Citalopram treatment of pediatric recurrent abdominal pain and comorbid internalizing disorders: an exploratory study.
OBJECTIVE
To assess the potential efficacy, tolerability, and safety of citalopram in the treatment of functional pediatric recurrent abdominal pain and comorbid internalizing disorders.


METHODS
Twenty-five clinically referred children and adolescents with recurrent abdominal pain aged 7 to 18 years, inclusive, participated in a 12-week, flexible-dose, open-label trial of citalopram. Primary outcome measure was the Clinical Global Impression Scale-Improvement, with responders defined by ratings of 1 (very much improved) or 2 (much improved). Secondary measures included self- and parent reports of abdominal pain, anxiety, depression, other somatic symptoms, and functional impairment. Side effects were assessed using a standardized checklist. Data were analyzed using an intent-to-treat format and the last observation carried forward procedure.


RESULTS
Twenty-one subjects (84%) were classified as responders (Clinical Global Impression Scale-Improvement score < or =2). Citalopram was generally well tolerated. Four subjects withdrew prematurely, one due to reported visual side effects. Ratings of abdominal pain, anxiety, depression, other somatic symptoms, and functional impairment all improved significantly over the course of the study compared with baseline.


CONCLUSIONS
Citalopram is a promising treatment for functional pediatric recurrent abdominal pain and deserves additional study with a randomized, placebo-controlled clinical trial.
Campo
John V
JV
Department of Pyschiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. campojv@msx.upmc.edu
Perel
James
J
Lucas
Amanda
A
Bridge
Jeff
J
Ehmann
Mary
M
Kalas
Catherine
C
Monk
Kelly
K
Axelson
David
D
Birmaher
Boris
B
Ryan
Neal
N
Di Lorenzo
Carlo
C
Brent
David A
DA
D015746:Abdominal Pain / Q000188:drug therapy* / Q000523:psychology*; D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy*; D002648:Child; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D003863:Depression / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013001:Somatoform Disorders
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors