. Materials and methods. The study involved 68 patients aged 19-69 years with cryptogenic and focal epilepsy and different disease duration (from 5 to 21 years), different types of seizures and suffering depression interictal (between 2 and 5.5 years). Depression Rating Scale of Montgomery-Asberg (MADRS) was used. To assess the severity of the patient ’s condition at the time of the survey, a global assessment of disease severity (CGI-S) and the global assessment of the mental state (CGI-I) were used. While taking escitalopram (10-20 mg per day.), all patients received basic anticonvulsant therapy. Results. During follow-up the patients with epilepsy who took escitalopram, proconvulsant effect were not denoted. In assessing depressive symptoms improved markedly. Against the background of escitalopram no deterioration was marked, no sedation, addiction to the drug was observed, minimum drug interactions with anticonvulsants was registered. Conclusion. The results described observation program suggests a safe and effective treatment of escitalopram epilepsy patients with depression, it is well tolerated, low drugdrug interactions, as well as improve the quality of life of patients.

Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial.

Depression is common after acute coronary syndrome (ACS) and has adverse effects on prognosis. There are few evidence-based interventions for treating depression in ACS. This study investigated the efficacy and safety of escitalopram in treating depressive disorders identified 2-14 weeks after a confirmed ACS episode. A total of 217 patients with DSM-IV depressive disorders (121 major and 96 minor) and ACS were randomly assigned to receive escitalopram in flexible doses of 5-20 mg/d (n = 108) or placebo (n = 109) for 24 weeks. The study was conducted from 2007 to 2013. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS). Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Clinical Global Impressions-Severity of Illness scale (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and World Health Organization Disability Assessment Schedule-12. Cardiovascular safety outcomes included echocardiography, electrocardiography, laboratory test, body weight, and blood pressure results. Escitalopram was superior to placebo in reducing HDRS scores (mean difference = 2.3, P = .016, effect size = 0.38). Escitalopram was also superior to placebo in decreasing depressive symptoms evaluated by the MADRS, BDI, and CGI-S and in improving SOFAS functioning level. Escitalopram was not associated with any harmful changes in cardiovascular safety measures. Dizziness was significantly more frequently reported in the escitalopram group (P = .018), but there were no significant differences in any other adverse events. These results indicate that escitalopram has clinically meaningful antidepressant effects with no evidence of reduced cardiovascular safety in depressive disorder following ACS. ClinicalTrials.gov identifier: NCT00419471.

Особенности терапии хронического вертеброгенного болевого синдрома

Статья посвящена хроническому болевому синдрому в неврологии. Уделяется внимание развитию депрессивных состояний у пациентов с длительно существующим хроническим болевым синдромом. Что касается применения антидепрессантов у данной категории больных, в последнее время наибольшее внимание уделяется препаратам группы селективных ингибиторов обратного захвата серотонина, одним из которых является эсциталопрам. Приведены данные собственного исследования эффективности и безопасности эсциталопрама у пациентов с хронической вертеброгенной люмбалгией, люмбоишиалгией.

Safety of escitalopram in pregnancy: a case series

BackgroundThe aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding.MethodsWomen enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items) and Hamilton Rating Scale for Anxiety (14 items). Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded.ResultsThe case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems.ConclusionOur experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding.

The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review

Escitalopram (ESC) is considered one of the most effective selective serotonin reuptake inhibitors for the treatment of major depression. However, little is known on its potential risk of inducing major malformations (MMs) and perinatal complications (PCs). Hence, aim of the present study is to provide a comprehensive review of the available literature on the safety profile of ESC during pregnancy and breastfeeding. MEDLINE and PubMed databases were searched for English language articles by using the following keywords: escitalopram, selective serotonin reuptake inhibitors, major malformations, perinatal complications, pregnancy, and breastfeeding. Although some cases of MMs have been reported after maternal exposure to ESC during early pregnancy, the rate of these adverse events is substantially in the range of those reported in unexposed women. On the contrary, exposure to ESC seems to be significantly associated with some PCs. No adverse effects have been reported in the few studies evaluating its safety during breastfeeding. The available data seem to support the notion that ESC might be considered safe during pregnancy, in particular as far as MMs is concerned. However, similar to other selective serotonin reuptake inhibitors, it could be associated with an increased risk of PCs. Given the paucity of the studies published so far, no definitive conclusions can be drawn on its safety profile during breastfeeding.

