This 11-week study aims to determine how genetic factors affect the way African Americans and Caucasians with major depression respond to antidepressant medication [citalopram (Celexa®)].

Depressed patients vary substantially in their responses to antidepressants. Genetic factors may account for a large part of these differences in response. This study will include both African Americans and Caucasians to examine the role of genetic factors in treatment response.

Participants receive citalopram (Celexa) for 8 weeks and a placebo for 1 week. Visits occur once a week for 11 weeks. A variety of interviews, scales, tests, and questionnaires are used to assess participants.

Inclusion Criteria:

• DSM-IV criteria for Major Depression
• African-American or Caucasian ethnic background (both parents and 3 out of 4 grandparents)

Exclusion Criteria:

• Schizophrenia, schizophreniform disorder, schizoaffective disorder, schizotypal disorder, psychotic depression, or bipolar disorder
• Current drug abuse or history of drug abuse within the past 6 months
• Unstable medical or neurological conditions that interfere with the treatment of depression
• Allergy to citalopram
• Failure to respond to adequate citalopram drug trial (40 mg for at least 6 weeks)
• Seizure disorder
• Pregnancy
• Psychotropic medications, including antidepressants and neuroleptics
• Suicidal ideation or other safety issues
• Fluoxetine (Prozac) or MAOIs (Nardil, Parnate) in the last 2 months
• Ongoing cognitive behavioral therapy or intensive psychotherapy. General talk therapy is acceptable