Citalopram in the treatment of dysthymic disorder

Abstract

This study aimed to provide preliminary data on the tolerability and effectiveness of citalopram for patients with dysthymic disorder. Twenty-one adult subjects meeting DSM-IV criteria for dysthymic disorder were enrolled in this 12-week open-label study, of whom 15 had pure dysthymia (e.g. no major depression in the past 2 years). Citalopram was initiated at 20 mg/day, and increased to a maximum of 60 mg/day. Response was defined as 50% or greater drop in score on the Hamilton Depression Rating Scale (HDRS) and a Clinical Global Impressions-I score of 1 ('very much improved') or 2 ('much improved'). Of these 15 pure dysthymic disorder subjects, all completed the trial, and 11 (73.3%) were treatment responders. All paired sample t-tests were highly significant, demonstrating significant average improvement on all measures of symptomatology and functioning. Scores on the 24-item HDRS decreased from 22.3+/-4.3 at baseline to 9.1+/-7.8 at week 12 [t(14)=6.1, P<0.001]. In addition, improvement was noted in self-reported measures of temperament and social functioning. The average final dose of citalopram was 39 mg/day. Side-effects were reported by nine of 15 subjects (60%), most frequently gastrointestinal symptoms (n=5), dry mouth (n=5) and sexual side-effects (n=3). These findings suggest the effectiveness and tolerability of citalopram in treating dysthymic disorder. Double-blind prospective studies are needed comparing citalopram both to placebo and to other medications, assessing both initial and sustained response to treatment.

Association of citalopram with congenital anomalies: A meta-analysis

“…In a comparative analysis of 12 new-generation antidepressants, escitalopram and citalopram were ranked as highly acceptable [13]. Moreover, citalopram is frequently used off-label for anxiety, panic disorder, dysthymia, premenstrual dysphoric disorder, body dysmorphic disorder, and obsessive-compulsive disorder [141516]. The properties of citalopram, including its highly lipophilic nature, intermediate protein binding, and low molecular weight, enable it to cross the placenta.…”

Does a History of Alcohol Use Disorder Affect Response to Antidepressant Medication in Patients With Dysthymic Disorder?

“…Table 1 lists the 6 original trials, study designs, antidepressant agents used, mean doses, and the number of subjects from the no lifetime alcohol use disorder (NLAUD) and lifetime alcohol use disorder (LAUD) groups included in response analyses. At the time of this publication, data from 4 of these trials were published (Hellerstein et al, 1999;Hellerstein, Little, et al, 2001;Hellerstein, Batchelder, Kreditor, & Fedak, 2001;Hellerstein et al, 2004). All trials examined treatment response to pharmacotherapy in outpatients who met the most recent DSM criteria for DD (DSM-III-R or DSM-IV) and received treatment in an outpatient research program in an urban medical center.…”

HPLC determination of Escitalopram in tablet dosage forms

“…Antidepressant discontinuation syndrome may occur when stopped. There are concerns that use during pregnancy may harm the fetus (Hellerstein et al 2004;Pittenger and Bloch 2014).…”