Escitalopram in the treatment of major depressive disorder: clinical efficacy, tolerability and cost-effectiveness vs. venlafaxine extended-release formulation
Summary Major depressive disorder (MDD), a prevalent and serious mental illness, is associated with a substantial disease and economic burden. Long‐term pharmacotherapy is often necessary; selective serotonin reuptake inhibitors (SSRIs) or the serotonin–noradrenaline reuptake inhibitor venlafaxine a...
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Published in | International journal of clinical practice (Esher) Vol. 61; no. 4; pp. 702 - 710 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.04.2007
Blackwell |
Subjects | |
Online Access | Get full text |
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Summary: | Summary
Major depressive disorder (MDD), a prevalent and serious mental illness, is associated with a substantial disease and economic burden. Long‐term pharmacotherapy is often necessary; selective serotonin reuptake inhibitors (SSRIs) or the serotonin–noradrenaline reuptake inhibitor venlafaxine are the most frequently prescribed medications in patients with moderate‐to‐severe depressive symptoms. This article reviews head‐to‐head clinical studies and health economic models comparing the efficacy, tolerability and cost‐effectiveness of escitalopram, a dual‐action selective inhibitor of serotonin reuptake, and the extended‐release (XR) formulation of venlafaxine. While there has been some evidence that conventional SSRIs are inferior to venlafaxine in terms of efficacy, escitalopram was at least as effective as venlafaxine XR in reducing Montgomery‐Åsberg Depression Rating Scale scores from baseline in two short‐term (8‐week) comparative studies. Furthermore, escitalopram had potentially important advantages over venlafaxine XR in terms of time to remission, tolerability and discontinuation (withdrawal) symptoms. The results of economic evaluations, including a ‘gold standard’ prospective study conducted alongside one of the studies are consistent in suggesting that escitalopram offers a more cost‐effective alternative to venlafaxine XR for the treatment of MDD, both from a healthcare and societal perspective. Based on this evidence, it is concluded that escitalopram is at least as effective as venlafaxine XR in the treatment of MDD, but is better tolerated and may also have cost advantages. |
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Bibliography: | Supporting info item ark:/67375/WNG-C169D4XS-T istex:B019326B3D835E88137A3E8F813DF56E6D909EA2 ArticleID:1335 Disclosures Prof. Llorca declares that he has received research grants and/or honoraria from AstraZeneca, Eli Lilly, Lundbeck, Janssen Cilag, Pfizer, Servier, Bristol Myers Squibb and Wyeth. Dr Fernandez declares that he accepts no personal retainers from or owns shares in any pharmaceutical company nor does any dependent member of his family. He has acted as a consultant to a number of corporations with an interest in anxiety and depressive disorders, including EISAI, Lundbeck and Pfizer. He holds or has held research grants (on behalf of his employer) from a number of corporations with an interest in anxiety and depressive disorders, including Lundbeck. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 |
ISSN: | 1368-5031 1742-1241 |
DOI: | 10.1111/j.1742-1241.2007.01335.x |