An open trial of citalopram in children and adolescents with depression.
OBJECTIVE
The aim of this study was to collect pilot data on the magnitude of effect and tolerability of citalopram in early-onset major depressive disorder (MDD).


METHODS
This study was performed in two academic child and adolescent psychiatric clinics (2000 through 2002). Thirty children and adolescents, 8-17 years of age (mean age, 13.57 +/- 2.5), of both sexes (53.3% girls; 46.7% boys) and diagnosed with MDD by means of clinical psychiatric evaluation, Diagnostic Interview for Children and Adolescents (DICA) and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, were studied in an open-label clinical trial with 10-40 mg/day of citalopram for 6 weeks. The outcome measures were the Hamilton Depression Rating Scale (HDRS), the Children Global Assessment Scale (CGAS), and the New York State Psychiatric Institute side-effect form.


RESULTS
Moderate (50%-70% change in HDRS and CGAS) to large (> 70% change in HDRS and CGAS) effect were seen in 91.7% of children (22/24). There were significant changes on HDRS (X = 22.78; t = -14.12; p < 0.000) and CGAS (X = 26.02; t = 9.68; p < 0.000) between baseline and the 6th week. Mild side effects were reported in 2 patients (8.3%). Adverse effects that contributed to discontinuation were nausea and vomiting in 3.3% (n = 1) of patients and unexpectedly switching to mania in 16.7% (n = 5) of patients.


CONCLUSIONS
Citalopram may be an efficatious treatment in early-onset MDD. However, the high switch rate to mania warrants further investigations, as well as cautions, in using it.
Shirazi
Elham
E
Unit on Child and Adolescent Psychiatry, Iran Hospital, Iran University of Medical Sciences, Tehran, Iran.
Alaghband-Rad
Javad
J
D000293:Adolescent; D002648:Child; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects
D015283:Citalopram