Escitalopram in the treatment of major depressive disorder in primary-care settings: an open-label trial

Background: The present trial was designed to assess the efficacy and safety of escitalopram prescribed to patients seeking treatment of major depressive disorder (MDD) in a Canadian primary‐care setting. Methods: Investigators (mainly primary‐care physicians) enrolled patients with MDD from their daily practice. Patients were treated with escitalopram (flexible dose 10–20 mg/day) for up to 24 weeks. Efficacy assessments included the Montgomery–Åsberg Depression Rating Scale (MADRS), the Clinical Global Impression‐Improvement and ‐Severity scales (CGI‐I, CGI‐S), the Patient Global Evaluation (PGE), and the Medical Outcome Study 36‐item Short Form (SF‐36). Results: Out of the 647 patients enrolled, 461 (71%) completed 24 weeks of treatment. The most common reason for discontinuation was adverse events (10%). The mean MADRS score decreased from 30.7 at baseline to 10.9 at the end of 24 weeks (last observation carried forward, LOCF). Remission (MADRS≤12) was achieved by 65.5% of patients (LOCF). Symptom improvements were confirmed by global ratings of improvement made by physicians (CGI‐I) as well as patients PGE. There was improvement on all dimensions of the SF‐36, suggesting an overall improvement in quality of life. Conclusions: Escitalopram was well tolerated, safe, and efficacious. Escitalopram can be used with confidence to treat patients with MDD in Canadian primary‐care settings. Depression and Anxiety, 2008. © 2008 Wiley‐Liss, Inc.