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Meta-Analysis
. 2023 Nov 24;23(1):876.
doi: 10.1186/s12888-023-05382-8.

Escitalopram versus other antidepressive agents for major depressive disorder: a systematic review and meta-analysis

Juntao Yin #  1   2 , Xiaoyong Song #  1 , Chaoyang Wang  3 , Xuhong Lin  4 , Mingsan Miao  5
Affiliations
Meta-Analysis

Escitalopram versus other antidepressive agents for major depressive disorder: a systematic review and meta-analysis

Juntao Yin et al. BMC Psychiatry. .

Abstract

Background: Escitalopram is selective serotonin reuptake inhibitors (SSRIs) and one of the most commonly prescribed newer antidepressants (ADs) worldwide. We aimed to explore the efficacy, acceptability and tolerability of escitalopram in comparison with other ADs in the acute-phase treatment of major depressive disorder (MDD).

Methods: Medline/PubMed, EMBASE, the Cochrane Library, CINAHL, and Clinical Trials.gov were searched from inception to July 10, 2023. Trial databases of drug-approving agencies were hand-searched for published, unpublished and ongoing controlled trials. All randomized controlled trials comparing escitalopram against any other antidepressant for patients with MDD. Responders and remitters to treatment were calculated on an intention-to-treat basis. For dichotomous data, risk ratios (RRs) were calculated with 95% confidence intervals (CI). Continuous data were analyzed using standardized mean differences (with 95% CI) using the random effects model.

Results: A total of 30 studies were included in this meta‑analysis, among which sixteen trials compared escitalopram with another SSRI and 14 compared escitalopram with a newer AD. Escitalopram was shown to be significantly more effective than citalopram in achieving acute response (RR 0.67, 95% CI 0.50-0.87). Escitalopram was also more effective than citalopram in terms of remission (RR 0.53, 95% CI 0.30-0.93).

Conclusions: Escitalopram was superior to other ADs for the acute phase treatment of MDD in terms of efficacy, acceptability and tolerability. However, no significant difference was found between escitalopram and other ADs in early response or follow-up response to treatment of MDD.

Keywords: Antidepressant; Escitalopram; Major depressive disorder (MDD); Meta-analysis; Selective serotonin reuptake inhibitors (SSRI).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study selection
Fig. 2
Fig. 2
Failure to respond at endpoint (6–12 weeks): Escitalopram versus other SSRIs
Fig. 3
Fig. 3
Failure to respond at endpoint (6–12 weeks): Escitalopram versus newer ADs
Fig. 4
Fig. 4
Failure to remission at endpoint (6–12 weeks): Escitalopram versus other SSRIs
Fig. 5
Fig. 5
Subjects with at least one TEAE: Escitalopram versus other SSRIs
See this image and copyright information in PMC

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