Citalopram, a selective serotonin reuptake inhibitor, in the treatment of aggression in schizophrenia

Abstract

The aim of this double-blind cross-over study was to investigate whether treatment with the selective serotonin reuptake inhibitor, citalopram reduces aggressiveness in chronically violent schizophrenic inpatients. Initially 19 patients were enrolled into this double-blind cross-over study in which the patients were treated for 24 weeks with placebo and 24 weeks with citalopram (20-60 mg/day) as a supplement to their previous neuroleptic medication. Fourteen patients completed the entire study, but sufficient data on 15 patients could be used in the end-point analysis of efficacy. Psychiatric assessments (Brief Psychiatric Rating Scale, Clinical Global Impression Scale for Severity of Illness, Social Dysfunction and Aggression Scale and the Global Aggression Scale) and side effects (UKU Side Effect Scale) were recorded at baseline and 4 times during both periods. Aggressive incidents (Staff Observation Aggression Scale) were recorded throughout the study. During citalopram treatment, the frequency of aggressive incidents was significantly lower and the mental state did not deteriorate. Patients either experienced no side effects or else side effects were equally mild during both periods.

Singing under the impulsiveness: impulsivity in psychiatric disorders

“…In a 3-month controlled trial, Coccaro and Kavoussi [47] reported that fluoxetine significantly decreased impulsive aggressive behaviour compared to placebo in personality disorder patients. A decrease in hostility was also reported for paroxetine, in a double-blind placebo-controlled study [48] and for citalopram, compared with placebo, in patients with schizophrenia [49].…”

Diretrizes da Federação Mundial das Sociedades de Psiquiatria Biológica para o tratamento biológico da esquizofrenia. Parte 1: tratamento agudo

“…A clomipramina (Berman et al, 1995) e a fluvoxamina (Reznik e Sirota, 2000) mostraram vantagens no tratamento de sintomas obsessivo-compulsivos em esquizofrenia, derivados de dois pequenos estudos abertos (Nível D). Num estudo cruzado, o citalopram revelou eficácia em pacientes com história de agressão em que a medicação reduziu a freqüência de incidentes (Nível D) (Vartiainen et al, 1995).…”

Possible role of more positive social behaviour in the clinical effect of antidepressant drugs

“…However, Rinne and colleagues 37 found no effect of the SSRI fluvoxamine after 6 weeks of treatment on aggression in women with borderline personality disorder. Vartiainen and colleagues 38 treated aggressive inpatients with schizophrenia, who were on but had not responded to neuroleptics, with citalopram for 24 weeks. The drug caused a significant decrease in the frequency of aggressive incidents.…”