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Comparison of escitalopram versus citalopram for the treatment of major depressive disorder in a geriatric population
- Source :
- Current Medical Research and Opinion. 24:2587-2595
- Publication Year :
- 2008
- Publisher :
- Informa Healthcare, 2008.
-
Abstract
- To compare escitalopram versus citalopram for the treatment of major depressive disorder (MDD) in geriatric patients.Administrative claims data (2003-2005) were analyzed for patients agedor =65 years with at least one inpatient claim or two independent medical claims associated with MDD diagnosis. Patients were continuously enrolled for at least 12 months, filled at least one prescription for citalopram or escitalopram and had no second generation antidepressant use during the 6-month pre-index date. Contingency table analysis and survival analysis were used to compare outcomes between the two treatment groups.Treatment persistence, hospitalization utilization, and prescription drug, medical, and total healthcare costs were analyzed. Outcomes were compared between patients initiated on escitalopram and those initiated on citalopram both descriptively and using multivariate analysis adjusting for baseline characteristics.Among 691 geriatric patients, escitalopram-treated patients (n=459) were less likely to discontinue treatment (hazard ratio [HR]=0.83, p=0.049) or switch to another second generation antidepressant (HR=0.62, p=0.001) compared to patients treated with citalopram (n=232). Patients treated with escitalopram had a significantly lower hospitalization rate (31.2% vs. 38.8%, p=0.045) and 66% fewer hospitalization days based on negative binomial regression (p0.001). While escitalopram patients had comparable prescription drug costs, they had lower total medical service costs (regression: $9748 vs. $19,208, p0.001) and lower total healthcare costs (regression: $11,434 vs. $20,601, p0.001).This study's limitations include its small sample size, short observational periods and exclusivity of indirect costs.Geriatric patients treated with escitalopram had better treatment persistence, fewer hospitalizations, and lower medical and total healthcare costs than patients treated with citalopram. Most of the cost reduction was attributable to significantly lower hospitalizations and total medical costs.
- Subjects :
- Male
medicine.medical_specialty
Multivariate analysis
Prescription drug
Citalopram
Internal medicine
mental disorders
medicine
Humans
Escitalopram
Medical prescription
Psychiatry
Survival analysis
Aged
Aged, 80 and over
Depressive Disorder, Major
business.industry
General Medicine
medicine.disease
Second-generation antidepressant
Hospitalization
Patient Compliance
Major depressive disorder
Female
business
Selective Serotonin Reuptake Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 14734877, 03007995, and 20032005
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Current Medical Research and Opinion
- Accession number :
- edsair.doi.dedup.....94ba8aa6e01e343e844992923e37baec