Citalopram effective for major depression

Clinical question: 
How effective is citalopram in comparison with tricyclics, heterocyclics, other selective serotonin reuptake inhibitors (SSRIs) and other conventional and non-conventional antidepressants in the acute-phase treatment of major (moderate-to-severe) depression?
Bottom line: 
Citalopram was more efficacious than paroxetine and reboxetine, and more acceptable (lower drop-out rate) than tricyclics, reboxetine and venlafaxine. However, it seemed to be less efficacious than escitalopram. Follow-up extended to 6 months.
Caveat: 
Economic analyses were not reported. Sponsorship bias and publication bias had the potential for overestimating treatment effects.
Context: 
Antidepressant drugs remain the mainstay of treatment in moderate-to-severe depression. During the past 20 years, SSRIs have progressively become the most commonly prescribed antidepressants.
Review CD#: 
CD006534
PEARLS No: 
372
Date: 
September, 2012
Authored by: 
Brian R McAvoy