Escitalopram: A New SSRI for the Treatment of Depression in Primary Care

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Escitalopram is the S-enantiomer of the racemiccompound citalopram, a selective serotoninreuptake inhibitor (SSRI) widely used for thetreatment of depression. This review describesthe current body of pharmacologic and clinicalevidence supporting the use of escitalopram forthe treatment of depression and anxiety. Preclinicalstudies have confirmed that it is primarily thismolecule that provides the inhibition of serotoninreuptake responsible for the antidepressant effectof citalopram, with minimal-to-nonexistent affinityfor other receptor sites. Clinical trials of escitalopramin depressed patients indicate thatescitalopram, 10 mg/day, is as effective as 40mg/day of its parent compound, citalopram, withan excellent safety and tolerability profile. Becauseof its increased selectivity, escitalopramrepresents a refinement in SSRI therapy forsymptoms of depression and anxiety. This articlealso explores the implications of a more selectiveSSRI on the management of depressed patients inthe primary care clinical practice.