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Increasing escitalopram dose is associated with fewer discontinuations than switch or combination approaches in patients initially on escitalopram 10mg.
MedLine Citation:
PMID:  21036548     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To examine the relationship between different intervention approaches and subsequent real-life outcomes in patients changing treatment from escitalopram 10mg.
METHOD: This was a retrospective cohort study of patients starting antidepressant treatment between 2002 and 2004. Data were extracted from a US health-insurance reimbursement claims database. Eligible patients started escitalopram 10mg and changed within 3 months to: escitalopram ≥20mg; another antidepressant; or a combination of escitalopram with another antidepressant. Medication persistence and healthcare costs over 3 months were compared between the treatment groups.
RESULTS: Overall, 37,791 patients started escitalopram 10mg. Of the 12,830 patients (34%) who changed treatment, 56% increased escitalopram dose, 26% switched antidepressant and 18% combined escitalopram with another antidepressant. Patients in the switch and combination groups had significantly higher rates of non-persistence (56% and 91%, respectively) vs the dose-increase group (39%; both P<0.001). Combination-group patients incurred significantly greater costs vs the dose-increase group ($2805 vs $1767, respectively; P<0.001).
CONCLUSION: Results suggest that increasing escitalopram dose in patients responding inadequately to 10mg is associated with higher persistence rates vs the other treatment approaches. Receiving an increased dose of escitalopram was associated with significantly lower costs than combining escitalopram 10mg with another antidepressant.
Authors:
T Sanglier; D Milea; D Saragoussi; M Toumi
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Publication Detail:
Type:  Journal Article     Date:  2010-10-30
Journal Detail:
Title:  European psychiatry : the journal of the Association of European Psychiatrists     Volume:  27     ISSN:  1778-3585     ISO Abbreviation:  Eur. Psychiatry     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111820     Medline TA:  Eur Psychiatry     Country:  France    
Other Details:
Languages:  eng     Pagination:  250-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
International Epidemiology Department, Clinical Research and Medical Affairs, Lundbeck SAS, 43-45, quai du Président-Roosevelt, 92445 Issy-les-Moulineaux, France.
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