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Melatonin, Neuroprotective Agents and Antidepressant Therapy pp 465–476Cite as

Antidepressant Efficacy of Escitalopram in Major Depressive Disorder

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Abstract

Escitalopram (escitalopram oxalate; Cipralex®, Lexapro®) is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) and anxiety disorder. This drug exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Escitalopram also has allosteric activity. Moreover, the possibility of interacting with other drugs is considered low.

This review covers randomized, controlled studies that enrolled adult patients with MDD to evaluate the efficacy of escitalopram based on the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HAM-D). The results showed that escitalopram was superior to placebo and nearly equal or superior to other SSRIs (e.g., citalopram, paroxetine, fluoxetine, sertraline) and serotonin noradrenaline reuptake inhibitors (SNRIs) (e.g., duloxetine, sustained-release venlafaxine). In addition, with long-term administration, escitalopram had a preventive effect on MDD relapse and recurrence.

Escitalopram also showed favorable tolerability, and associated adverse events were generally mild and temporary. Discontinuation symptoms were milder with escitalopram than with paroxetine.

In view of the patient acceptability of escitalopram, based on both a meta-analysis and a pooled analysis, this drug was more favorable than other new antidepressants. The findings indicated that escitalopram achieved high continuity in antidepressant drug therapy.

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Acknowledgments

The authors have no conflicts of interest to report.

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Authors and Affiliations

  1. Department of Psychiatry, Juntendo University Shizuoka Hospital, 1129 Nagaoka Izunokunishi, Shizuoka, 4102211, Japan

    Eiji Kirino MD, PhD

  2. Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan

    Eiji Kirino MD, PhD

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  1. Eiji Kirino MD, PhD
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Correspondence to Eiji Kirino MD, PhD .

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Editors and Affiliations

  1. Vice-Rectorate for Research and Sci, Camilo José Cela University Vice-Rectorate for Research and Sci, Madrid, Spain

    Francisco López-Muñoz

  2. International Medical Sciences Research Study Center, Sri Sathya Sai Medical Educational & Research Foundation, Coimbatore, India

    Venkataramanujam Srinivasan

  3. Department of Neurosciences and Ima, University of Chieti Department of Neurosciences and Ima, Italy, Italy

    Domenico de Berardis

  4. Department of Biomedical Sciences (Pharmacology Area), University of Alcalá, Madrid, Spain

    Cecilio Álamo

  5. Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan

    Takahiro A. Kato

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Kirino, E. (2016). Antidepressant Efficacy of Escitalopram in Major Depressive Disorder. In: López-Muñoz, F., Srinivasan, V., de Berardis, D., Álamo, C., Kato, T. (eds) Melatonin, Neuroprotective Agents and Antidepressant Therapy. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2803-5_30

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  • DOI: https://doi.org/10.1007/978-81-322-2803-5_30

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