Citalopram in doses of 20-60 mg is effective in depression relapse prevention: a placebo-controlled 6 month study

The aim of the present study was to determine whether, in patients with depression who had responded favourably to the selective serotonin reuptake inhibitor citalopram, there was a therapeutic benefit in continuation treatment. Three hundred and ninety-one depressive patients were included in an open short-term citalopram treatment period. Only patients who responded to treatment at 8 weeks (total score of 12 or less on the MADRS scale) were randomized to the 24 week double-blind phase. Seventy-four patients were treated with placebo and 152 with citalopram at the same constant dose to which the patient had responded in the first phase. Relapse was defined as a total score of 25 or more on the MADRS scale. Twenty-one patients (13.8%) continuing to receive citalopram relapsed compared with 18 patients (24.3%) receiving placebo. The log rank test for survival data used to test the quality of relapse hazards between the placebo group and the citalopram group showed that patients treated with citalopram had a significantly lower relapse rate (p = 0.04). The results of this study are in general agreement with those of other studies on antidepressants, and support the hypothesis that full dose continuation is more effective than placebo in preventing relapse of depression.