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Cited by 178Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Disorders

A Double-Blind Comparison of Escitalopram and Venlafaxine Extended Release in the Treatment of Major Depressive Disorder

Bielski, Robert J., Ventura, Daniel, Chang, Chung-Chi·2004·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.v65n0906
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Abstract

BACKGROUND: Escitalopram is the most selective serotonin reuptake inhibitor (SRI) antidepressant available. Venlafaxine is a non-selective SRI that also inhibits noradrenergic re-uptake. This study compared escitalopram and venlafaxine extended release (XR) in depressed outpatients at the highest doses recommended in the United States. METHOD: In this randomized trial, patients (diagnosis of DSM-IV-defined major depressive disorder; baseline Hamilton Rating Scale for Depression score of >/= 20) received 1 week of single-blind placebo treatment, followed by 8 weeks of double-blind, fixed-dose treatment with either escitalopram or venlafaxine XR (rapidly titrated to 20 mg/day and 225 mg/day, respectively, in accordance with prescribing information). The primary efficacy variable was change from baseline to week 8 in Montgomery-Asberg Depression Rating Scale (MADRS) total score. Data were collected from May to December 2002. RESULTS: Mean baseline MADRS scores for the escitalopram (N = 97) and venlafaxine XR (N = 98) groups were 30.7 and 30.0, respectively. There were no significant differences in measures of efficacy between the 2 antidepressants. Mean changes from baseline to endpoint in MADRS total score for escitalopram and venlafaxine XR were -15.9 and -13.6, respectively. Remission (MADRS score of </= 10) rates at endpoint were 41.2% for escitalopram and 36.7% for venlafaxine XR. Response (>/= 50% reduction from baseline MADRS score) rates for the escitalopram and venlafaxine XR groups were 58.8% and 48.0%, respectively. Tolerability measures favored escitalopram over venlafaxine XR treatment. The venlafaxine XR group had a higher incidence than the escitalopram group of treatment-emergent adverse events (85.0% vs. 68.4%) and discontinuation due to adverse events (16.0% vs. 4.1%; p <.01). CONCLUSION: Results of this study indicate that, when titrated rapidly to their maximum recommended doses, escitalopram is at least as effective as venlafaxine XR and significantly better tolerated. These results do not support the hypothesis that nonselective SRIs have greater efficacy than selective SRIs.

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Authors
Bielski, R. J., Ventura, D., & Chang, C.-C.
Affiliations
Summit Research Network (US)
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2004-09-15
Volume
65
Issue
9
Pages
1190-1196
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.v65n0906
OpenAlex
W2068083208
Cited by
178
References
33
Citations by year
2025: 3 · 2024: 1 · 2023: 5 · 2022: 3 · 2021: 1 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 5 · 2015: 6 · 2014: 8 · 2013: 8 · 2012: 9
FWCI
11.94
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords
escitalopram, venlafaxine extended release, major depressive disorder, antidepressant efficacy, selective serotonin reuptake inhibitors, treatment-emergent adverse events, drug tolerability, outpatients, antidepressant comparison, treatment-resistant depression
MeSH terms
Venlafaxine Hydrochloride, Adolescent, Adult, Aged, Ambulatory Care, Cyclohexanols, Delayed-Action Preparations, Depressive Disorder, Double-Blind Method, Drug Administration Schedule, Female, Headache, Humans, Male, Middle Aged, Patient Dropouts, Psychiatric Status Rating Scales, Xerostomia, Citalopram, Treatment Outcome, Selective Serotonin Reuptake Inhibitors

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