Citalopram and viloxazine in the treatment of depression by means of slow drop infusion. A double-blind comparative trial

Abstract

Antidepressant efficacy and tolerability of citalopram and viloxazine were compared under double-blind conditions during the first two weeks of treatment with slow drop infusion, followed by oral administration for the rest of the six week trial period. The 62 severely depressed and hospitalised patients included in the intention-to-treat analysis had a mean age of 45 years (range 23 to 70 years). About two thirds of the patients were female. Thirty patients were allocated to the citalopram and 32 patients to the viloxazine group. The mean MADRS total score at baseline was 34 in both groups and decreased to 12.3 in the citalopram and to 16.9 in the viloxazine group after 14 days of infusion. On day 42 (end point) the scores dropped to 6.7 in the citalopram and to 13.1 in the viloxazine group respectively. The group differences reached the level of significance at both time points (p < 0.05) in favour of citalopram. The analysis of treatment emergent adverse events based on the UKU scale showed a higher frequency of nausea on day 14 and constipation at study end in the viloxazine group (p < 0.05) whereas reported weight gain (day 21) and concentration difficulty (day 21) were more frequently seen in the citalopram group (p < 0.05). Standard laboratory investigations and ECG analyses did not show clinically relevant abnormalities. It is concluded that antidepressant treatment with citalopram infusion followed by oral citalopram may be more efficacious than a corresponding treatment schedule with viloxazine.