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Escitalopram in adolescent major depression
James L Schaller1, David B Rawlings
1Professional Medical Services of Naples, Naples, Florida, USA.
Medgenmed : Medscape General Medicine
|December 22, 2005
Summary
Escitalopram, an SSRI antidepressant, shows promise for adolescents when other treatments fail. Parents and patients should know all options, as it may offer benefits over other SSRIs.
Area of Science:
- Psychiatry and Pharmacology
- Adolescent Mental Health Treatment
Background:
- Selective serotonin reuptake inhibitors (SSRIs) are commonly used for adolescent depression.
- Fluoxetine is the only FDA-approved SSRI for adolescents in the U.S., but other antidepressants are used clinically.
- Escitalopram, a purified isomer of citalopram, is prescribed globally but has limited adolescent studies.
Observation:
- Five adolescent cases utilized escitalopram due to prior SSRI treatment failure (poor response or side effects).
- Parents chose escitalopram, considering potential advantages over other SSRIs like paroxetine (obesity) and fluoxetine (akathisia).
Findings:
- Escitalopram demonstrated potential benefits including lower akathisia frequency compared to fluoxetine.
- It offered more stable long-term blood levels than sertraline and had very few drug interactions.
- A low starting dose (5 mg) was associated with a low onset of anxiety.
Implications:
- Escitalopram may be a viable alternative antidepressant for adolescents, particularly when other SSRIs are ineffective or cause intolerable side effects.
- Increased awareness of escitalopram's potential benefits and risks is crucial for informed psychopharmacological decisions in adolescent mental health.
- Further research into escitalopram's efficacy and safety in adolescent populations is warranted, building on the extensive data of its parent drug, citalopram.