Efficacy, effectiveness and efficiency of escitalopram in the treatment of major depressive and anxiety disorders

Abstract

In addition to the large personal challenge that depression and anxiety present, these disorders are associated with a substantial burden of disability and lost productivity, and are responsible for considerable strain on healthcare resources and on society. Escitalopram is recommended as first-line therapy for the treatment of major depressive disorder and severe depression, and is indicated in anxiety disorders. Compared with other antidepressants, escitalopram has equal or superior efficacy, as proven in clinical trial settings, equal or superior real-life effectiveness, established in both clinical and observational studies, and a better tolerability profile. While drug acquisition costs are higher for escitalopram than for generic drugs such as fluoxetine and citalopram, numerous prospective and modeled economic analyses show that associated direct and indirect costs of treatment are lower with escitalopram than with citalopram, fluoxetine, sertraline and venlafaxine. Thus, escitalopram appears to be more economically efficient than many antidepressants currently available. Escitalopram has a prominent role in the treatment of major depressive disorder and anxiety disorders, and may also prove to be important in the treatment of mixed depressive anxiety disorder.

Keywords::

• anxiety disorders
• cost–effectiveness
• escitalopram
• health outcomes
• major depressive disorder
• obsessive–compulsive disorder
• panic disorder
• pharmacoeconomics

Financial & competing interests disclosure

R Lam is on speaker/advisory boards for, or has received research grants from ANS, Inc., AstraZeneca, Biovail, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Eli Lilly, GlaxoSmithKline, GreatWest Life, Janssen, Litebook Company, Ltd., Lundbeck, Sanofi-Aventis, Servier, VGH and UBC Hospital Foundation, and Wyeth.

L Annemans is on speaker/advisory boards, or has received research grants related to research in mood disorders from Cyberonics, Eli Lilly, Lundbeck, Sanofi-Aventis and Wyeth. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. The authors would like to thank Natalie Barker, a medical writer funded by H Lundbeck A/S, for writing assistance provided in the preparation of this manuscript.