Efficacy and Safety of Citalopram for the Treatment of Poststroke Depression: A Meta-Analysis.

OBJECTIVE: To objectively evaluate the efficacy and safety of citalopram versus other antidepressant drugs in poststroke depression (PSD) treatment.

METHODS: We searched randomized controlled trials (RCTs) that compared citalopram with other Selective serotonin reuptake inhibitors (SSRIs) and Serotonin norepinephrine reuptake inhibitor (SNRIs) on PSD treatment. The methodological quality of RCTs was assessed according to the Cochrane risk of bias tool. Meta-analysis was conducted using RevMan 5.3 software with standard mean difference (SMD) or Relative risk (RR) and their 95% confidence interval (CI).

RESULTS: A total of 20 studies involving 1485 patients were included .The RR of efficacy index compared to other SSRIs was 1.04 [95% CI: .98-1.09, P = .17], and to SNRIs was 1.01 [95% CI: .93-1.09, P = .83]. The RR of cure index compared to other SSRIs was .99 [95% CI: .82-1.19, P = .88], and to SNRIs was .95 [95% CI: .71-1.27, P = .74]. Significant decreases on Hamilton Depression Scale scores were observed in favor of citalopram when compared to other SSRIs after 4-, 6-week treatment [SMD = -.44, 95% CI: -.85 to -.03, P = .03; SMD = -.50, 95% CI: -.98 to -.02, P = .04], and no significant difference was found with SNRIs in any week [P > .05]. The rate of adverse effects also showed no significant difference between citalopram and other antidepressants [P > .05].

CONCLUSIONS: This meta-analysis indicates that the efficacy of citalopram is similar to that of other SSRIs and SNRIs, but citalopram takes action faster than other SSRIs. The adverse effects of citalopram have no significant difference compared to other antidepressants and those adverse effects are less and mild.