Relapse in depression

Escitalopram was efficacious in patients with major depressive disorder in short-term, placebo-controlled trials, three of which included citalopram as an active control, and in a 36-week study in the prevention of relapse in depression (7). It has also been used to treat generalized anxiety disorder, panic disorder, and social anxiety disorder. Results also suggest that, at comparable doses, escitalopram demonstrates clinically relevant and statistically significant superiority to placebo treatment earlier than citalopram. The most common adverse events associated with escitalopram include nausea, insomnia, disorders of ejaculation, diarrhea, dry mouth, and somnolence. Only nausea occurred in more than 10% of patients taking escitalopram. 

Thase ME. Achieving remission and managing relapse in depression, j Clin Psychiatry 2003 64 3-7. 

Inhibition of 5-HT biosynthesis reverses the therapeutic effects of treatment with antidepressants that have predominantly 5-HT reuptake inhibitory activity (e.g., fluoxetine) but less so with those that have predominantly NE reuptake inhibitory activity (e.g., desipramine) (11,12). Also, inhibition of 5-HT biosynthesis produced a relapse in depressed patients who had their depression successfully treated with imipramine or... 

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