Current treatment options: relief of symptoms and ultimate recovery

The inadequate outcome of existing antidepressant therapies has led to a shift in the expectations of optimal treatment toward remission rather than response. Important benchmarks for newer antidepressant treatments in the management of major depressive disorder (MDD) include early response and remission leading to recovery, regardless of severity. Preliminary data from a pooled analysis of trials, in which escitalopram was compared with selective serotonin reuptake inhibitors (SSRIs) and the selective serotonin noradrenaline reuptake inhibitor (SNRI) venlafaxine, suggest a faster onset of action compared with other SSRIs. In a further pooled analysis, a significant advantage in response and remission in favor of escitalopram against comparator SSRIs and venlafaxine was demonstrated. Studies appear to suggest that not only is escitalopram effective in depression, its superiority over comparators increases with baseline severity. Thus, escitalopram may satisfy many of the goals for the new generation of antidepressants in the management of MDD.