Randomized controlled study of early medication change for non-improvers to antidepressant therapy in major depression – The EMC trial

Abstract Patients with Major Depressive Disorder (MDD) and no improvement after two weeks of antidepressant pharmacotherapy have a high risk of treatment failure. The aim of the study was to determine whether an early medication change (EMC) strategy is superior to a guideline-based treatment in MDD...

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Published in:European neuropsychopharmacology 2016-04, Vol.26 (4), p.705-716
Main Authors: Tadić, André, Wachtlin, Daniel, Berger, Mathias, Braus, Dieter F, van Calker, Dietrich, Dahmen, Norbert, Dreimüller, Nadine, Engel, Alice, Gorbulev, Stanislav, Helmreich, Isabella, Kaiser, Anne-Katrin, Kronfeld, Kai, Schlicht, Konrad F, Tüscher, Oliver, Wagner, Stefanie, Hiemke, Christoph, Lieb, Klaus
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antidepressant
Antidepressive Agents - administration & dosage
Antidepressive Agents - adverse effects
Antidepressive Agents - therapeutic use
Antidepressive Agents, Second-Generation - therapeutic use
Citalopram - administration & dosage
Citalopram - adverse effects
Citalopram - therapeutic use
Delayed-Action Preparations - therapeutic use
Depressive Disorder, Treatment-Resistant - drug therapy
Drug Therapy, Combination
Early improvement
Early Medical Intervention
Female
Guidelines
Humans
Internal Medicine
Lithium - therapeutic use
Major Depressive Disorder
Male
Middle Aged
Pharmacotherapy
Psychiatry
RCT
Treatment Outcome
Venlafaxine Hydrochloride - administration & dosage
Venlafaxine Hydrochloride - adverse effects
Venlafaxine Hydrochloride - therapeutic use
Young Adult
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Summary:Abstract Patients with Major Depressive Disorder (MDD) and no improvement after two weeks of antidepressant pharmacotherapy have a high risk of treatment failure. The aim of the study was to determine whether an early medication change (EMC) strategy is superior to a guideline-based treatment in MDD patients without improvement after two weeks of antidepressant pharmacotherapy. Eight-hundred-and-eighty-nine patients with MDD were enrolled, 879 patients received the SSRI escitalopram. Of those, 192 patients had no improvement, defined as a reduction of
ISSN:0924-977X
1873-7862
DOI:10.1016/j.euroneuro.2016.02.003