PS99. First episode depression and monotherapy with escitalopram: A 16-week, open-label, flexible-dose study
Bibliographic record
Abstract
Abstract Objective: Depressive disorders typically emerge during early adolescence and adulthood, and if left untreated, increase risk of chronicity, morbidity and mortality. Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) is first-line treatment, though increased risk of suicidality with SSRI use in youth populations is cautioned in the literature. Escitalopram is a newer SSRI with superior efficacy and tolerability to other SSRIs, but without data specifically in early depression patients. The aim of this study was to investigate the efficacy, safety and tolerability of escitalopram monotherapy in young adult patients with first-episode depression. Methods: Forty-two (42) patients, 18–29 years, medication-free and diagnosed with first-episode depression, were recruited. Open-label escitalopram was administered for 16 weeks at flexible dose (5–30 mg/day). The primary efficacy measure was the 17-item Hamilton Depression Scale (HAMD-17). The secondary efficacy measures were the Beck Depression Inventory (BDI) and the Neo Personality Inventory (NEO-PI-R). All measures were completed at baseline, 8 weeks and 16 weeks. Safety and tolerability were assessed via questioning at each patient visit. Results: Between baseline and 16 weeks, there was a significant decrease in depression scores on the HAMD-17 (p<0.001) and BDI (p<0.0001). On the NEO-PI-R, there was a significant decrease in neuroticism (p=0.003), and significant increase in extraversion (p=0.0002) and openness to experience (p<0.0001). The response rate was 77% and the remission rate was 64%. The mean dose at 16 weeks was 19.05 mg/day, with no significant difference between responders and non-responders (p=0.06). Side effects reported were mild, consisted mainly of dry mouth and nausea, and did not lead to discontinuation. Conclusions: Open-label escitalopram was effective in improving both symptoms and functioning in young adults with first-episode depression. It was also well tolerated. Limitations include lack of placebo control, non-randomized design and small sample size.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".