(First choice is a good quality talking therapy, but meds may be useful)
> The full guideline on depression concluded that antidepressants have largely equal efficacy and that choice should mainly depend on side‑effect profile, people's preference and previous experience of treatments, propensity to cause discontinuation symptoms, safety in overdose, interactions and cost. However, a generic SSRI is recommended as first‑choice because of its favourable risk–benefit ratio. Neither escitalopram nor any of the available 'dual action' antidepressants, such as venlafaxine and duloxetine, were judged to have any clinically important advantages over other antidepressants. Results from meta‑analyses (Comparative benefits and harms of second-generation antidepressants for treating major depressive disorder, Gartlehner et al. 2011 and 2 Cochrane reviews: Cipriani et al. 2012, CD006534 and Cipriani et al. 2012, CD006533) have provided no evidence to depart from NICE guidance when selecting antidepressants for people with depression.
> Citalopram and escitalopram have been found to prolong the QT interval and are now contraindicated in people who are already taking medication known to prolong the QT interval as there may be an additive effect [Lundbeck Ltd, 2011a; Lundbeck Ltd, 2011b; MHRA, 2011]. Caution is advised in people with congenital long QT interval or who have pre-existing QT interval prolongation as they have a higher risk than average of developing a ventricular arrhythmia including Torsade de Pointes.
It's mentioned here: https://www.nice.org.uk/advice/ktt8/chapter/evidence-context
(First choice is a good quality talking therapy, but meds may be useful)
> The full guideline on depression concluded that antidepressants have largely equal efficacy and that choice should mainly depend on side‑effect profile, people's preference and previous experience of treatments, propensity to cause discontinuation symptoms, safety in overdose, interactions and cost. However, a generic SSRI is recommended as first‑choice because of its favourable risk–benefit ratio. Neither escitalopram nor any of the available 'dual action' antidepressants, such as venlafaxine and duloxetine, were judged to have any clinically important advantages over other antidepressants. Results from meta‑analyses (Comparative benefits and harms of second-generation antidepressants for treating major depressive disorder, Gartlehner et al. 2011 and 2 Cochrane reviews: Cipriani et al. 2012, CD006534 and Cipriani et al. 2012, CD006533) have provided no evidence to depart from NICE guidance when selecting antidepressants for people with depression.
And similarly here: http://cks.nice.org.uk/depression#!scenario
> Citalopram and escitalopram have been found to prolong the QT interval and are now contraindicated in people who are already taking medication known to prolong the QT interval as there may be an additive effect [Lundbeck Ltd, 2011a; Lundbeck Ltd, 2011b; MHRA, 2011]. Caution is advised in people with congenital long QT interval or who have pre-existing QT interval prolongation as they have a higher risk than average of developing a ventricular arrhythmia including Torsade de Pointes.
But it's interesting.