Early non-response in patients with severe depression: escitalopram up-titration versus switch to duloxetine.

Clinical Drug Investigation
Anjana BoseDayong Li

Abstract

Comparative evidence for second-step treatment strategies in severe depression is scarce. Up-titrating a well tolerated selective serotonin reuptake inhibitor (SSRI) versus switching to a serotonin norepinephrine reuptake inhibitor (SNRI) after initial SSRI non-response are possible treatment options. It is often unclear whether relevant tolerability and efficacy differences exist between SSRI up-titration versus switch to an SNRI. The objective of this study was to evaluate tolerability and efficacy of up-titration of escitalopram versus switch to duloxetine in patients who failed to respond to escitalopram 10 mg/day. This was an active-controlled, parallel-group, double-blind, randomized study in a general community comparing escitalopram and duloxetine in patients with severe depression; patients who did not respond (<50% Montgomery-Åsberg Depression Rating Scale [MADRS] improvement) to 2 weeks of single-blind escitalopram 10 mg/day during the lead-in period were randomized to 8 weeks of double-blind treatment. 571 male and female outpatients aged 18-65 years with severe depression (MADRS total score ≥30) participated in the study and received at least one dose of escitalopram 10 mg/day in the single-blind lead-in phase. Dur...Continue Reading

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Feb 18, 2016·L'Encéphale·E Haffen, E Poulet
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