Abstract:
OBJECTIVE:To determine the efficacy and tolerability of citalopram when compared to other antidepressants for late-life depression (LLD). METHODS:We searched electronic databases and trial registries to identify randomized controlled trials comparing citalopram to other antidepressants for LLD. Study quality was assessed using the Cochrane collaboration risk of bias tool. We summarized the efficacy of citalopram compared to other antidepressants by examining rates of depression remission, depression response and change in depression symptom scores. Medication tolerability was assessed through trial withdrawals due adverse events and withdrawals due to any cause. We used meta-analysis to determine the odds ratios (OR) of efficacy and tolerability outcomes for citalopram compared to other antidepressants. RESULTS:Seven studies comparing citalopram (N = 647) to other antidepressants (N = 641) for LLD were identified including four studies with tricyclic comparators and three studies with non-tricyclic comparators. Most of the studies had methodological limitations that placed them at risk for potential bias. The majority of studies reported no significant differences between citalopram and comparator medications for depression efficacy or tolerability outcomes. Meta-analysis did not find any significant differences between citalopram and other antidepressants for depression remission [OR = 0.84; 95%CI: 0.56-1.28] or for trial withdrawals due to adverse effects [OR = 0.70; 95%CI: 0.48-1.02]. CONCLUSIONS:Currently there are few studies directly comparing citalopram to other antidepressants for LLD. The small number of studies and methodological issues in many studies limit any conclusions about the relative efficacy and tolerability of citalopram compared to other antidepressants. Well-designed studies comparing citalopram to other antidepressants for LLD are required.
journal_name
Int J Geriatr Psychiatryjournal_title
International journal of geriatric psychiatryauthors
Seitz DP,Gill SS,Conn DKdoi
10.1002/gps.2483subject
Has Abstractpub_date
2010-12-01 00:00:00pages
1296-305issue
12eissn
0885-6230issn
1099-1166journal_volume
25pub_type
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