New Treatment Strategy for the Prevention of Recurrent Depression
Sathya Achia Abraham
VCU Communications and Public Relations
(804) 827-0890
sbachia@vcu.edu
11/6/2006
Some patients who experience recurrent depression may benefit
from long-term maintenance treatment with anti-depressant medication, according to a new
study led by a Virginia Commonwealth University researcher.
Major depressive disorder is a recurrent condition that can have
a profound impact on an individual's quality of life. In the United
States, approximately 17 percent of individuals
will experience major depressive disorder during their lifetime.
Of those who experience one episode of major depression,
more than 50 percent will have a recurrence. After two episodes, more than 70
percent of patients will have a recurrence, and after three episodes that
figure jumps to 90 percent. Each episode poses a new risk that the depression
may not respond to treatment, making prevention of recurrent depression an
important focus of long-term treatment.
In the November
issue of the Journal of Clinical Psychiatry, Susan G. Kornstein, M.D., a professor of psychiatry
and obstetrics and gynecology in VCU's School of Medicine and lead author on
the study, reported with her colleagues that maintenance
treatment with
escitalopram, a
selective serotonin reuptake inhibitor (SSRI) approved for the treatment of depression,
may reduce the risk of recurrent depression in patients with major
depressive disorder.
Between
2000 and 2003, researchers evaluated approximately 200 participants at 28 centers in the United States who had
responded positively to eight weeks of treatment with one of four different
SSRIs: fluoxetine, sertraline, paroxetine or citalopram. This was followed by
four months of treatment with escitalopram. These participants were then randomly
assigned to fixed-dose treatment with 10 or 20 mg of escitalopram or placebo
for one year.
"Patients who were switched to
placebo showed a significantly higher rate of depression recurrence (65
percent), compared to those who stayed on escitalopram (27 percent)," said Kornstein. "This was true
even though the patients showed a full resolution of their depression at the
start of maintenance treatment." The medication was found to be safe and well
tolerated throughout the study, she said.
"These
findings indicate the importance of maintenance therapy for patients with recurrent
major depressive disorder beyond four to six months of improvement, even if a
patient's depressive symptoms appear to be resolved," she said.
This work was funded by Forest Research Institute.
Kornstein is also the executive director of VCU's Mood Disorders
Institute and VCU's Institute for Women's Health, designated a National Center
of Excellence by the U.S. Department of Health and Human Services. She collaborated
on the study with Anjana Bose, Ph.D., Dayong Li, Ph.D., Khalil G. Saikali,
Ph.D., and Chetan Gandhi, Ph.D., who are researchers with Forest Research
Institute.
- About VCU and the VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located on two downtown campuses in Richmond, VCU enrolls more than 32,000 students in 211 certificate and degree programs in the arts, sciences and humanities. Sixty-nine of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.
