title: Effectiveness and safety of citalopram in hospitalized adolescents with major depression: a preliminary, 8-week, fixed-dose, open-label, prospective study.
abstract: OBJECTIVE
  Citalopram is widely used in adolescents with major depressive disorder (MDD) and anxiety; however, data on efficacy and safety are still limited and inconsistent. The aim of this study was to evaluate both the efficacy and the safety of citalopram for treatment of MDD and anxiety symptoms in adolescent inpatients.
  
  
  METHODS
  An open-label, prospective design of an 8-week trial with a fixed dose of 20 mg/d of citalopram was performed in 10 hospitalized adolescents. Clinical state was assessed by Hamilton Depression (HAM-D 17) and Hamilton Anxiety scales, Beck Depression Inventory (BDI), and the Clinical Global Impression-Severity Scale for depression. Suicidal risk was assessed by the Suicide Risk Scale. A 30% improvement in the rating scales was considered as being a response to the treatment.
  
  
  RESULTS
  After 8 weeks, depression levels as measured by the HAM-D 17 (P = 0.002), the BDI (P = 0.011), and the Clinical Global Impression-Severity Scale (P = 0.002) showed significant improvement. So did anxiety levels, as measured by the Hamilton Anxiety (P = 0.026) at end point. Subjective depression level (BDI) decreased significantly between week 2 and 4 (Z = -2.36, P = 0.018), whereas objective depression level (HAM-D 17) decreased significantly between week 4 and 6 (Z = -2.53, P = 0.012). Suicide risk, as assessed by the Suicide Risk Scale, however, increased significantly after 8 weeks (P = 0.011).
  
  
  CONCLUSIONS
  This pilot small-scale trial found that citalopram was effective for both depressive and anxiety symptoms in adolescents with MDD and that response started as early as the second week. However, suicidal risk was elevated for some of the subjects. Larger randomized placebo-controlled trials are needed.
authors.affiliation: Adolescent Day Unit, Geha Mental Health Center, Petach Tikva, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Shoval
authors.forename: Eitan
authors.initials: E
authors.lastname: Nahshoni
authors.forename: Doron
authors.initials: D
authors.lastname: Gothelf
authors.forename: Iris
authors.initials: I
authors.lastname: Manor
authors.forename: Pavel
authors.initials: P
authors.lastname: Golobchik
authors.forename: Zvi
authors.initials: Z
authors.lastname: Zemishlany
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Gil
authors.initials: G
authors.lastname: Zalsman
mesh_terms: D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D011581:Psychological Tests; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram