Some statistically significant differences between citalopram and other antidepressants for the acute phase treatment of major depression were found in terms of efficacy , tolerability and acceptability .
Citalopram was more efficacious than paroxetine and reboxetine and more acceptable than tricyclics , reboxetine and venlafaxine , however , it seemed to be less efficacious than escitalopram .
BACKGROUND Recent US and UK clinical practice guidelines recommend that second-generation antidepressants should be considered amongst the best first-line options when drug therapy is indicated for a depressive episode .
Systematic review s have already highlighted some differences in efficacy between second-generation antidepressants .
Citalopram , one of the first selective serotonin reuptake inhibitors ( SSRI ) introduced in the market , is one of these antidepressant drugs that clinicians use for routine depression care .
OBJECTIVES To assess the evidence for the efficacy , acceptability and tolerability of citalopram in comparison with tricyclics , heterocyclics , other SSRIs and other conventional and non-conventional antidepressants in the acute-phase treatment of major depression .
Selecting among second-step antidepressant medication monotherapies: predictive value of clinical, demographic, or first-step treatment features.
CONTEXT Little is known about selecting among second-step medications for major depressive disorder after intolerance or lack of remission with an initial selective serotonin reuptake inhibitor . OBJECTIVE To determine whether sociodemographic , clinical , or first-step treatment features predict remission with or intolerance overall or differentially to any 1 of 3 second-step medications after an unsatisfactory outcome with citalopram hydrobromide . DESIGN An equipoise stratified r and omized study . Participants were recruited from July 17 , 2001 , through April 20 , 2004 . SETTING Public or private sector primary care ( n = 18 ) and psychiatric care ( n = 23 ) setting s across the United States . PARTICIPANTS Representative out patients aged 18 to 75 years with nonpsychotic major depressive disorder ( N = 727 ) . INTERVENTIONS Sustained-release bupropion hydrochloride was started at 150 mg/d and incrementally increased to 400 mg/d . Sertraline hydrochloride was started at 50 mg/d and incrementally increased to 200 mg/d . Extended-release venlafaxine hydrochloride was started at 37.5 mg/d and incrementally increased to 375 mg/d . MAIN OUTCOME MEASURES The 16-item Quick Inventory of Depressive Symptomatology , Self-Rated and the Frequency , Intensity , and Burden of Side Effects Rating . RESULTS Remission was more likely among participants who were white , employed , cohabiting or married , or privately insured or who had prior intolerance to citalopram or at least a response to citalopram , and no prior suicide attempts . Remission was less likely among participants with concurrent generalized anxiety , obsessive-compulsive , panic , or posttraumatic stress disorders ; social phobia ; anxious or melancholic features ; or more severe depression . Intolerance was less likely for Hispanic participants , but more likely for participants with previous suicide attempts or intolerance to citalopram . Participants with concurrent substance use were less likely to remit ( odds ratio , 0.37 ) and more likely not to tolerate extended-release venlafaxine . Intolerance to citalopram was associated with intolerance to sertraline ( P = .04 ) . CONCLUSIONS Clinical , demographic , and treatment history were of little value in recommending 1 medication vs another as a second-step treatment for major depressive disorder . Participants most likely to remit in the second step had less Axis I psychiatric disorder comorbidity , less social disadvantage , and at least a response to citalopram in the first step . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00021528
Some statistically significant differences between citalopram and other antidepressants for the acute phase treatment of major depression were found in terms of efficacy , tolerability and acceptability .
Citalopram was more efficacious than paroxetine and reboxetine and more acceptable than tricyclics , reboxetine and venlafaxine , however , it seemed to be less efficacious than escitalopram .
BACKGROUND Recent US and UK clinical practice guidelines recommend that second-generation antidepressants should be considered amongst the best first-line options when drug therapy is indicated for a depressive episode .
Systematic review s have already highlighted some differences in efficacy between second-generation antidepressants .
Citalopram , one of the first selective serotonin reuptake inhibitors ( SSRI ) introduced in the market , is one of these antidepressant drugs that clinicians use for routine depression care .
OBJECTIVES To assess the evidence for the efficacy , acceptability and tolerability of citalopram in comparison with tricyclics , heterocyclics , other SSRIs and other conventional and non-conventional antidepressants in the acute-phase treatment of major depression .