An open trial of adjunctive escitalopram in bipolar depression

Manoela Fonseca, Jair C. Soares, John P. Hatch, Aida P. Santin, Flavio Kapczinski

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective: This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic antidepressant, escitalopram, in the treatment of bipolar depression. Method: Twenty outpatients with DSM-IV bipolar depression types I and II were enrolled in a 12-week open trial of escitalopram, 10 mg daily, adjunctive to their ongoing mood stabilizer. Assessments were carried out using the Hamilton Rating Scale for Depression (HAM-D), the Young Mania Rating Scale (YMRS), and the Clinical Global Impressions for Severity (CGI-S) and Improvement (CGI-I) scales. The study was conducted from August 2003 to February 2004. Results: Escitalopram was associated with significant improvement as measured by the HAM-D total score, which showed a mean reduction from baseline (mean = 20.9, SD = 4.2) to endpoint (mean = 8.9, SD = 3.6; p < .001) of 12 points. The mean CGI-S score decreased by 3.3 points (baseline: mean = 4.8, SD = 0.7; week 12: mean = 1.5, SD = 0.6; p < .001). Adverse events emerged in 75% of the patients (N = 15), usually of mild-to-moderate severity. Four dropouts took place due to manic switch (N = 1), hypomanic symptoms (N = 2), and hospitalization due to the emergence of suicidal ideation and psychosis (N = 1). Conclusion: These findings suggest that escitalopram in association with mood stabilizers may be an effective and reasonably well-tolerated treatment for patients with moderate-to-severe bipolar depression. The switch rate was similar to what is described in the literature for the selective serotonin reuptake inhibitors. Randomized controlled trials of escitalopram in bipolar depression are warranted.

Original languageEnglish (US)
Pages (from-to)81-86
Number of pages6
JournalJournal of Clinical Psychiatry
Issue number1
StatePublished - Jan 2006

ASJC Scopus subject areas

  • Psychiatry and Mental health


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