Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with posttraumatic stress disorder.
BACKGROUND
Although the pathophysiology of posttraumatic stress disorder (PTSD) is considered multifactorial, empirical evidence suggests that serotonergic dysregulation may characterize the disorder. The efficacy of the selective serotonin reuptake inhibitors (SSRIs) in treating essential symptoms (re-experiencing, avoidance, numbing, hyperarousal) in both adults and children is likely to involve potentiation of this neurotransmitter.


OBJECTIVE
This study compared outcome in an 8-week open trial of citalopram (an SSRI) in children/adolescents and adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of PTSD.


METHODS
Twenty-four children/adolescents and 14 adults assessed for PTSD severity at baseline were followed up on citalopram treatment (20-40 mg/day) at two-weekly intervals over 8 weeks. The Clinician-Adminstered PTSD Scale (CAPS) and the Clinical Global Improvement Scale (CGI) were used as outcome measures.


RESULTS
Although there were no significant differences in outcome measures between children/adolescents (n = 24) and adults (n = 14), both groups had significant reductions in mean CAPS total scores, symptom cluster scores, and CGI ratings at endpoint.


CONCLUSIONS
Although the SSRIs have established efficacy and safety in the treatment of adult PTSD, literature on their use in child and adolescent PTSD is sparse. Controlled data are needed to support the clinical perception that SSRIs are agents of choice in the treatment of pediatric PTSD.
Seedat
Soraya
S
Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders, Tygerberg, Cape Town, South Africa. sseedat@gerga.sun.ac.za
Stein
Dan J
DJ
Ziervogel
Carl
C
Middleton
Tessa
T
Kaminer
Deborah
D
Emsley
Robin A
RA
Rossouw
Wendy
W
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015283:Citalopram / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors