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Is escitalopram exchangeable by citalopram? A systematic survey

Published online by Cambridge University Press:  16 April 2020

H.-P. Volz  and
W. Flürenbrock
H.-P. Volz
Affiliation:
KPPPM Schloss Werneck, Werneck, Germany
W. Flürenbrock
Affiliation:
Lundbeck GmbH Germany, Hamburg, Germany

Abstract

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Objective

Efficacy differences between antidepressants have only been detected exceptionally (Bauer et al., 2009). Due to the fact that escitalopram is the enantiomer of the racemate citalopram the question arose whether this compound possesses besides pharmacodynamic differences (e.g. Sánchez, 2006) also clinical relevant advantages.

Methods

In order to investigate this issue thoroughly the relevant studies of evidence level Ia (systematic surveys of randomized controlled studies) and Ib (randomized controlled trials) were summarized regarding three main outcome parameters: response (decrease of the depressive symptomatology of at least 50% on a depression scale), remission (reduction of the depressive symptomatology below a certain threshold on a depression scale) and change in depression symptomatology (point difference on a depression scale during the treatment period).

Results

Overall, approximately 20% more patients responded under escitalopram than under Citalopram. Regarding remission, this difference is approximately 30%. The point difference on the Montgomery-Åsberg depression scale was between 1 and 2 (statistically significant). In a subanalysis it was found that the superiority of escitalopram increased with increasing initial depression severity.

Conclusion

These very robust data are discussed regarding their clinical implications.

Type
P03-123
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 1292
Copyright
Copyright © European Psychiatric Association 2011

References

Literatur

Bauer, M.Tharmanathan, P.Volz, H.P.Möller, H.J.Freemantle, N.The effect of venlafaxine compared with other antidepressants and placebo in the treatment of major depression. Eur Arch Psychiatry Clin Neurosci 2009; 259: 172–18510.1007/s00406-008-0849-0CrossRefGoogle ScholarPubMed
Sánchez, C.TI: The Pharmacology of Citalopram Enantiomers: The Antagonism by RCitalopram on the Effect of S-Citalopram. Basic & Clinical Pharmacology & Toxicology 2006; 99: 91–9510.1111/j.1742-7843.2006.pto_295.xCrossRefGoogle Scholar
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