Uncommon Tips: Which Is Better—Citalopram or Escitalopram?

Topics: Anxiety | Citalopram | Depression | Escitalopram | SSRIs

Editor’s note: We’re pleased to introduce the new feature “Uncommon Tips.” In this series, Dr. Aiken will discuss little-known pearls about commonly used medications. The series starts with a comparison of citalopram and escitalopram. The rivalry between these two SSRIs began in 2002 when the Lundbeck pharmaceutical company split citalopram (

Citalopram Plus Stimulants for Chronic Irritability?

Topics: Citalopram | Disruptive Mood Dysregulation Disorder (DMDD) | Irritability

REVIEW OF: Towbin K et al, J Am Acad Child Adolesc Psychiatry 2020;59(3):350–361 STUDY Type: Randomized controlled trial Chronic irritability in youth is ever-present in daily practice. Currently called disruptive mood dysregulation disorder (DMDD) in the DSM-5, there is an ever-evolving debate about how to treat this condition, but no definitiv

SSRIs and Intracerebral Hemorrhage Risk

Topics: Bleeding | Citalopram | Depression | Escitalopram | Fluoxetine | Geriatric | Hemorrhagic | Intra-cerebral hemorrhage | Mortality | Paroxetine | Post-stroke depression | Prozac | Serotonin Specific Reuptake Inhibitors (SSRIs) | Sertraline | SSRIs | Stroke

REVIEW OF: Kubiszewski P et al, JAMA Neurol 2020;e203142. Epub ahead of print. Depression after strokes is very common, affecting about 50% of stroke patients. Many such patients are treated with SSRIs, which are generally effective but potentially dangerous because they can increase the risk of bleeding due to impaired platelet aggregation. This is

Can Antidepressants Prolong Survival in Cancer Patients?

Topics: Adherence | Cancer | Citalopram | Depression | Escitalopram | Fluoxetine | Mortality | Paroxetine | Prozac | Serotonin Specific Reuptake Inhibitors (SSRIs) | Sertraline | SSRIs

Review Of: Shoval G et al, Depress Anxiety 2019;36(10):921–929 Many cancer patients experience depression, especially those with poor prognoses. Compared with euthymic patients, depressed cancer patients are less adherent to their cytotoxic medications, and this poor adherence can worsen their long-term survival. Yet surprisingly, some studies have

How to Come Off a Psych Med Part 1: Antipsychotics

Topics: Citalopram | Escitalopram | Fluoxetine | Prozac | Risk | Serotonin Specific Reuptake Inhibitors (SSRIs) | SSRIs | Violence

TCPR: There are a lot of books on deprescribing from the antipsychiatry movement, but your book seems to take a different approach.Dr. Gupta: The biggest difference is that the authors of this book all acknowledge that there is a place for psychotropic medications. They can be extremely beneficial for the patient in the right situation. My concern is wi

How to Select an SSRI

Topics: Antidepressants | Citalopram | Escitalopram | Fluoxetine | Prozac | Psychopharmacology | Psychotropic medication | Serotonin Specific Reuptake Inhibitors (SSRIs) | Sertraline | SSRIs

On March 14, 2012, Lexapro became the last SSRI to lose its patent, closing the book on a quarter century of science and marketing that changed and sometimes confused the way we think about antidepressants. Now that the unpublished studies have come to light and the incentives to favor one drug over another have dried up, it’s a good time to take a so

Mood and Menopause

Topics: Antidepressants | Citalopram | Depressive Disorder | Effexor | Escitalopram | Female Issues in Psychiatry | Fluoxetine | gabapentin | Gender | Hormone Replacement Therapy | Oral Contraceptives | Prozac | Serotonin Specific Reuptake Inhibitors (SSRIs) | SSRIs | Women’s Issues in Psychiatry

TCPR: When does perimenopausal depression tend to start?Dr. Nonacs: It’s during the transition into menopause that women are most vulnerable to depression. And that transition can actually take quite a while, like 5–7 years. TCPR: How does it present?Dr. Nonacs: Often they’ve had a history of depression, but have done fairly well up to this point

Optimal Antidepressant Doses in Major Depression

Topics: Antidepressants | Bupropion | Citalopram | Depression | Depressive Disorder | Escitalopram | Fluoxetine | Mirtazapine | Paroxetine | Pharmacology | Pharmacology Tips | Research | Research Update | Sertraline | SSRIs | Venlafaxine | Wellbutrin

Review of: Furukawa TA et al, Lancet Psychiatry;2019;6(7):601–609 Type of study: Systematic review and meta-analysis Most antidepressants do not have a linear response curve. In other words, the benefits level off as the dose goes up. If the dose gets too high, the side effects start to outweigh those diminishing returns. What’s not clear is whe