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 .
Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial.
CONTEXT Depression occurs in more than half of patients who have experienced a stroke . Poststroke depression has been shown in numerous studies to be associated with both impaired recovery in activities of daily living and increased mortality . Prevention of depression thus represents a potentially important goal . OBJECTIVE To determine whether treatment with escitalopram or problem-solving therapy over the first year following acute stroke will decrease the number of depression cases that develop compared with placebo medication . DESIGN , SETTING , AND PARTICIPANTS A multisite r and omized controlled trial for prevention of depression among 176 nondepressed patients was conducted within 3 months following acute stroke from July 9 , 2003 , to October 1 , 2007 . The 12-month trial included 3 groups : a double-blind placebo-controlled comparison of escitalopram ( n = 59 ) with placebo ( n = 58 ) , and a nonblinded problem-solving therapy group ( n = 59 ) . MAIN OUTCOME MEASURES The main outcome measure was the development of major or minor poststroke depression based on symptoms elicited by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders ( Fourth Edition ) ( DSM-IV ) and the diagnostic criteria from DSM-IV for depression due to stroke with major depressive-like episode or minor depression ( ie , research criteria ) . RESULTS Patients who received placebo were significantly more likely to develop depression than individuals who received escitalopram ( 11 major and 2 minor cases of depression [ 22.4 % ] vs 3 major and 2 minor cases of depression [ 8.5 % ] , adjusted hazard ratio [ HR ] , 4.5 ; 95 % confidence interval [ CI ] , 2.4 - 8.2 ; P < .001 ) and also more likely than individuals who received problem-solving therapy ( 5 major and 2 minor cases of depression [ 11.9 % ] , adjusted HR , 2.2 ; 95 % CI , 1.4 - 3.5 ; P < .001 ) . These results were adjusted for history of mood disorders and remained significant after considering possible confounders such as age , sex , treatment site , and severity of impairment in the model . Using an intention-to-treat conservative method of analyzing the data , which assumed that all 27 patients who did not start r and omized treatment would have developed depression , and controlling for prior history of mood disorders , escitalopram was superior to placebo ( 23.1 % vs 34.5 % ; adjusted HR , 2.2 ; 95 % CI , 1.2 - 3.9 ; P = .007 ) , while problem-solving therapy was not significantly better than placebo ( 30.5 % vs 34.5 % ; adjusted HR , 1.1 ; 95 % CI , 0.8 - 1.5 ; P = .51 ) . Adverse events , including all-cause hospitalizations , nausea , and adverse effects associated with escitalopram were not significantly different between the 3 groups . CONCLUSIONS In this study of nondepressed patients with recent stroke , the use of escitalopram or problem-solving therapy result ed in a significantly lower incidence of depression over 12 months of treatment compared with placebo , but problem-solving therapy did not achieve significant results over placebo using the intention-to-treat conservative method of analysis . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00071643
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 .