A PHARMACOLOGICAL COMPARISON OF CITALOPRAM, A BICYCLIC SEROTONIN SELECTIVE UPTAKE INHIBITOR, WITH TRADITIONAL TRICYCLIC ANTIDEPRESSANTS

Major depressive disorder is a very common and a very serious illness that not only disrupts the lives of the people with the condition but also the lives of their families. Effective identification and treatment of those with this disease would greatly improve the lives of a very sizeable proportion of the people of the world. Numerous drugs have been introduced since the 1950s that have proven to be useful in the therapy of major depressive disorder patients but these compounds typically have unwanted side effects due to their actions on many different aspects of brain function. Citalopram, one of the more recently developed antidepressant drugs, is a selective inhibitor of the transport of the neurotransmitter serotonin into nerve terminals and other cells that accumulate serotonin. Citalopram does not affect the uptake of other neurotransmitters nor does it have affinity for the receptors of any neurotransmitter. It is as effective therapeutically as the older antidepressants but it produces considerably fewer side effects than the traditional antidepressants such as amitriptyline. Citalopram appears to have minimal effects on the cardiovascular system and to be one of the few antidepressants to be eliminated to any extent by the kidneys. These characteristics may be an advantage in treating elderly patients with major depressive disorder, or those patients unable to tolerate the anti-cholinergic side effects of the traditional antidepressants.