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 journalArticle

18 Citations (Scopus)

Abstract

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
Volume67
Issue number1
StatePublished - Jan 2006

Fingerprint

Citalopram
Bipolar Disorder
Suicidal Ideation
Serotonin Uptake Inhibitors
Diagnostic and Statistical Manual of Mental Disorders
Psychotic Disorders
Antidepressive Agents
Hospitalization
Outpatients
Randomized Controlled Trials
Depression
Safety
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Fonseca, M., Soares, J. C., Hatch, J. P., Santin, A. P., & Kapczinski, F. (2006). An open trial of adjunctive escitalopram in bipolar depression. Journal of Clinical Psychiatry, 67(1), 81-86.

An open trial of adjunctive escitalopram in bipolar depression. / Fonseca, Manoela; Soares, Jair C.; Hatch, John P.; Santin, Aida P.; Kapczinski, Flavio.

In: Journal of Clinical Psychiatry, Vol. 67, No. 1, 01.2006, p. 81-86.

Research output: Contribution to journalArticle

Fonseca, M, Soares, JC, Hatch, JP, Santin, AP & Kapczinski, F 2006, 'An open trial of adjunctive escitalopram in bipolar depression', Journal of Clinical Psychiatry, vol. 67, no. 1, pp. 81-86.
Fonseca M, Soares JC, Hatch JP, Santin AP, Kapczinski F. An open trial of adjunctive escitalopram in bipolar depression. Journal of Clinical Psychiatry. 2006 Jan;67(1):81-86.
Fonseca, Manoela ; Soares, Jair C. ; Hatch, John P. ; Santin, Aida P. ; Kapczinski, Flavio. / An open trial of adjunctive escitalopram in bipolar depression. In: Journal of Clinical Psychiatry. 2006 ; Vol. 67, No. 1. pp. 81-86.
@article{724bbd253224433d96af744a870abc94,
title = "An open trial of adjunctive escitalopram in bipolar depression",
abstract = "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.",
author = "Manoela Fonseca and Soares, {Jair C.} and Hatch, {John P.} and Santin, {Aida P.} and Flavio Kapczinski",
year = "2006",
month = "1",
language = "English (US)",
volume = "67",
pages = "81--86",
journal = "The Journal of clinical psychiatry",
issn = "0160-6689",
publisher = "Physicians Postgraduate Press Inc.",
number = "1",

}

TY - JOUR

T1 - An open trial of adjunctive escitalopram in bipolar depression

AU - Fonseca, Manoela

AU - Soares, Jair C.

AU - Hatch, John P.

AU - Santin, Aida P.

AU - Kapczinski, Flavio

PY - 2006/1

Y1 - 2006/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=32244449256&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=32244449256&partnerID=8YFLogxK

M3 - Article

C2 - 16426092

AN - SCOPUS:32244449256

VL - 67

SP - 81

EP - 86

JO - The Journal of clinical psychiatry

JF - The Journal of clinical psychiatry

SN - 0160-6689

IS - 1

ER -