Lexapro® curbs risk of recurrent depression

Maintenance therapy with the antidepressant Lexapro® (also known as escitalopram) significantly reduces the risk for recurrent depression, according to study findings.

"Escitalopram is another treatment option that has now been shown to be effective for maintenance treatment of major depressive disorder," Dr. Susan G. Kornstein from Virginia Commonwealth University, Richmond, told Reuters Health.

"This study also reinforces the importance of maintenance antidepressant therapy for patients with recurrent major depressive disorder in order to prevent future recurrences of depression."

Kornstein and colleagues investigated the preventive effect of escitalopram maintenance treatment in 139 patients who had responded to treatment with another similar antidepressant and maintained that response when switched to escitalopram for continuation therapy.

"All patients with a major depressive episode need acute phase treatment to get their symptoms into remission, followed by continuation phase treatment to prevent that episode from returning (which would be called a relapse)," Kornstein explained.

"Then, for patients who have had a recurrent course of illness, which is the case for most patients with major depressive disorder, maintenance treatment is also needed in order to prevent future episodes of depression."

Time to recurrence of depression in the current study was significantly longer for escitalopram-treated patients - on average 252 days with escitalopram versus 130 days with placebo, the authors report.

Cumulative recurrence rates were 27 percent for the escitalopram group and 65 percent for the placebo group.

Escitalopram treatment was safe and well tolerated, the researchers note.

"Escitalopram continuation treatment over a period of 36 weeks has been previously shown to prevent relapse of depression. The current study extends those findings to demonstrate the efficacy of escitalopram in maintenance treatment," the team concludes.

"I have no particular reason to believe," Kornstein emphasized, "that escitalopram would be better for maintenance treatment than another SSRI (selective serotonin reuptake inhibitor), but there have been no studies comparing one SSRI with another for maintenance treatment, so we can't really answer that question."

"But even if a study were done and didn't show an overall difference, there may be differences for individual patients in treatment response with one drug versus another - even ones from the same class - so it's important to have a number of different options to offer patients."

SOURCE: Journal of Clinical Psychiatry, November 2006.