Seven trials were included in the review (n=2,476 patients and 2,522 in the safety analysis). For six trials, an interpretation of fair quality was adopted from a previous Cochrane review. The additional trial was judged by the present authors to be of limited quality. All trials were double-blind. Three trials were placebo-controlled. Trial duration ranged from one week to 24 weeks.
Compared with citalopram, escitalopram was associated with greater reductions in MADRS symptom score and CGI-S score and a higher response rate at week eight, but none of the results were clinically relevant. Escitalopram was superior to citalopram in patients with severe depression (one trial), but this was not considered to be clinically relevant.
Discontinuation rates due to adverse events or inefficacy were comparable between the drugs up to eight weeks of treatment, beyond which data were inconclusive.