Key result
Citalopram improves post-stroke depression efficacy ~7% vs TCAs, causing fewer first-week side effects than other SSRIs.
Why the study?
The comparative efficacy and safety of citalopram versus other SSRIs, TCAs, and traditional Chinese medicines in treating post-stroke depression were unclear.
Does citalopram improve depression symptoms and reduce side effects in patients with post-stroke depression compared to other SSRIs, TCAs, or TCMs?
Meta-Analysis
Does citalopram improve depression symptoms and reduce side effects in patients with post-stroke depression compared to other SSRIs, TCAs, or TCMs?
Citalopram shows comparable or slightly better efficacy and fewer early side effects compared to other SSRIs and TCAs in treating post-stroke depression.
Citalopram may be preferred for post-stroke depression given modestly better efficacy; extends comparative data versus SSRIs and TCAs.
BACKGROUND AND PURPOSE: To evaluate the citalopram in post-stroke depression treatment, we compared its use to other selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and traditional Chinese medicines (TCMs). METHODS: We searched databases up to May 2015. Relative risk (RR) for dichotomous data and standard mean difference (SMD) for continuous variables were analyzed using Stata 13.1. RESULTS: The RR of the efficacy index compared to TCAs was 1.07 (95% CI 1.01-1.14, p = 0.02), and the Hamilton Depression Scale with citalopram was lower than that found with other SSRIs (SMD -0.43, 95% CI -0.85 to -0.01, p < 0.05) and TCAs (SMD -0.31, 95% CI -0.50 to -0.12, p < 0.05) in 6-week. The Treatment Emergent Symptom Scale with citalopram was lower than that with other SSRIs (SMD -0.33, 95% CI -0.56 to -0.10, p = 0.01, 1-week). The p values were all >0.05 on citalopram vs. TCMs. CONCLUSIONS: The efficacy of citalopram maybe not very significant compared to that of other SSRIs or TCAs. But citalopram has fewer side effects especially in the first week. We, however, need further researches to compare citalopram to TCMs in future.
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Tan et al. (2015) conducted a meta-analysis in Post-stroke depression. Citalopram vs. Other SSRIs, TCAs, and TCMs was evaluated on Efficacy index compared to TCAs (RR 1.07, 95% CI 1.01-1.14, p=0.02). Citalopram had a higher efficacy index than TCAs for post-stroke depression (RR 1.07; 95% CI 1.01-1.14; p=0.02) and fewer side effects in the first week compared to other SSRIs.
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