THE OPTIMAL DOSING REGIMEN FOR CITALOPRAM - A METAANALYSIS OF 9 PLACEBO-CONTROLLED STUDIES

Optimal dosing schedules for an antidepressant drug can only be establ ished during clinical studies in depressed patients. The benefits of a ntidepressant therapy are usually progressive, and thus patients must be maintained on a particular treatment for at least 3-4 weeks to asse ss the efficacy of different doses. Meta-analysis, a widely accepted s tatistical technique which allows the combination of the results of mu ltiple studies, was used to assess the efficacy of several doses of ci talopram over nine placebo-controlled clinical trials. Statistically s ignificant differences between citalopram and placebo were found at bo th the 20 and 40 mg dose levels. The minimal effective dose of citalop ram was shown to be 20 mg. However, analysis of patient subgroups reve aled a tendency for those patients suffering from severe or recurrent depression to achieve better results with a higher dosage (40 mg), whi le patients experiencing their first period of depression or with less severe depression responded well to the minimally effective dose of 2 0 mg.