Clinical multicentre study of citalopram compared double-blindly with mianserin in depressed patients in Finland

Ahlfors UG, Elovaara S, Harma P, Suoniemi I, Heikkilä L, Nummi K, Vartiainen A, Var-tiainen H, Tarnminen T, Elgen K, Sundman K. Clinical multicentre study of citalopram compared double-blindly with mianserin in depressed patients in Finland. The aim of the trial was to study the antidepressant effect and side effects of citalopram and mianserin in a double-blind, multicentre study in six psychiatric hospitals in Finland. Patients of both sexes, aged 18 to 70 years, were included. The depression was classified as endogenous or non-endogenous by means of the Newcastle Depression Scale (1). Thirty-seven patients were allocated to treatment with citalopram and 34 to treatment with mianserin. Six patients (5+1) did not fulfil the inclusion criteria and nine patients (4+5) dropped out of the study. Citalopram. 40-60 mg daily, and mianserin, 60-90 mg daily, were given once a day in the evening for 4 weeks. The patients were assessed before treatment and after 1, 2, and 4 weeks. The Clinical Global Impression Scale. the CPRS Subscale for Depression. and a Side Effect Check List were used. There were 17 endogenously and 11 non-endogen-ously depressed patients in the citalopram group and 14 of each category in the mianserin group. In patients with endogenous depression, the CGI and CPRS scores indicate that citalopram and mianserin were equally effective as antidepressants. In patients with non-endogenous depression a significant reduction of scores was seen after only I week in both groups. However, after 4 weeks of treatment the mianserin group had a significantly lower score than the citalopram group. The frequency of side effects in both treatment groups was lower than that usually observed after treatment with tricyclic antidepressants, and a reduction of the number of symptoms was obtained during treatment. The laboratory tests showed some transient abnormalities unrelated to drug treatment.