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In a study analyzing the clinical effects of citalopram serum levels in patients with major depressive disorder (MDD), a significant number of patients who had serum concentrations of <50 ng/ mL showed less than favorable treatment outcomes, even at therapeutic doses.
Citalopram and other selective serotonin reuptake inhibitors (SSRIs) are firstline treatment for patients with MDD. Despite widespread availability and evidence-based treatment guidelines recommending SSRIs for MDD, a considerable number of SSRI-treated patients are partial or nonresponders, and may need a longer period of treatment to achieve remission.
Citalopram is widely used, since it has a lower risk of pharmacokinetic interactions compared with other SSRIs such as fluoxetine, fluvoxamine, or paroxetine. …