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 .
Can phase III trial results of antidepressant medications be generalized to clinical practice? A STAR*D report.
OBJECTIVE Phase III clinical trials for depression enroll participants with major depressive disorder according to stringent inclusion and exclusion criteria . These patients may not be representative of typical depressed patients seeking treatment . This analysis used data from the Sequenced Treatment Alternatives to Relieve Depression ( STAR*D ) project -- which used broad inclusion and minimal exclusion criteria --to evaluate whether phase III clinical trials recruit representative depressed out patients . METHOD Of 2,855 participants , 22.2 % met typical entry criteria for phase III clinical trials ( efficacy sample ) and 77.8 % did not ( nonefficacy sample ) . These groups were compared regarding baseline sociodemographic and clinical features and the characteristics and outcomes of acute-phase treatment . RESULTS The efficacy sample had a shorter average duration of illness and lower rates of family history of substance abuse , prior suicide attempts , and anxious and atypical symptom features . Despite similar medication dosing and time at exit dose , the efficacy participants tolerated citalopram better . They also had higher rates of response ( 51.6 % versus 39.1 % ) and remission ( 34.4 % versus 24.7 % ) . These differences persisted even after adjustments for baseline differences . CONCLUSIONS Phase III trials do not recruit representative treatment-seeking depressed patients . Broader phase III inclusion criteria would increase the generalizability of results to practice , potentially reducing placebo response and remission rates ( reducing the risk of failed trials ) but at the risk of some increase in adverse events
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 .