98: Escitalopram use in pregnancy: an observational cohort study

Escitalopram is a 5-HT re-uptake inhibitor prescribed for depression and anxiety. To date, a single published study has described fetal outcome following gestational exposure to escitalopram. We sought to determine whether escitalopram is associated with an increased risk for adverse pregnancy outcomes. We analysed pregnancy outcomes of women who contacted the Motherisk Program and other Teratogen Information Services regarding the safety of escitalopram during pregnancy. Data were collected using a standardized questionnaire. Two comparison groups of pregnant women exposed to other antidepressants (N=212) and non-teratogenic exposures (N=212) were matched for maternal age (+/−2 years) alcohol and tobacco use and gestational age at time of initial call (+/−2 years). Statistical analysis was performed using Chi Squared. Among 213 escitalopram exposures were 172 (80.8%) live births, 32 (15.0%) spontaneous abortions, 3 (1.4%) stillbirth, 6 (2.8%) artificial abortions, 19 (8.9%) premature births and 4 (1.9%) major malformations. Mean birth weight of exposed infants was 3198 (plus/minus) 594 gram and mean gestational age at delivery was 38.6 (plus/minus) 2.2 weeks. Rates of spontaneous abortions were significantly higher in both antidepressant groups [17.3% escitalopram, 16.0% other antidepressants] in comparison to the non teratogen group (8.5%). The rate of low birth weight (<2500 grams) was higher in the escitalopram group (9.9%) compared to the other antidepressants (3.6%, P=0.038) and non-teratogens (2.1%, P=0.003). There were no differences in the rates of major malformations, premature births, stillbirths or NICU admissions. escitalopram exposure during pregnancy does not appear to increase the rate of major malformations above baseline (1-3%). However, the higher number of spontaneous abortions in both antidepressant groups confirms previous findings. The high rate of low birth weight requires further investigation.

Clinical Features and Efficacy of Escitalopram Treatment for Geriatric Depression

This study investigated the psychological characteristics and clinical features of 55 patients with geriatric depression, and evaluated the efficacy and safety of escitalopram in the treatment of geriatric depression, in a randomized controlled trial. Fifty-five patients with geriatric depression were randomly assigned to receive 8 weeks of escitalopram 10 mg, daily, orally (n = 29) or placebo (n = 26). At baseline, these patients had significantly higher neuroticism and psychoticism scores on the Eysenck Personality Questionnaire - Adult scale than Chinese population norms. General Severity Index scores and the mean values of the nine subscales of the Symptom Checklist-90 - Revised scale were also significantly higher in these patients than in Chinese population norms. The response rate to escitalopram after 8 weeks' treatment was 74.1% (20/27 patients). Adverse reactions included nausea, dry mouth and dizziness. In conclusion, depressed geriatric patients were found to have abnormal personality traits, and escitalopram was efficacious and had a good safety profile in the treatment of geriatric depression.

A control study on the curative effect and reliability of escitalopram with paroxetine for treatment of depression

Objective To evaluate efficacy and safety of escitalopram in treating depression. Methods In this randomized, double-blind, double-mimicry, paroxetine parallel controlled study,the study group was treated with escitalopram and the control group with paroxetine. Hamilton Rating Scale for Depression was taken to evaluate efficacy score. Results At the end of six weeks,compared with the total scores of HAMD before and after treatment, escitalopram (17.5±7.8) and paroxetine (16.0±7.9) group both showed the significant difference, while the difference compared between two groups ,the efficacy (87.0% and 81.7%) for depression and side effects were no significance. Conclusion Escitalopram is an efficient and safety antidepressant. Key words: Escitalopram; Paroxetine; Depression