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 .
Efficacy and tolerability of escitalopram versus citalopram in major depressive disorder: a 6-week, multicenter, prospective, randomized, double-blind, active-controlled study in adult outpatients.
BACKGROUND The S-enantiomer of citalopram ( escitalopram ) is the active moiety linked to the anti-depressant effects associated with citalopram ( the racemate ) . For escitalopram to be approved for the treatment of depression in Europe , findings from clinical trials of escitalopram are required to match previous results from studies of the racemate , citalopram . OBJECTIVE The aim of this study was to compare the efficacy and tolerability of escitalopram and citalopram in out patients with major depressive disorder ( MDD ) . METHODS This prospect i ve , r and omized , double-blind , active-controlled study was conducted at 8 psychiatric outpatient clinics in the Federation of Russia . Adult out patients aged 25 to 45 years with MDD and a total score > or = 25 on the Montgomery-Asberg Depression Rating Scale ( MADRS ) were eligible . Patients were r and omly assigned to receive 6 weeks of treatment with fixed daily doses of escitalopram 10 mg , citalopram 10 mg , or citalopram 20 mg . Efficacy assessment s were made at weeks 0 ( baseline ) , 1 , 4 , and 6 ( study end or last observation carried forward ) . The primary efficacy parameter was the change from baseline in MADRS total score . Secondary measures were the change from baseline in MADRS total score in a subgroup of severely depressed patients ( baseline MADRS total score , > or = 35 ) , MADRS core depression subscale score , and Clinical Global Impression-Severity and Improvement ( CGI-S and CGI-I ) scores ; and the proportions of patients classified as responders and remitters at study end . Tolerability was assessed using adverse events ( AEs ) recorded by the investigator . RESULTS Of 330 assessable r and omized patients , 8 withdrew , including 7 who withdrew consent and 1 who withdrew due to recurrence of a preexisting event . Thus , 322 patients were included in the assessment ( mean age , 35 years ; 41.6 % male ; all white ;  escitalopram 10 mg , 108 patients ; citalopram 10 mg , 106 ; citalopram 20 mg , 108 ) . At study end , the mean ( SE ) change from baseline in MADRS total score was significantly greater in the escitalopram arm than in the 10- and 20-rag citalopram arms ( -28.70 [ 0.78 ] vs -20.11 [ 0.80 ] and -25.19 [ 0.78 ] ; both , P < 0.001 ) . Improvements were more marked in the severely depressed subgroup ( -30.33 [ 0.95 ] vs -20.87 [ 0.99 ] and -26.34 [ 0.91 ] ) . Changes in the CGI-S and CGI-I scores and the rates of response and remission were significantly greater in the escitalopram group compared with those in the citalopram 10- and 20-mg groups ( CGI-S : -2.60 [ 0.10 ] vs -1.61 [ 0.10 ] and -2.05 [ 0.10 ] ; CGI-I : + 1.58 [ 0.09 ] vs + 2.35 [ 0.10 ] and + 1.80 [ 0.09 ] ; response : 95.4 % vs 44.3 % and 83.3 % ; remission : 89.8 % vs 25.5 % and 50.9 % [ all , P < 0.001 ] ) . Mean ( SE ) changes from baseline in core depression subscale score were -19.00 ( 0.59 ) , -13.00 ( 0.60 ) , and -16.52 ( 0.58 ) with escitalopram , citalopram 10 mg , and citalopram 20 mg , respectively . The prevalence of AEs was significantly lower in the escitalopram group ( 7 ) compared with the citalopram groups ( 16 and 19 in the 10- and 20-mg groups , respectively ; both , P < 0.05 ) . Nausea ( 2 [ 1.9 % ] , 5 [ 4.7 % ] , and 7 [ 6.5 % ] patients in the escitalopram and citalopram 10- and 20-mg groups , respectively ) and headache ( 1 [ 0.9 % ] , 2 [ 1.9 % ] , and 4 [ 3.7 % ] ) were the most frequently reported AEs . CONCLUSIONS The results from this study suggest that escitalopram 10 mg was more effective than citalopram 10 and 20 mg at 6 weeks in these adult out patients with MDD . All treatments were well tolerated
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 .