Researchers evaluate SSRIs against older antidepressants, each other.

Medscape (5/14, Anderson) reported that, according to a meta-analysis published Apr. 15 in the Cochrane Database of Systematic Reviews, “sertraline, one of the oldest selective serotonin-reuptake inhibitors (SSRIs), is superior to a number of other antidepressants in terms of efficacy and tolerability.” For the study, researchers from Italy’s University of Verona “searched several medical databases, including MEDLINE and EMBASE,” and “included 59 randomized controlled trials allocating a total of 10,000 patients with major depression to sertraline or another antidepressant agent.” The investigators found that “sertraline proved more effective than fluoxetine and more acceptable or tolerable than amitriptyline, imipramine, paroxetine…and mirtazapine.” Notably, the team “uncovered some differences favoring newer antidepressants in terms of efficacy (mirtazapine) and acceptability (bupropion).” In a “second literature review, researchers searched medical databases for randomized controlled trials comparing escitalopram against any other antidepressant,” and found that “escitalopram was significantly more effective than citalopram…in achieving acute response and remission.”

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FDA approves escitalopram oxalate for acute, maintenance treatment of MDD in adolescents.

Following an AP story, Medscape (3/23, Hitt) reported that “escitalopram oxalate (Lexapro, Forest Laboratories, Inc.) has been approved by the US Food and Drug Administration (FDA) for the acute and maintenance treatment of major depressive disorder (MDD) in adolescents aged 12 to 17 years.” The FDA granted approval “based on data from two flexible-dose, placebo-controlled trials that each lasted eight weeks. One trial was conducted in adolescents aged 12 to 17 years and compared escitalopram with placebo,” while “the other trial was conducted in children and adolescents aged seven to 17 years and compared citalopram with placebo.” The results of both studies demonstrated “a significant improvement in the Children’s Depression Rating Scale-Revised (CDRS-R) in the treatment group compared with the placebo group,” with the “greatest benefit” being “observed in the adolescent group.”

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Can’t afford your psychiatric medications? Try these programs!

Zypreza, Strattera and Cymbalta
Seroquel
Zoloft and Geodon
Invega and Risperdal
Lamictal and Wellbutrin XL
Effexor XR and Pristiq
Abilify
Lexapro

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Antidepressant Poll

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Study indicates escitalopram may help treat generalized anxiety disorder in older adults.

 Bloomberg News (1/21, Ostrow) reports that, according to a study published in the Jan. 21 issue of the Journal of the American Medical Association, “Forest Laboratories, Inc.’s antidepressant Lexapro (escitalopram) aided older adults suffering from” generalized anxiety disorder (GAD). Researchers from Washington University in St. Louis, MO, found that nearly “70 percent of those aged 60 and older who took Lexapro improved in anxiety symptoms and social functioning, compared with about 51 percent of those given a dummy pill.” Still, lead author Eric Lenze, M.D., of Washington University, said that a combination of a selective serotonin reuptake inhibitor (SSRI) “and psychotherapy may provide more advantage.” Noting that the “overall benefit” of the medication is “modest,” Dr. Lenze stated, “This is not a cure-all. It doesn’t mean older adults shouldn’t take this medicine for an anxiety disorder; it means that medication alone won’t be sufficient.” For the study, the researchers “tested the effectiveness of Lexapro in 177 adults 60 and older suffering from” GAD, HealthDay (1/21, Reinberg) added. The participants “were randomly assigned to Lexapro or a placebo for 12 weeks.” The investigators found that participants “on Lexapro…had greater improvement in functioning, activity, and social functioning.” Notably, subjects “with high blood pressure taking Lexapro had a significant decrease in blood pressure,” thereby suggesting “some additional health-related benefits of getting treatment for anxiety in this age group,” Dr. Lenze explained. And, even though the team “used Lexapro for this study,” Dr. Lenze “believes that other SSRIs would produce the same beneficial effect.” WebMD (1/20, Doheny) pointed out that “SSRIs are medications prescribed for both anxiety and depression, and are thought to work by correcting an imbalance of the brain chemical serotonin.” Currently, experts estimate that “nearly one in 10 older adults” may be “affected by GAD,” and therefore may be exposed to “high levels of [the stress hormone] cortisol,” which may be “hard on one’s health.” In addition to “medication, treatment” of GAD “can include cognitive behavior therapy, also known as ‘talk therapy,’” Dr. Lenze said, adding, “Relaxation therapy can be effective at well.” Dr. Lenze emphasized that GAD is “distressing and burdensome,” but “people can get help. It is a treatable problem.”

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