title: Citalopram treatment of pediatric recurrent abdominal pain and comorbid internalizing disorders: an exploratory study.
abstract: 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.
authors.affiliation: Department of Pyschiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. campojv@msx.upmc.edu
authors.forename: John V
authors.initials: JV
authors.lastname: Campo
authors.forename: James
authors.initials: J
authors.lastname: Perel
authors.forename: Amanda
authors.initials: A
authors.lastname: Lucas
authors.forename: Jeff
authors.initials: J
authors.lastname: Bridge
authors.forename: Mary
authors.initials: M
authors.lastname: Ehmann
authors.forename: Catherine
authors.initials: C
authors.lastname: Kalas
authors.forename: Kelly
authors.initials: K
authors.lastname: Monk
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Neal
authors.initials: N
authors.lastname: Ryan
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: 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
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors