Sertraline or Citalopram?

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Hi all,

Just asking this question out of curiosity really. My doctor put me on 100mg of Sertraline, but I find that far more people seem to be on Citalopram. My CBT therapist even said that almost all his patients who are taking anti-depressants are on Citalopram.

I know there's more than just the two medications, but how do GPs decide which one to prescribe? I'm just curious as to why mine chose Sertraline for me rather than Citalopram, or indeed anything else.

Does anybody have any idea?

EDIT: Just realised this should have gone in the medication section, although I'm not sure if it should be in Sertraline or Citalopram!

[shiznit76]

Think citalopram is common choice of drug by docs as they are cheap and do seem to have a good success rate. Sertraline is in same family of drugs. Should be just as good as citalopram

[Suziewuzie]

I've been on sertraline in the past & had really good effect from it. I'm on Citalopram this time round because I washaving a particularly rough time & couldn't handle the startup effects of Sertraline. But they are both very similar x

[MyNameIsTerry]

NICE guidance for GAD states to try Sert first. However, it clearly states this is not due to clinical significance, merely that it is the cheapest.

Sert is licenced for anxiety disorder, Cit isn't. Where Cit is used it is being used "off label", which is usually a big no-no for a GP because it places additional responsibility on it however it has been acknowledged that Cit has been commonly used in this manner for such a long time that it doesn't matter.

How do GP's decide? Mine just dips his hand into a hat and pulls out a piece of paper. He literally has no understanding of these meds which has been proved on various occasions. Some GP's have more experience of different meds so have built up their own ideas based on anecdotal evidence, often not a good indicator of anything with something as individual as an anxiety disorder let alone the meds for them as you will have seen across this forum.

The local trusts also issue guidance on which meds to use in a staged manner. SSRI's fit stage one, stage 2 takes you into such as Mirt, Ven, etc and stage 3 is the more specialist stuff like Preg where GP's tend to refer on or need advice. Antipsychotics are a no-go for GP's, hence more in that later stage and beyond.

How do you know far more people are on Cit? Looking at this forum I would say it's a 50:50 and how busy those two boards are ebbs & flows. And that's not an indicator of anything anyway, in the context of who is on what, this is a tiny tiny webforum.

In terms of cost, both are incredibly cheap with Sert being cheaper per NICE, although I would have to check the prices as that was years ago. Eitherway, if you pay a prescription charge for Cit or Sert, you are overpaying and the NHS are making a profit.