372: Citalopram effective for major depression

November 30, 2012

PEARLS 372, September 2012, written by Brian R McAvoy

Clinical question: How effective is citalopram in comparison with tricyclics, heterocyclics, other selective serotonin reuptake inhibitors (SSRIs) and other conventional and non-conventional antidepressants in the acute-phase treatment of major (moderate-to-severe) depression?

Bottom line: Citalopram was more efficacious than paroxetine and reboxetine, and more acceptable (lower drop-out rate) than tricyclics, reboxetine and venlafaxine. However, it seemed to be less efficacious than escitalopram. Follow-up extended to 6 months.

Caveat: Economic analyses were not reported. Sponsorship bias and publication bias had the potential for overestimating treatment effects.

Context: Antidepressant drugs remain the mainstay of treatment in moderate-to-severe depression. During the past 20 years, SSRIs have progressively become the most commonly prescribed antidepressants.

Cochrane Systematic Review: Cipriani A et al. Citalopram versus other anti-depressive agents for depression. Cochrane Reviews, 2012, Issue 7. Article No. CD006534. DOI: 10.1002/14651858.CD006534.pub2. This review contains 37 studies involving over 6000 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.