Efficacy and safety of escitalopram in elderly patients with major depression:A randomized and control study

Objective:To evaluate the efficacy and safety of escitalopram in elderly patients with major depression.Method:This was an 8 weeks,randomized control and open-label study.Totally 107 elderly patients were randomly assigned to escitalopram group(n=52)or paroxetin group(n=55).The efficacy was evaluated with the Hamilton Rating Scale for Depression(HRSD)and Geriatric Depression Scale(GDS).The Treatment Emergent Symptom Scale(TESS)was used to evaluate the side effects caused by the antidepressants.Intent to Treat Analysis(ITT)was used to process study data,and Last Observation Carried Forward(LOCF)was adopted to deal with missing value caused by withdrawing patients during 8-week observation.Results:The 8-week drop rate in escitalopram group was lower than that in paroxetine group(21% vs.40.0%,P=0.034).In patients who completed 8-week trial,the difference of symptom improvement rate between escitalopram group and paroxetine group was not statistically significant(P0.05).ITT analysis showed that at the end of 8-week observation,there was no statistically difference in efficacy between the two groups.But escitalopram group showed earlier improvement in depressive symptoms than paroxetine group(e.g.GDS score at the end of the 1st week,(13.7±4.5)vs.(17.3±5.1),P0.001;HRSD score at the end of the 2nd week,(16.6±3.5)vs.(24.4±6.1),P0.001),and lower rate of adverse reactions than paroxetine group(28.8% vs.47.3%,P0.05).Conclusion:Escitalopram in the treatment of depression in elderly patients may have better efficacy and tolerance than paroxetine.