Efficacy measures were total score on the rating scales, their ch

Efficacy measures were total score on the rating scales, their change from baseline, or the response rate. Responders were generally defined as patients with a decrease in the HAMD or MADRS total score of at least 50% after at least 3 weeks of therapy (or time not given), or a score of 1 or 2 on the CGI. Parallel-group dose comparison studies Citalopram The short-term studies with citalopram did not show significant differences In terms of clinical efficacy across a dose range of 20 to 60 mg/day Even a dose of 10 mg/day was effective compared with placebo.10 The results of the maintenance

Inhibitors,research,lifescience,medical study by Montgomery et al11 and the meta-analysis by the same authors12 support these findings. Therefore, for the majority of patients, there Is no advantage of increasing the dose of citalopram above 20 mg/day. The study by Montgomery et al11 Is particularly Interesting, because, In the acute double-blind phase of one of the two Initial studies (Table I),13 citalopram 20 mg/day was no more effective Inhibitors,research,lifescience,medical than placebo. However, in the long-term phase, the relapse rate was similar In the group of responders Inhibitors,research,lifescience,medical on citalopram 20 mg/day who were randomized to placebo and In the group of those who were responders and continued In double-blind on placebo, but higher than in the group of those who were randomized to continue on citalopram

20 mg/day. These results Inhibitors,research,lifescience,medical tend to show that citalopram 20 mg/day was effective in the acute phase despite the observation that it was not significantly different from placebo. Table I Selective and serotonin reuptake inhibitors (SSRls) and dose-efficacy relationship in parallel-group dose comparison studies ranked in order of increased efficacy. HAMD, Hamilton Rating Scale for Depression; MADRS, Montgomery and Åsberg Depression … The study by Montgomery et al13 failed Inhibitors,research,lifescience,medical to show a benefit of citalopram 20 mg/day on the HAMD 17 Items and MADRS total scores In a group

of 56 évaluable patients, ie, those who remained at least 3 weeks In the study; only citalopram 40 mg/day, In a group of 49 évaluable patients, was superior to placebo and to citalopram 20 mg/day. When using change on the HAMD and MADRS total score, citalopram 20 and 40 mg/day were no different from placebo. Using the 50% reduction on the HAMD and MADRS total score, there were no differences between citalopram 20 and 40 mg/day and placebo at the end of 6 weeks. In other words, there why were no more responders In the two citalopram groups than In the placebo group. All analyses were carried out on a LOCF. In a large study by Felghner and Overo (Table I), 14 citalopram 40 and 60 mg/day, but not 10 and 20 mg/day, were more effective than placebo on change on the HAMD 21 Items total score on ITT-LOCF at the end of 6 weeks. However, there was no Epigenetic pathway inhibitors statistical analysis comparing the different doses of citalopram.

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