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I was intrigued by the choice of antidepressant for this gorilla.1 Is escitalopram on the zoo's formulary? It is not on our local NHS formulary. Escitalopram is an s-enantiomer of citalopram, which is now off-patent, and a recent Drug and Therapeutics Bulletin2 highlighted how such drugs are developed and marketed after the patent expiry of the originator drug, to extend profits. In humans, as pointed out by DTB, there is little evidence that it is any better than any other serotonin reuptake inhibitors, but it is many times more expensive than generic alternatives. Has the gorilla unwittingly been experimented on in this way as a result of drug company marketing?
Competing interests: MD is on the editorial board for Drug and Therapeutics Bulletin.