A Comprehensive Clinical and Pharmacological Review of Citalopram (DB00215)

1.0 Introduction and Drug Identification

1.1 Overview and Classification

Citalopram is a widely prescribed antidepressant medication belonging to the class of selective serotonin reuptake inhibitors (SSRIs).[1] As a small molecule drug, its primary therapeutic application is in the management of major depressive disorder and other mood-related conditions.[1] A defining feature of citalopram is its pharmacological profile; among all SSRIs, it is recognized as one of the most selective inhibitors of serotonin reuptake, a characteristic that fundamentally shapes its clinical efficacy and tolerability.[1]

The global significance of citalopram in mental healthcare is underscored by its inclusion in the World Health Organization (WHO) Model List of Essential Medicines for the treatment of depressive disorders.[2] Its extensive clinical use is further highlighted by prescription statistics; in 2022, it was the 40th most commonly prescribed medication in the United States, accounting for over 15 million prescriptions.[3]

1.2 Historical Development and Regulatory Milestones

The journey of citalopram from laboratory synthesis to a cornerstone of depression treatment illustrates key trends in pharmaceutical development and public health. The molecule was first synthesized in 1972 by the Danish pharmaceutical company Lundbeck, which subsequently patented the compound.[4] The path to market was protracted, involving a rigorous 15-year period of development and clinical trials to establish its efficacy and safety profile.[4] This lengthy timeline is not unusual for neuropsychiatric agents, where demonstrating a clear therapeutic benefit against a complex and variable disease background presents significant scientific and regulatory challenges.