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Women With Depression Respond Better to Citalopram Compared With Men

ANN ARBOR, Mich -- August 29, 2008 -- Women with depression may be much more likely than men to get relief from citalopram (Celexa), although both sexes may find that it helps ease their depression symptoms, according to a study published online in the Journal of Psychiatric Research.

The persistence of a gender difference in response to the drug -- even after the researchers accounted for many complicating factors -- suggests that there's a real biological difference in the way the medication affects women compared with men.

Elizabeth Young, MD, the Depression Center, University of Michigan Medical School, Ann Arbor, Michigan, and colleagues from around the country conducted the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to test citalopram's ability to help patients with depression achieve remission, or total relief from their symptoms.

The gender differences emerged from a detailed analysis of data from 2,876 men and women aged 18 to 75 years who had a clear diagnosis of major depression, and took citalopram over a number of weeks, with the doses increasing over time.

Many of the patients were being treated by primary care physicians and not psychiatrists, and all of the patients had been experiencing depression for years, with the average length of experience around 12 years.

In the end, women were 33% more likely to achieve a full remission of their depression, despite the fact that women in the study were more severely depressed than the men when the study began.

The study showed no differences between men and women in side effects, the amount of time that patients remained on the drug, or the amount of time it took for them to achieve remission of their symptoms.

"Other studies have suggested that there are differences between men and women in response to different antidepressants, but the evidence has been conflicting," said Dr. Young.

"This study is large enough, and we were able to control for enough complicating factors, that we feel confident there is a true difference. These results have clear implications for the clinical treatment of depression."

The study did not include people with bipolar disorder. Participants in the study could continue with psychotherapy that they had been undergoing before the start of the study, but could take any other antidepressants.

The authors caution that their findings do not mean that citalopram should only be used in women. Raw data from the study showed that 24% of men achieved remission with the drug, compared with 29% of women.

Rather, they note that STAR*D and other studies have shown that many people with depression need to try several treatments to find the one that's right for them and will produce lasting results.

SOURCE: University of Michigan Health System

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