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 .
Targeting remission by 8 weeks: when should supplementation be considered in patients with major depression treated with a specific serotonin reuptake inhibitor?
BACKGROUND Timely administration/supplementation of a specific serotonin reuptake inhibitor with a second therapeutic agent could improve treatment outcome in patients with major depressive disorder ( MDD ) . The purpose of this study was to identify the optimal time at which to implement supplementation so as to maximize the likelihood of remission by 8 weeks and minimize overtreatment . METHOD Data from patients with MDD treated with sertraline ( n = 108 ) or citalopram ( n = 107 ) in a r and omized controlled trial were analyzed by multivariate logistic regression . The 21-item Hamilton Depression Scale scores at weeks 1 , 2 , 3 , 4 , and 6 ; sex ; age ; and baseline Hamilton Anxiety Scale score were used as predictors of remission by 8 weeks sustained for a further 4 weeks . RESULTS Regression models for weeks 2 , 3 , 4 , and 6 were significant ( area under the curve values , 0.73 - 0.91 ) . The models for weeks 3 to 6 yielded κ coefficients greater than 0.40 with the outcome variable . A Hamilton Depression Scale reduction score of 50 % at week 4 as a criterion for supplementation would have result ed in overtreatment of 4 % and 0 % of patients in the sertraline and citalopram groups , respectively , and none if applied at week 6 . The rates at which patients who should have received supplementation ( destined to be nonremitters at 8 weeks ) would have been missed would be 49%/54 % for sertraline/citalopram at week 4 and 43%/50 % at week 6 . LIMITATIONS The study limitations are as follows : secondary analysis of data , relatively low sertraline dose , and relatively small sample sizes . CONCLUSIONS It may be possible to identify patients treated with specific serotonin reuptake inhibitors  who will not achieve sustained remission by 8 weeks . If supplementation were implemented accordingly , the number of overtreated patients would be small . However , a substantial number of patients who should be supplemented would be missed , indicating a need for greater sensitivity of the prediction model . Further studies are needed
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 .