Addiction, Author Interviews, Mental Health Research / 31.03.2025
Does evergreening contribute to the prescribing pattern of citalopram and escitalopram to U.S. Medicaid and Medicare patients?
Parita K. Ray
Medical Student
Department of Medical Education
Geisinger College of Health Sciences
Scranton, PA 18509
MedicalResearch.com: What is the background for this study?
- Citalopram and escitalopram are two of the most commonly prescribed antidepressants in the U.S. and are widely used for treating major depressive disorder (MDD) and generalized anxiety disorder (GAD), along with various off-label indications. While both medications share similar mechanisms of action, escitalopram was introduced as a purified version of citalopram’s active enantiomer. Despite little evidence showing a clear superiority of escitalopram over citalopram in efficacy or tolerability, prescribing trends appear to favor escitalopram, raising concerns about "evergreening"—a practice where pharmaceutical companies promote newer formulations of existing drugs to extend market exclusivity. Prior research has shown variations in the prescription rates of psychotropic medications across states and within specific populations, particularly among Medicaid and Medicare patients. However, little is known about the long-term prescribing patterns of citalopram versus escitalopram in these populations and whether these trends reflect potential evergreening practices.