Efficacy differences between escitalopram and citalopram: A systematic survey

Efficacy differences between escitalopram and citalopram: A systematic survey Efficacy differences between antidepressants have only been detected exceptionally (e. g. venlafaxine versus SSR Is; [3,37]; but [39]). Due to the fact that escitalopram is the enantiomer of the racemate citalopram, the question whether this compound possesses besides pharmacodynamic differences (e. g. [30]) also clinical relevant advantages has been a matter of discussion since the approval of the compound. In order to investigate this issue thoroughly the relevant studies of evidence level la (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). Overall, approximately 20% more patients responded under escitalopram than under citalopram; regarding remission, this difference is approximately 30%; the point difference on the Montgomery-Asberg Depression Scale (MADRS) was between 1 and 2 (statistically significant). In a subanalysis it was found that the superiority of escitalopram increased with increasing initial depression severity.