Effectiveness and acceptability of sertraline and citalopram in major depressive disorder: pragmatic randomized open‐label comparison

Matreja, Prithpal S; Badyal, Dinesh; Khosla, Prem Parkash; Deswal, Randhir S

doi:10.1002/hup.864

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…The great majority of included studies had been carried out in Europe or in the US (29 out of 37 RCTs, that is 78.4%). Two studies randomised patients in China (Hsu 2011; Ou 2010), three in India (Khanzode 2003; Lalit 2004; Matreja 2007) and one in Russia (Yevtushenko 2007).…”

Section: Resultsmentioning

confidence: 99%

“…In the review we have included one “single-blind” trial (Navarro 2001) which was rated as having a “high risk of bias” because it was unclear whether its outcome assessment was blinded to the medication. Four trials were open trials that did not seek blinding (Castanedo de Alba 1998; Hosak 1999; Lewis 2011; Matreja 2007) and in two studies the blinding was unclear (Moeller 2003; Ou 2010).…”

Section: Resultsmentioning

confidence: 99%

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Citalopram versus other anti-depressive agents for depression

Cipriani

Purgato

Furukawa

et al. 2012

Cochrane Database of Systematic Reviews

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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 reviews 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. Search methods We searched The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register and the Cochrane Central Register of Controlled Trials up to February 2012. No language restriction was applied. We contacted pharmaceutical companies and experts in this field for supplemental data. Selection criteria Randomised controlled trials allocating patients with major depression to citalopram versus any other antidepressants. Data collection and analysis Two reviewers independently extracted data. Information extracted included study characteristics, participant characteristics, intervention details and outcome measures in terms of efficacy (the number of patients who responded or remitted), patient acceptability (the number of patients who failed to complete the study) and tolerability (side-effects). Main results Thirty-seven trials compared citalopram with other antidepressants (such as tricyclics, heterocyclics, SSRIs and other antidepressants, either conventional ones, such as mirtazapine, venlafaxine and reboxetine, or non-conventional, like hypericum). Citalopram was shown to be significantly less effective than escitalopram in achieving acute response (odds ratio (OR) 1.47, 95% confidence interval (CI) 1.08 to 2.02), but more effective than paroxetine (OR 0.65, 95% CI 0.44 to 0.96) and reboxetine (OR 0.63, 95% CI 0.43 to 0.91). Significantly fewer patients allocated to citalopram withdrew from trials due to adverse events compared with patients allocated to tricyclics (OR 0.54, 95% CI 0.38 to 0.78) and fewer patients allocated to citalopram reported at least one side effect than reboxetine or venlafaxine (OR 0.64, 95% CI 0.42 to 0.97 and OR 0.46, 95% CI 0.24 to 0.88, respectively). Authors’ conclusions 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. As with most systematic reviews in psychopharmacology, the potential for overestimation of treatment effect due ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Citalopram versus other anti-depressive agents for depression

Cipriani

Purgato

Furukawa

et al. 2012

Cochrane Database of Systematic Reviews

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“…The Jadad scores ranged from 0 to 5 with a median of 2 (mean of 1.97, mode 2). Newer studies had explicitly used intention-to-treat analysis,[34505458596364] while the older studies had not relied on such statistical procedures. [293032333640434748] When correlation of the year of publication was drawn with risk of bias (measured with Jadad scale), there was no statistically significant correlation (Kendall tau correlation of −0.031, P=0.813).…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of trials of treatment of depression from India

