Escitalopram in the treatment of Malaysian patients with Obsessive-compulsive disorder

Objective: This post-hoc analysis examined the efficacy and tolerability of escitalopram in the prevention of relapse in Malaysian patients with obsessive-compulsive disorder. Participants and Methods: In Malaysia, 47 patients with obsessive-compulsive disorder were treated with open-label escitalopram (10 mg or 20 mg/day) for 16 weeks, after which the 34 responders (Yale-Brown Obsessive Compulsive Scale total decrease score, 25) were randomised to placebo or escitalopram for 24 weeks, using a double-blind protocol. Results: The primary efficacy analysis suggested a trend in favour of escitalopram treatment with respect to time to relapse (log-rank test, p = 0.07). A higher proportion of patients relapsed after placebo treatment (5 of 14, 36) than with escitalopram treatment (2 of 20, 10) Fishers exact test, 2-sided; p = 0.10. The risk of relapse was 4-fold higher for placebo than escitalopram treatment (p = 0.09). During the double-blind period, the proportion of patients reporting treatment-emergent adverse events was comparable in the 2 groups (10% in the escitalopram group vs. 14% in the placebo group); no serious events being reported. Conclusions: This post-hoc subgroup analysis suggests that escitalopram is well tolerated in Malaysian patients with obsessive-compulsive disorder and appears to confer an advantage over placebo, in terms of time to relapse and other efficacy variables

Citalopram 20 mg, 40 mg and 60 mg are all effective and well tolerated compared with placebo in obsessive-compulsive disorder

Serotonin reuptake inhibitors appear to be uniquely effective treatments for obsessive-compulsive disorder (OCD). This double-blind, placebo-controlled study was the first trial to assess the efficacy of the most selective of the serotonin reuptake inhibitors, citalopram, in OCD. A total of 401 patients were randomized to receive citalopram 20, 40 or 60 mg/day or placebo for 12 weeks. All three doses of citalopram were significantly more effective than placebo measured on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) change score (P < 0.01). The highest response rate, defined as 25% improvement in Y-BOCS entry score, was observed in the 60 mg group (65%). This compared with 52% and 57.4% in the 40 mg and 20 mg groups. Response rate on placebo was 36.6% (P < 0.05 for all three doses of citalopram compared to placebo). There was no significant difference between the individual doses of citalopram. An advantage was seen for citalopram on the Sheehan Disability Scale compared with placebo (P < 0.05 on all three citalopram groups versus placebo for both the work situation and the family life and home responsibilities and P < 0.05 on citalopram 60 mg and 20 mg versus placebo for the social life and home activities). Citalopram was well tolerated; only 4 to 6 patients in each dose group discontinued the study prematurely due to adverse events. © 2001 Lippincott Williams & Wilkins.Articl