REVIEWSIs the significant superiority of escitalopram compared with other antidepressants clinically relevant?Montgomery, Stuart A.a; Möller, Hans-JürgenbAuthor Information aImperial College School of Medicine, University of London, London bLudwig Maximilians University, Munich, UK Correspondence to Professor Stuart A. Montgomery, PO Box 8751, London W13 8WH, UK Tel: +44 20 8997 2689; fax: +44 20 8566 7986; e-mail: firstname.lastname@example.org Received 13 November 2008 Accepted 18 February 2009 International Clinical Psychopharmacology: May 2009 - Volume 24 - Issue 3 - p 111-118 doi: 10.1097/YIC.0b013e32832a8eb2 Buy Metrics Abstract The methods of assessing the clinical relevance of a significant difference between antidepressants and placebo are discussed. The commonly used criteria of treatment effect and responder rates, as well as the percentage difference in responders between antidepressant and placebo, are critically reviewed and applied to assess the clinical relevance of the significant advantages reported in double-blind, randomized, controlled studies of escitalopram compared with other antidepressants. A significant advantage for escitalopram has been reported in randomized, double-blind, short-term studies compared with citalopram, paroxetine and duloxetine. The reported significant differences are clinically relevant based on a treatment effect difference of at least 2 points on the Montgomery and Asberg Depression Rating Scale as well as a significant advantage in the protocolled responder or remission analysis. The mean unadjusted treatment effect advantage for escitalopram compared with the antidepressants studied is 2.42 points on the Montgomery and Asberg Depression Rating Scale in the short-term treatment. Excluding one study that did not report short-term responder rates, there were significantly more responders on escitalopram (74%) than comparators (63%). Both of these measures demonstrate a clinically relevant difference in favour of escitalopram. © 2009 Lippincott Williams & Wilkins, Inc.