Double-Blind Randomized Clinical Trial of the Efficacy of Venlafaxine Versus Citalopram in the Treatment of the Acute Phase of Major Depressive Disorder

BACKGROUND: There are many antidepressant medications with different side-effects and efficacy profiles. OBJECTIVES: In this study, we compared the efficacy of citalopram and venlafaxine in major depression, which has not yet been studied in Iran. PATIENTS AND METHODS: In this double-blind, randomized controlled trial study, 39 patients aged 18-54 year old with major depressive disorder were randomly allocated into two groups in Yazd City, Iran, between March 2011 and December 2012. A total of 16 patients were treated with velafaxine and 23 patients were treated with citalopram for 8 weeks. Hamilton Depression Rating Scale (HDRS) questionnaire was used for monitoring depression severity. Data were analyzed by SPSS version 20.0 software using Mann Whitney U test and chi-square statistical tests. RESULTS: The HDRS scores were decreased significantly in each group after 8 weeks of treatment (P = 0.001). However, there was no significant difference considering the score of HDRS (P = 0.110). Ten patients in the venlafaxine group and two patients in the citalopram group stopped using medication, all due to nausea or vomiting, or both, and the rate of these two side-effects was significantly higher in the venlafaxine group (P = 0.010). CONCLUSIONS: The efficacy of venlafaxine and citalopram are almost the same, but compliance for the use of medication, such as nausea and vomiting, in patients using venlafaxine is much higher than the citalopram group. Therefore, this implies that citalopram could be a safer antidepressant for patients suffering from major depression.