Role of escitalopram in therapy of affective and anxiety disorders in primary care Review article
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Abstract
The problem of affective disorders still grows. According to the latest WHO estimates: disorders of this spectrum are the most common chronic disease (more than 120 million people the world is currently affected by depression). Unfortunately, the treatment of anxiety and depressive disorders is still difficult, despite the very intensive development of pharmacology, and many psychotherapeutic possibilities, determined by the late diagnosis and wrong choice of drugs. As a result of this, is growing recurrence and chronicity of emotional disorders. There are numerous consequences of these phenomena: somatic pain syndromes complications, immunological disorders, and less perceived such invalidisation’s growth in society – and thereby – increased social costs, up to the most dramatic events, such as death by suicide. The solution lies in quicker intervention, ie. the diagnosis, which should take place already at the level of primary care physician, and starting treatment with antidepressants. World experience shows that the treatment of depression is best suited to a system based on the assistance provided by the GP (primary care physician). Thanks to the optimal selection of drugs (by safety, tolerability) it is possible to reducing appearance of depressive episodes, and as consequence faster and easier patients’ return to health and to minimizing the risk of recurrence. Currently, the optimal choice in the pharmacotherapy of affective disorder seems to be the market leader of antidepressants – escitalopram. Escitalopram, left optical isomer of citalopram, prevails in both terms: effectiveness and tolerance in primary indications of affective disorders. So far, no systematic studies have been published demonstrating lower efficacy of escitalopram compared with other antidepressants, and there many direct studies showing superior efficacy of escitalopram than others drugs, or showing comparable efficacy to escitalopram.
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