title: A review of escitalopram and citalopram in child and adolescent depression.
abstract: OBJECTIVE
  To review the basic pharmacology and published literature regarding escitalopram and citalopram in child and adolescent depression.
  
  
  METHODS
  A LITERATURE REVIEW WAS CONDUCTED USING THE SEARCH TERMS: 'escitalopram', 'citalopram', 'depression', 'randomized controlled trial', 'open label trial' and limits set to: Human trials, English Language and All Child (Age 0-18). Additional articles were identified from reference information and poster presentation data.
  
  
  RESULTS
  Three prospective, randomized controlled trials (RCT) were found for escitalopram in pediatric depression, and two RCTs were found for citalopram. One RCT each for escitalopram and citalopram showed superiority over placebo on the primary out come measure. Adverse effects in escitalopram and citalopram trials were generally mild to moderate. Suicidality was not assessed systematically in all RCTs reviewed, but did not appear to be elevated over placebo in escitalopram RCTs. One trial reported numerically higher suicide related events for citalopram compared to placebo (14 vs. 5, p=0.06).
  
  
  CONCLUSIONS
  At present, escitalopram and citalopram should be considered a second-line option for adolescent depression. The US Food and Drug Administration approval of escitalopram for treatment of adolescent depression was based on a single positive RCT. This is less evidence than typically required for approval of a drug for a new indication.
authors: Mental Health and Addictions Program, IWK Health Centre, Halifax, Nova Scotia.
authors: Carlo
authors: C
authors: Carandang
authors: Rekha
authors: R
authors: Jabbal
authors: Angela
authors: A
authors: Macbride
authors: Dean
authors: D
authors: Elbe