Citalopram (Celexa) versus Other
Citalopram vs. Reboxetine
- Panic disorder:
Both citalopram and reboxetine significantly improve panic attack
severity. However, Citalopram appears to have superior efficacy in
treating comorbid depressive symptoms 1.
- Pain disorder:
In the 8-week, randomized double-blind study, patients with a DSM-IV-TR
diagnosis of Pain Disorder were randomly assigned to receive either
citalopram 40 mg/day or reboxetine 8 mg/day. In the citalopram group,
Present Pain Intensity (PPI) and Total Pain Rating Index (tPRI) scores
measured at baseline decreased after treatment (tPRI: 41.9 vs. 30.0;
PPI: 3.5 vs. 2.8) whereas in the reboxetine group differences were
not statistically significant (tPRI: 35.2 vs. 31.5; PPI: 3.7 vs. 3.1).
The results of the study suggests that the SSRI citalopram may have
a moderate analgesic effect in patients with Pain Disorder. This analgesic
activity appears to be not correlated to changes in depressive scores
Citalopram vs. Fluoxetine (Prozac)
- Major depressive disorder: Citalopram is as effective as
fluoxetine in the treatment of unipolar major depression. In the study
citalopram showed an earlier onset of recovery than fluoxetine 8.
- Bulimia nervosa: In the study patients treated with fluoxetine
displayed a greater reduction in introjected anger, whereas those
treated with citalopram displayed a greater reduction in depressive
feelings. Citalopram may be useful in depressed patients with bulimia,
whereas fluoxetine is more specific for those with introjected anger
and bulimia 2.
Citalopram vs. Paroxatine (Paxil)
Panic disorder: Paroxetine and citalopram have similar anti-panic
properties and a good tolerability profile 5.
Citalopram vs. Sertraline (Zoloft)
Major depressive disorder: Sertraline and citaloptam have similar
efficacy in the treatment of major depression. However, citalopram
has more pronounced antianxiety effects 11, 12.
- Side effects: Sertraline treatment is associated with
higher rate of gastrointestinal side effects 12. Sertraline is associated
with lower incidence of weight gain and sexual side effects than citalopram
Citalopram vs. Escitalopram (Lexapro)
- Escitalopram appears to have greater efficacy and faster onset
of action than comparable doses of citalopram. The lower efficacy
of citalopram in the studies is apparently due to the inhibition of
the effect of the S-enantiomer by the R-enantiomer. Data from randomised
clinical trials consistently show better efficacy with escitalopram
than with citalopram, including higher rates of response and remission,
and faster time to symptom relief 6.
- Major depressive disorder: Escitalopram may be a cost-saving
alternative to citalopram for the treatment of severe depression 7.
Escitalopram may have a faster onset and greater overall magnitude
of effect than citalopram in improving symptoms of depression and
anxiety in patients with major depressive disorder 10. Escitalopram
has better efficacy in the treatment of severe depression than citalopram
- Antinociceptive properties: Study findings show that citalopram
given i.p. is a weak antinociceptor, (not mediated through opioid
mechanisms), while escitalopram possesses no antinociceptive properties
when injected i.p. 9.
Citalopram vs. Nortriptyline
Major depressive disorder: A comparative study demonstrated
significantly higher remission rate to nortriptyline than to citalopram
in moderate to severe major depressive patients, especially if severe
patients (endogenous or psychotic patients) were assessed 16.
- Side effects: Citalopram appears to be better tolerated
than nortriptyline. Autonomic side effects are significantly higher
for nortriptyline than for citalopram 16.
Citalopram vs. Amitriptyline
- Comorbidity of depression, migraine, and tension-type headache:
Amitriptyline and citalopram are equally efficacious in relieving
depressive symptoms. However, amitriptyline appears to be more efficacious
than citalopram in reducing migraine and tension-type headache attacks
Combined therapy with amitriptyline and citalopram may be particularly
beneficial for individuals with tension-type headache, migraine
and comorbid depression that do not respond to monotherapy.
- Chronic tension-type headache: Amitriptyline can significantly
reduce the duration of headache, headache frequency, and intake
of analgesics, whereas citalopram has no significant effect 12.
- Depression: Both drugs are effective, and citalopram is
probably as efficacious as amitriptyline. However, amitriptyline
may have a better effect on sleep disturbances due to its more hypnotic
effect 19, 20.
- Side effects: Amitriptyline produces side effects
more frequently than citalopram 19, 20.
Citalopram vs. Mirtazapine (Remeron)
Major depressive disorder: Mirtazapine has potentially faster
onset of efficacy than citalopram.
In the study, mirtazapine and citalopram were equally effective in
reducing symptoms of depression and anxiety. However, mirtazapine
was significantly more effective than citalopram after 2 weeks of
treatment on the several Severity of illness and Quality of life scales
(MADRS, HAM-A and CGI ) 4.
- Side effects: Sweating and nausea are associated significantly
more frequently with citalopram treatment, whereas increased appetite
and complaints of weight increase with mirtazapine treatment 4.
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Published: March 31, 2008
Last updated: April 25, 2011