Citalopram Therapy for Depression: A Review of 10 Years of European Experience and Data From U.S. Clinical Trials
J Clin Psychiatry 2000;61(12):896-908
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: This review summarizes and
evaluates clinical experience with citalopram, the latest
selective serotonin reuptake inhibitor (SSRI) to be approved for
the treatment of depression in the United States.
Data Sources: Published reports of randomized,
double-blind, controlled clinical studies of citalopram were
retrieved using a MEDLINE literature search. Search terms
included citalopram, SSRI, TCA (tricylic antidepressant),
depression, and clinical. For each study, data on
antidepressant efficacy and adverse events were evaluated.
Pharmacokinetic studies and case reports were reviewed to
supplement the evaluation of citalopram's safety and
tolerability. Data presented at major medical conferences and
published in abstract form also were reviewed.
Study Findings: Thirty randomized, double-blind,
controlled studies of the antidepressant efficacy of citalopram
were located and reviewed. In 11 studies, citalopram was compared
with placebo (1 of these studies also included comparison with
another SSRI). In 4 additional studies, the efficacy of
citalopram in preventing depression relapse or recurrence was
investigated. In another 11 studies (including 1 meta-analysis of
published and unpublished trials), citalopram was compared with
tricyclic and tetracyclic antidepressants. Finally, results are
available from 4 studies in which citalopram was compared with
other SSRIs. A placebo-controlled study of citalopram for the
treatment of panic disorder was reviewed for data on long-term
Conclusion: Data published over the last
decade suggest that citalopram is (1) superior to placebo in the
treatment of depression, (2) has efficacy similar to that of the
tricyclic and tetracyclic antidepressants and to other SSRIs, and
(3) is safe and well tolerated in the therapeutic dose range of
20 to 60 mg/day. Distinct from some other agents in its class,
citalopram exhibits linear pharmacokinetics and minimal drug
interaction potential. These features make citalopram an
attractive agent for the treatment of depression, especially
among the elderly and patients with comorbid illness.