Investigation of early suicide-related symptoms in a non-suicidal depressed patient population after Escitalopram administration: a pilot study

Background: The efficacy of selective serotonin reuptake inhibitors (SSRIs) is well established in the treatment of major depression. However, an important delay in the onset of global action relative to placebo is described within the first weeks after their administration. Little is known about the experience over time on specific and suicide-related symptoms. Aims: This study aimed at investigating the experience over time of escitalopram on depression-related symptoms that are also associated with increased risk for suicidal behaviour. Methods: In an 8-week prospective uncontrolled open-label design, escitalopram was administered to 18 patients with a current major depressive episode. Mood, state anxiety, state anger and hopelessness were assessed at baseline and after 2, 4 and 8 weeks of treatment with escitalopram in a flexible dose regimen up to 20 mg. Results: Mood (p < 0.001), state anxiety (p = 0.002), state anger (p = 0.002) and hopelessness (p = 0.002) significantly improved after 8 weeks of treatment with escitalopram. However, symptom improvement varied over time. Mood and anger significantly improved after 2 weeks of treatment, whereas significant reductions of state anxiety and hopelessness were noticed only by the end of the study.Conclusions: This study underlines the early beneficial experience of treatment with escitalopram on mood and different suicide-related symptoms in a non-suicidal depressed patient group