Sarkar

Grover

2014

Indian J Psychiatry

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Background:Antidepressants hold the center stage in the treatment of depression in current clinical practice. However, it is also well-known that the treatment response and dosage requirement are influenced by ethnic variations. Although many efficacy studies have evaluated the efficacy of antidepressants, there is lack of systematic reviews and meta-analysis of the existing literature from India.Objective:To systematically review the efficacy of treatment of depression in the Indian context.Materials and Methods:We searched PubMed, Psychinfo, Medknow and Google scholar to identify studies published in peer-reviewed English language journals. All controlled trials from India evaluating the clinical efficacy of antidepressants, electroconvulsive therapy (ECT), and repetitive transcranial magnetic stimulation (rTMS) for management of depression were evaluated. Data were extracted using standard procedures and risk of bias was evaluated. Effect sizes were computed for the individual studies.Results:Effect sizes were computed from 35 clinical trials. Overall, medications were superior to placebo for treatment of depression (mean effect size (ES) of 0.87, confidence intervals (CI of 0.71-1.02). The effect was greatest for tricyclic antidepressants (ES of 1.00, CI of 0.80-1.21) followed by monoamine oxidase inhibitors (ES 0.54, CI of 0.40-0.67). ECT was superior to antidepressants (ES 0.32, CI of − 0.21 to 0.86) and active rTMS was found to be superior to sham rTMS with mean effect size of 0.74 (CI 0.39-1.08). Risk of bias was found to be considerable. However, the review literature suggests that most of the studies have not been powered adequately and have been limited to small sample sizes.Conclusions:Although there is some data from India with respect to efficacy of antidepressants, most of the trials have been of shorter duration have been inadequately powered. The available data support the superiority of antidepressants over placebo and that of ECT over antidepressants.

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“…The calculation of sample size in this study was based on the parameters that > is 0.05 and power is 0.8 (assuming SD is 5 and the ratio of case to control number is 1). 38 Then, if the mean difference of MADRS score is 5, the sample size will be 34. If the mean difference of MADRS score is 4, the sample size will be 52.…”

Section: Discussionmentioning

confidence: 99%

Faster Onset of Antidepressant Effects of Citalopram Compared With Sertraline in Drug-Naïve First-Episode Major Depressive Disorder in a Chinese Population

Hsu¹,

Su²,

Huang³

et al. 2011

Journal of Clinical Psychopharmacology

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Several previous studies, including a meta-analysis, reported no significant differences between various selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder. However, because of the different chemical structure of SSRIs and the difference in the frequency of serotonin transporter polymorphisms between ethnic groups, a head-to-head comparative study between SSRIs in different populations may be enlightening. We compared the efficacy and adverse effect profiles of citalopram and sertraline in a double-blinded randomized clinical trial in a Chinese population of drug-naïve patients with first-episode major depressive disorder. Fifty-one patients were randomly assigned to citalopram or sertraline treatment. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary outcome. Efficacy and adverse effects were analyzed in an intent-to-treat population. Efficacy was analyzed using a last-observation-carried-forward method for early terminators. There were no significant differences in demographic characteristics at baseline. No significant differences were found in MADRS scores between citalopram and sertraline at baseline (36.6 ± 5.5 vs 38.2 ± 4.9; P = 0.322) or at the end of treatment (week 6; 10.8 ± 10.0 vs 16.7 ± 11.3; P = 0.082). However, MADRS scores in the citalopram group were significantly lower at week 1 (25.2 ± 8.5 vs 30.4 ± 6.1; P = 0.029) and week 3 (15.9 ± 10.0 vs 22.1 ± 8.7; P = 0.037). Overall, treatment-emergent adverse effects were reported by 14.3% and 28.6% of patients in the citalopram and sertraline groups, respectively. In conclusion, citalopram and sertraline were both efficacious and well tolerated. However, citalopram exhibited a significantly faster onset than sertraline during the early weeks of treatment and tended to have a better efficacy in overall treatment, although the statistic was not significant.

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Effectiveness and acceptability of sertraline and citalopram in major depressive disorder: pragmatic randomized open‐label comparison

Abstract: Citalopram had shown better efficacy, earlier onset of action and more number of responders and remitters as compared to sertraline in MDD in Indian patients.

Cited by 10 publications

References 12 publications

Citalopram versus other anti-depressive agents for depression

Citalopram versus other anti-depressive agents for depression

A systematic review and meta-analysis of trials of treatment of depression from India

Faster Onset of Antidepressant Effects of Citalopram Compared With Sertraline in Drug-Naïve First-Episode Major Depressive Disorder in a Chinese Population

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