Citalopram versus maprotiline: A controlled, clinical multicentre trial in depressed patients

Abstract

In a double-blind trial, comprising 96 depressed patients, citalopram was compared with maprotiline. The trial period was 6 weeks with ratings (MADRS, CGI) and side effects recordings taking place at Weeks 0, 1, 2, 4, and 6. Both drugs were administered as a single evening dose, 40 or 60 mg for citalopram, and 75 or 150 mg for maprotiline. MADRS total scores and CGI scores showed a highly significant reduction in both groups with no significant difference between them, whether the groups were considered as a whole or whether they were subdivided into endogenously/non-endogenously depressed or melancholic/non-melancholic patients. Side effects were not significantly different, but the maprotiline group showed more anticholinergic side effects, whereas the citalopram group showed more nausea, increased sweating and headache. Two patients on maprotiline were withdrawn because of side effects (hypotension and somnolence in the one case; tremor and insomnia in the other). One patient in each group was withdrawn because of increased transaminases, the citalopram-treated patient having increased values, however, already at baseline. Apart from this, no cardiovascular side effects and no pathological laboratory values related to treatment were observed. The authors conclude that citalopram is a safe antidepressant drug and as effective as maprotiline.

The efficacy of selective serotonin re-uptake inhibitors in depression: a meta-analysis of studies against tricyclic antidepressants

“…For the purpose of metaanalysis, it is desirable to maximise the information available and this led us to use group HDRS scores rather than responder/ non-responder analysis. We did include the four studies (Bouchard et al, 1987;Gravem et al, 1987;Rahman et al, 1991;Thompson, 1991) that only used the Montgomery and Asberg Depression Rating Scale (MADRS) (Montgomery and Asberg, 1979) as it is likely that a relative effect size calculated from this will be broadly similar to that derived from the HDRS. It is not clear whether change (i.e.…”

Three new antidepressants

“…Randomised double-blind comparisons in hospital patients showed no significant difference in efficacy between citalopram (usually 40-60mg daily for 6 weeks) and maprotiline (75-150mg daily)7 or mianserin (60-120mg daily) 8. A larger, multicentre double-blind study conducted by 97 general practitioners, compared citalopram (10-30mg or 20-60mg daily) with imipramine (50-150mg daily) in 472 patients with milder depression 9.…”

Clinical trials of potential antidepressants: to what extent are the elderly represented: a review

“…Subjects are classified as depressed (Table 1) and non-depressed healthy volunteers (Table 2). The minimum age for inclusion in most of the studies was 18 years (Chouinard et al, 1981;Harto-Truax et al, 1982;Lindegaard Peterson, 1982;Ofsti, 1982;Chouinard, 1983;De Wilde et al, 1983;Fabre et al, 1983;Gottlieb et al, 1983;Halaris et al, 1983;Mendels et al, 1983;Preskorn, 1983;Zung 1983;Battegay et al, 1985;Bjerkenstedt et al, 1985a;Christensen et al, 1985;De Wilde et al, 1985;Lund Laursen et al, 1985;Guy et al, 1986;Stark and Hardison, 1985;Shaw et al, 1986;Bouchard et al, 1987;Dufour et al, 1987;Gravern et al, 1987;Mertens and Pintens, 1988;Reimherr et al, 1988;Amin et al, 1989;Feighner and Boyer, 1989;Feighner et al, 1989a;Rickels et al, 1989;Mendels et al, 1993;Rickels et al, 1994;Fontaine et al, 1994;Claghorn and Lesem, 1995;Khan, 1995;Mendels et al, 1995).…”