Forest's successor to Celexa more effective

Forest Laboratories has presented the results from several clinicalstudies at the annual meeting of the American Psychiatric Association in New Orleans, USA, which demonstrate that Cipralex (escitalopram), the second-generation, single-isomer version of its antidepressant Celexa (citalopram), showed greater improvement, relative to placebo, over the original in reducing the symptoms of major depression.

The double-blind, placebo-controlled study involved 491 patients with ongoing major depressive episodes who were randomized for eight weeks in one of four trial arms: placebo, citalopram 40mg per day, escitalopram 10mg per day and escitalopram 20mg per day. The primary endpoint, defined by the Montgomery-Asberg Depression Rating Scale, demonstrated that both doses of escitalopram statistically separated from placebo at week two, and maintained that separation at all time points to a greater degree than citalopram.

There was no difference between the three trial groups in the incidence of discontinuations due to adverse effects, which included diarrhea, nausea, insomnia and dry mouth. William Burke, professor of psychiatry at the University of Nebraska Medical School, USA, attributed the low discontinuation rates of escitalopram to its high tolerability.