Clinical milestones predict symptom remission over 6-month and choice of treatment of patients with major depressive disorder (MDD).

BACKGROUND

It is uncertain as to what short-term outcomes predict long-term treatment compliance and outcomes in patients with MDD.

AIMS

To determine what treatment milestones predict symptom remission with long-term treatment with antidepressant medication.

METHOD

Pooled analysis of four randomised, double-blind, active comparator, 6-month trials in MDD.

RESULTS

Patients received double-blind treatment with escitalopram (N=699) or a comparator (citalopram, duloxetine, or paroxetine) (N=699). Onset of effect at week 2 was correlated with response at week 8, and response at week 8 with completion of 6-month treatment. Week 8 response was associated with a greater probability of achieving later remission. Week 24 remission (MADRS>or=10) was significantly (p<0.01) higher for patients treated with escitalopram (70.7%) than for the pooled comparators (64.7%). Week 24 complete remission (MADRS<or=5) was significantly (p<0.01) higher for escitalopram (51.7%) than for the pooled comparators (45.6%). Fewer patients discontinued treatment with escitalopram (15.9%) than with the pooled comparators (23.9%) (p<0.001).

CONCLUSION

A higher probability of achieving remission is associated with responding after 8 weeks and with completing 6 months of treatment.