To assess the efficacy and tolerability profile of treatment with escitalopram under naturalistic conditions, in elderly outpatients (≥65 years and above) with depression.

2050 patients completed 8 weeks of treatment with escitalopram in a multi-centre naturalistic study. Rating scales included a short version of the Montgomery-Åsberg Depression Rating Scale (svMADRS) for the assessment of response.

Most patients improved in their general state of health and showed a decrease in the severity of their depression. The majority (83.8%) of patients received 10mg/day escitalopram. The mean svMADRS total score decreased from 31.9 (SD=7.9) at baseline to 14.2 (SD=8.5) at Week 8. On completion, 63.9% of the patients were responders (≥50% decrease of svMADRS from baseline) and 48.6% were remitters (svMADRS≤12). Statistically significant more patients aged ≤75 years responded to treatment and achieved remission than those aged >75 years. Logistic regression was used to model response to treatment. Statistically significant positive factors were having a current episode of less than 1 month and duration of illness of less than 1 year. The diagnosis showed increasing responder rates from affective disorder (F31 or F34; odds ratio=1.00) over involutional depression (F03; odds ratio=1.68) and depressive episode (F32; odds ratio=2.21) to recurrent depressive episode (F33; odds ratio=2.32). The differences between affective disorders and involutional depression were significant, while F32 and F33 showed no relevant differences in the responder rates.

The results from this observational study corroborate the effectiveness and tolerability of escitalopram treatment of elderly patients in a naturalistic treatment setting.