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Escitalopram and suicidality in adult depression and anxiety

Pedersen, Anders Gersel

International Clinical Psychopharmacology: May 2005 - Volume 20 - Issue 3 - p 139-143

The escitalopram clinical trial database, consisting of all placebo-controlled and relapse prevention trials within major depressive disorder (MDD) and anxiety disorders, was analysed for specific adverse events indicative of suicidal behaviour (fatal suicide, non-fatal self-harm or suicidal thoughts) in relation to treatment. The number of events was low, with no fatal suicides in the first 2 weeks of treatment. There was one fatal suicide during the full treatment period on placebo (incidence 0.1%; rate 0.003), and none on escitalopram. None of these figures were significantly different between escitalopram (n=2277) and placebo (n=1814) patients. There was no indication that escitalopram provokes suicidal behaviour compared to placebo in either MDD or anxiety disorders. Based on efficacy ratings (Montgomery–Åsberg Depression Rating Scale, item 10), escitalopram was more efficacious versus placebo in lowering suicidal thoughts from weeks 1 through 8 in the treatment of patients with MDD.

Drug Development, H. Lundbeck A/S, Copenhagen, Denmark

Correspondence and requests for reprints to Dr Anders Gersel Pedersen, Drug Development, H. Lundbeck A/S, Ottiliavej 9, Copenhagen, DK-2500, Denmark


Received 10 December 2004 Accepted 14 January 2005

© 2005 Lippincott Williams & Wilkins, Inc.