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Antidepressant, Celexa (Citalopram), Produces Less Weight Gain Than Paxil (Paroxetine)
SAN JUAN, PUERTO RICO -- December 15, 2000 -- Clinically significant body weight gain is five times more prevalent with Paxil (paroxetine HCl) than Celexa™ (citalopram HBr), according to a major new study of patients treated for depression and anxiety.
The study involving the two selective serotonin reuptake inhibitors (SSRIs) was presented by University of Wisconsin researchers at the American College of Neuropsychopharmacology Annual Meeting in San Juan.
"Though they all belong to the same category of antidepressants, SSRIs have significant structural and clinical differences, including side effects," says James W. Jefferson, MD, clinical professor of psychiatry, University of Wisconsin Medical School, and lead investigator of the study. "Evaluating weight gain was a primary focus of this study due to the serious emotional role it can play in the patient's life and the relative lack of data available on the subject."
In the 28-week, randomized, double-blind, parallel group study, citalopram and paroxetine produced significant improvements of similar magnitude on measures of anxiety and depression among 104 adult male and female participants (18-65 years of age). However, clinically significant body weight gain occurred among 21.6 percent of paroxetine-treated patients compared to 3.9 percent of citalopram-treated patients. Clinically significant body weight gain was defined in this study as greater than or equal to 7 percent increase.
"Weight gain is an extremely important factor in evaluating SSRIs," notes Dr. Jefferson. "A weight gain of seven percent or more is considerable for a patient who is suffering from depression and anxiety. This physical change may lead a patient to make a unilateral decision to end treatment."
During the post-medication follow-up period of the study comparing citalopram and paroxetine, the paroxetine group exhibited a trend towards more dizziness, headache, and nausea -- adverse events that may be associated with a discontinuation syndrome. The two-week post-medication period was the last part of the study design that consisted of a one-week single-blind placebo lead-in period, followed by a 24-week double-blind treatment period, and a two-week double-blind down-titration period. Dosing started at 20 mg/day and could be titrated (based on response and tolerability) up to 40 mg/day for
either drug.
All patients enrolled in the study had a diagnosis of Major Depression and Mixed Anxiety Depressive Disorder (according to DSM-IV) and were required to score at a certain level on two different depression and anxiety ratings scales.
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