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Study Compares Tolerability, Efficacy of 2 Antidepressants
The efficacy of escitalopram, compared with duloxetine, for the treatment of acute major depressive disorder varied over multiple measures, but escitalopram showed higher tolerability than duloxetine in a new study.
The systematic review and meta-analysis synthesized results from 3 randomized controlled trials that compared the 2 antidepressant medications in a total of 1200 patients with major depressive disorder. Researchers published the findings in Neuropsychiatric Disease and Treatment.
The meta-analysis found no significant differences between escitalopram and duloxetine on mean-changed scores on the Hamilton Depression Rating Scale (HAM-D) and the Clinical Global Impression-Severity scale, on the overall response rate on the HAM-D, or on remission rate using the HAM-D and Montgomery-Åsberg Depression Rating Scale (MADRS).
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Yet patients treated with escitalopram did demonstrate a greater mean-changed score on the MADRS, a greater mean-end score on the Clinical Global Impression-Improvement scale, and a greater overall response on the MADRS than patients treated with duloxetine.
“However, the remission rate was not different between 2 active agents,” researchers wrote.
In addition, patients tended to tolerate escitalopram better than duloxetine, the study found. However, the overall discontinuation rate did not significantly differ between the 2 antidepressants.
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“This review indicated that the efficacy in acute treatment of escitalopram vs duloxetine is varied and relies on measurement across the studies. However, the tolerability of escitalopram is superior to duloxetine in acute major depressive disorder treatment,” researchers wrote. “Based on this systematic review, selection between the 2 antidepressants may depend on the economic evaluation of each treatment as well as the tolerability of major depressive disorder patients.”
Noting the small number of studies eligible for review, researchers recommended more large-scale and well-defined randomized controlled trials to better clarify the differences in outcomes between the antidepressants.
—Jolynn Tumolo
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