Fig. 3

Comparison of the effectiveness and safety of escitalopram treatment in cohorts treated with guided and unguided dosing. (a) Meta-analysis comparing the effectiveness of escitalopram treatment between the placebo, 10 mg/day and 20 mg/day arms in fixed-dose randomized controlled trials and the current study using relative symptom reduction on the scale defined as the primary outcome. The placebo arm showed a 43% (95% CI: 38–49%; N = 1,309, p < 0.001), the 10 mg/day escitalopram arm showed a 52% (95% CI: 47–57%; N = 1,355, p < 0.001), and the 20 mg/day escitalopram arm a 51% (95% CI: 46–57%; N = 865, p < 0.001) reduction in symptom severity. (b) Comparison of the incidence of the most common adverse drug reactions between the two fixed-dose studies listed on the FDA drug label for escitalopram and the current study is presented indicating that the incidence of adverse drug reactions was between the incidence observed in patients treated with 10 mg/day and 20 mg/day. (c) Comparison of the observed change in QTc interval between the current study with TDM guided-dose and the FDA randomized, controlled, cross-over, multiple fixed-dose study. The white and gray bars represent the same cohort (N = 113) sequentially exposed to different escitalopram doses, while the red bar represents the current cohort as change from baseline to week 8. The QTc elongation in the present cohort is comparable to the QTc prolongation observed when subjects were treated with 10 mg/day and 20 mg/day. Results are presented as means ± 95% CI.