title: Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with posttraumatic stress disorder.
abstract: 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.
authors.affiliation: Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders, Tygerberg, Cape Town, South Africa. sseedat@gerga.sun.ac.za
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Carl
authors.initials: C
authors.lastname: Ziervogel
authors.forename: Tessa
authors.initials: T
authors.lastname: Middleton
authors.forename: Deborah
authors.initials: D
authors.lastname: Kaminer
authors.forename: Robin A
authors.initials: RA
authors.lastname: Emsley
authors.forename: Wendy
authors.initials: W
authors.lastname: Rossouw
mesh_terms: 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
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors