The Effect and Reliability of Escitalopram in the Treatment of Adolescents With Major Depressive Disorder or Anxiety Disorders
Overview
- Phase
- Phase 4
- Intervention
- Escitalopram
- Conditions
- Major Depressive Disorder
- Sponsor
- Erzurum Regional Training & Research Hospital
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- The Hamilton Anxiety Rating Scale
- Last Updated
- 9 years ago
Overview
Brief Summary
Escitalopram has been approved by FDA in the treatment of adolescents with major depressive disorder since March 2009. To date, there are only 3 clinical trials assessing the effect and validity of escitalopram on major depressive disorder, which of them has resulted in inconsistent findings. In the present study, the authors aimed to assess the effect and validity of this drug in the treatment of adolescents with major depressive disorder and or anxiety disorders.
Detailed Description
Escitalopram has been approved by FDA in the treatment of adolescents with major depressive disorder since March 2009. Although Wagner and colleagues reported that escitalopram has a tendency toward positive findings for the treatment of pediatric patients with major depressive disorder in their study it was found that this effect has not reached a statistical significance. Noteworthy the authors reported statistical significance for escitalopram when they only included adolescent subgroup into further analysis. However, there are also clinical trials in the literature reporting the effectiveness of escitalopram on adolescence major depressive disorder (Emslie, Findling). It was indicated that no serious adverse effect of escitalopram was reported in these studies comparing escitalopram with placebo. In this study the authors aimed to investigate the effect and reliability of the drug in the treatment of adolescents with major depressive disorder and/or anxiety disorders. Additionally, cognitive behavioral therapy and SSRIs are indicated for the first-line treatment of anxiety disorders. The authors included escitalopram for the treatment of pediatric anxiety disorders.
Investigators
Muharrem Burak Baytunca
Child Psychiatry Consultant, MD
Erzurum Regional Training & Research Hospital
Eligibility Criteria
Inclusion Criteria
- •drug-naive
- •being in the age range of 12-18
- •lack of any psychiatric comorbidity, except for ADHD-like problems during the illness
- •IQ level\> 80
- •lack of history of any major medical disease, substance abuse
Exclusion Criteria
- •inappropriate age
- •history of drug abuse, major medical disease
- •mental retardation
- •any psychotropic drug use
- •hospitalization required for suicidal ideation/behavior
Arms & Interventions
Major depressive disorder
In this group, adolescents with major depressive disorder will be recruited. It was planned to include 30 participants.Escitalopram treatment will be given to those with Major Depressive Disorder with a starting dose of 2.5 mg day. The treatment dose will be gradually increased up to 20 mg day (if necessary) and the maximal treatment dose was determined as 30 mg day in each group.
Intervention: Escitalopram
Anxiety disorders
In this group, adolescents with anxiety disorders will be recruited. It was planned to include 30 participants. Additionally, the specification of which anxiety disorders are assigned to the participants will also be provided. Escitalopram treatment will be given to participants with anxiety disorders with a starting dose of 2.5 mg day. The treatment dose will be gradually increased up to 20 mg day (if necessary) and the maximal treatment dose was determined as 30 mg day in each group.
Intervention: Escitalopram
Outcomes
Primary Outcomes
The Hamilton Anxiety Rating Scale
Time Frame: will be assessed in the 1st, 2nd and 6th month of the treatment in anxiety disorders arm.
The authors will compare 3-time points of the treatment in the study. The first assessment point will be the starting point of the study and the other ones are 2nd and 6th months of the treatment course. Total scores of the Hamilton Anxiety scale of the 3-time points will be recorded. Change in the scores of the starting point and 2nd month of the treatment will be compared. A decrease in the Hamilton Anxiety score at the 2nd month of the treatment with a percentage of 50% or above will be considered as positive treatment response. Any scores on the Hamilton Anxiety scale below 15 points at the 6th month of treatment course will be accepted as remission.
Clinical Global Impression Scale (CGI)
Time Frame: will be assessed in the 1st, 2nd and 6th month of the treatment.
The authors will compare 3-time points of the treatment in the study. The first assessment point will be the starting point of the study and the other ones are 2nd and 6th months of the treatment course. Total scores of the CGI scale of the 3-time points will be recorded. Change in the scores of the starting point and 2nd month of the treatment will be compared. A decrease in the CGI score at the 2nd month of the treatment with a percentage of 50% or above will be considered as positive treatment response. The CGI score at the 6th month of the study with a result of 2 points or below will be accepted as remission.
The Hamilton Rating Scale for Depression
Time Frame: will be assessed in the 1st, 2nd and 6th month of the treatment in major depressive disorder arm.
The authors will compare 3-time points of the treatment in the study. The first assessment point will be the starting point of the study and the other ones are 2nd and 6th months of the treatment course. Total scores of the Hamilton Depression scale of the 3-time points will be recorded. Change in the scores of the starting point and 2nd month of the treatment will be compared. A decrease in the Hamilton Depression scale score at the 2nd month of the treatment with a percentage of 50% or above will be considered as positive treatment response. Any scores on the Hamilton Depression scale below 8 points at the 6th month of treatment course will be accepted as remission.