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Escitalopram More Effective Than Maprotiline for Treatment of Sleep Disturbances in Major Depressive Disorder: Presented at EPA By Chris Berrie LISBON, Portugal -- January 26, 2009 -- The specific serotonin reuptake inhibitor escitalopram shows significantly improved efficacy and fewer adverse effects than the tetracyclic antidepressant maprotiline for patients with sleep disturbances associated with major depressive disorder (MDD), according to a prospective, randomised, controlled clinical study. Coinvestigator Nebojsa Zivkovic, MD, Emergency Psychiatry, "Laza Lazarevic" Institute for Neuropsychiatry, Belgrade, Serbia, discussed the study findings in a presentation on January 25 here at the 17th European Congress of Psychiatry, organised by the European Psychiatric Association (EPA). The aim of the study was to determine the efficacy and safety of the selective serotonin reuptake inhibitor escitalopram in the treatment of sleep disturbances in patients with MDD, in comparison with the tetracyclic antidepressant maprotiline. Ninety-five patients diagnosed with MDD according to the International Classification of Diseases criteria were enrolled in the study. The researchers randomised 30 of these patients to receive maprotiline 75 to 150 mg/24 hours and 65 to escitalopram 10 to 20 mg/24 hours. Dr. Zivkovic also stressed, "We give the escitalopram as an evening dose, which is new, because it promotes sleep." Patient assessments were carried out according to the Hamilton Depression Rating Scale (HAM-D) and the Leeds Sleeping Evaluation Questionnaire (LSEQ). These scores were recorded on day 1 (baseline) and days 30 and 180 of treatment. Following randomisation, there were no significant differences seen across the control and escitalopram treatment groups at baseline for HAM-D scores (30.5 vs 30.0, respectively), and for the LSEQ scores for "feeling on wakening" (20 vs 21) and "quality of sleep" (21 vs 20). After 6 months of treatment, patients in the escitalopram group showed significantly better HAM-D scores over the maprotiline group (12.0 vs 17.5, respectively; P < .001). Similarly, the feeling and quality LSEQ scores were significantly better for escitalopram treatment compared with maprotiline (54 vs 63, P < .001; 53 vs 67, P < .001; respectively). The percentage of patients experiencing adverse events was significantly lower for escitalopram over maprotiline (10.8% vs 26.7%; P < .01). Dr. Zivkovic said that these data confirmed that evening doses of escitalopram had significantly better efficacy compared with maprotiline in the treatment of sleep disturbances in patients with MDD. [Presentation title: Escitalopram in Treatment of Sleep Disturbances in Major Depressive Disorder. Abstract P1189] E-mail this page to a friend or colleague! To print, use this version