Comparison of the Efficacy of the Escitalopram and Citalopram in the Treatment of Major Depressive Disorder

US Food and Drug Administration (FDA) approved Escitalopram (the active S-isomer of racemic SR-citalopram) to treat people who are suffering from Major Depressive Disorder (MDD) and for relapse prevention.

This study aims to compare the therapeutic efficacy, cost-effect, time onset of action and patient adherence of escitalopram versus citalopram in the treatment of MDD.

Based on Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria, a random single-blind comparative therapeutics study is conducted to compare the impact of taking

escitalopram and citalopram at an oral dose of 20 mg/once daily for 12 weeks’ duration on 100 patients with MDD. The patients are randomly divided into two equally treatment groups (i.e. 50 per each group) in the Department of Psychiatry at the Teaching Hospitals in Kirkuk, Sulaymaniyah and Erbil cities during November 2012-May 2013. The severity of depressive symptoms is assessed by a 4 degrees’ scale (0 to 3) derived from DSM-IV. The scales are: 0 = Not at all, 1 = sometimes suffered (mild), 2 = Almost Always suffered (moderate) and 3 = Always suffered (severe).

This study is conducted on 100 patients aged from 18 to 70 years old after receiving 12 weeks of treatment with a fixed dose of 20 mg of escitalopram and 20 to 30 or 40mg of citalopram. The total score of depressive symptoms of patients with 0 degree (i.e. not at all) demonstrates that escitalopram is superior to citalopram regarding the effectiveness, early symptoms relief starting week one, patient adherence and significant change in dosage scores.

This study confirmed that the new SSRI escitalopram 20 mg is more effective than citalopram 20mg. As a consequence, we recommend it as first-line therapy for MDD patients.