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| |  APA: Escitalopram Appears to Achieve Better Tolerability Than Venlafaxine XR Among Patients with Depression By Bruce Sylvester NEW YORK, NY -- May 10, 2004 -- Escitalopram achieved a better risk/benefit profile than did venlafaxine XR in the treatment of depression, according to the findings of a randomized, head-to-head, double-blind study "The most significant finding in this study is the differences in tolerability of the 2 drugs. Escitalopram patients discontinued at a far lower rate due to side effects or adverse events than venlafaxine-treated patients, and this difference was statistically significant, " said lead researcher Robert Bielski, MD, clinical director at Summit Research Network Institute in Okemos, Michigan. Dr. Bielski reported the study's findings here on May 6th at the American Psychiatric Association Annual Meeting. The investigators enrolled 195 subjects presenting with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-defined episode of major depressive disorder (baseline HAMD, Hamilton Depression Rating Scale € 20). All the subjects began the study with 1 week of single-blind placebo treatment. Ninety-seven patients then received 8 weeks of double-blind fixed-dose treatment with escitalopram and 98 with venlafaxine XR, titrated to 20 mg/day and 225 mg/day, respectively, and following standard prescribing information. Mean change from baseline to endpoint in MADRS (Montgomery-Asberg Depression Rating Scale) scores was the primary end point measurement. The investigators defined remission as end point MADRS score € 10. Response was defined as a 50% or greater reduction from baseline MADRS scores. The mean baseline MADRS scores were 30.7 for escitalopram and 30.0 for venlafaxine XR and indicated moderate-to-severe illness. The investigators found at endpoint that escitalopram was at least as effective for symptoms of depression as venlafaxine XR, with mean changes in MADRS scores from baseline to endpoint of -15.9 and - 13.6, respectively (P =.12). The researchers also found that remission rates at endpoint were 41.2% for escitalopram and 36.7% for venlafaxine, and that response rates were 58.8% and 48.0% for escitalopram and venlafaxine XR, respectively. In terms of tolerability, significantly more venlafaxine patients withdrew from the study due to adverse events, with withdrawal at 16.0% for venlafaxine XR and 4.1% for escitalopram, P <.01. The research was supported by Forest Laboratories, Inc.
[Presentation title: "Double-blind comparison of escitalopram and venlafaxine extended release in the treatment of MDD." Abstract #NR773]
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