US Food and Drug Administration (FDA) has approved escitalopram to treat people suffering from Major Depressive Disorder (MDD) and prevent relapse. 

The present study compared the therapeutic efficacy, cost-effectiveness, time onset of action, and patient adherence to escitalopram versus citalopram in treating MDD. 

Based on the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria, this study compared the effect of escitalopram and citalopram administration at an oral dose of 20 mg/ once daily for 12 weeks on 100 patients with MDD. The study randomized the patients into two equal treatment groups. It assessed the severity of depressive symptoms by a 4 degrees scale (0 to 3) derived from DSM-IV, with 0 = Not at all, 1 = occasionally suffered (mild), 2 = Nearly Always suffered (moderate), and 3 = Consistently suffered (severe). 

The study enrolled patients aged 18 to 70 years and gave them 12 weeks of treatment with a fixed dose of 20 mg of escitalopram and 20 to 30 or 40mg of citalopram. The total score of depressive symptoms of patients with 0 degrees (i.e., not at all) demonstrated the superiority of escitalopram over citalopram regarding the effectiveness, early symptoms relief beginning from week one, patient adherence, and changes in dosage scores. 

This study proved that the new SSRI escitalopram 20 mg is more effective than citalopram 20mg. Hence its use as first-line therapy for MDD patients is recommended.

Galleb AT, Shendi JM, Kanber CB. Comparison of the Efficacy of the Escitalopram and Citalopram in the Treatment of Major Depressive Disorder. Indian Journal of Forensic Medicine & Toxicology. 2019;13(4):p534-540.