title: Combination of citalopram plus paliperidone is better than citalopram alone in the treatment of somatoform disorder:  results of a 6-week randomized study.
abstract: The objective of this study was to evaluate the effectiveness and tolerability of citalopram versus citalopram plus paliperidone combination therapy in patients with somatoform disorders (SDs). In this 6-week, randomized, fixed-dose study, 60 patients with SD (ICD-10 F45.0), undifferentiated SD (F45.1), and somatoform autonomic dysfunction (F45.3) were randomly assigned to receive citalopram (20 mg/day) with or without paliperidone (3 mg/day). Four scales were used to evaluate effectiveness and tolerability at baseline and at the end of the second, fourth, and sixth week after treatment: Somatoform Disorders Screening Symptoms-7 (SOMS-7), Hamilton Anxiety Scale (HAMA), 17-item Hamilton Depression Scale (HAMD-17), and Treatment Emergent Symptom Scale (TESS). The rater was blinded to the kind of treatment patients received. (i) In the intention-to-treat population (N = 51), the overall response ratio (50% reduction in SMOS-7 scores) was significantly higher in the citalopram-paliperidone group compared with the citalopram group after a 6-week treatment (71.4 vs. 38.10%, χ² = 4.71, P = 0.03). (ii) The SOMS-7 and somatic subscore of the Hamilton Anxiety Scale (HAMA-SOM) total score of the citalopram plus paliperidone group decreased more significantly than that of the citalopram group, and a significant difference could be observed at the end of 4 weeks of treatment. (iii) There was no significant difference between the two groups in adverse effects, and no serious adverse event was reported in both groups. Our findings indicate that a combination with paliperidone is significantly better than monotherapy with citalopram whether synergistic or add-on for patients with SDs. Our results call for future studies with larger sample sizes and a longer duration to draw more definitive conclusions.
authors.affiliation: Departments of aPsychiatry bNeurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Manli
authors.initials: M
authors.lastname: Huang
authors.forename: Benyan
authors.initials: B
authors.lastname: Luo
authors.forename: Jianbo
authors.initials: J
authors.lastname: Hu
authors.forename: Ning
authors.initials: N
authors.lastname: Wei
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.forename: Shanshan
authors.initials: S
authors.lastname: Wang
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhou
authors.forename: Shaohua
authors.initials: S
authors.lastname: Hu
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002681:China; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000068882:Paliperidone Palmitate; D011569:Psychiatric Status Rating Scales; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D015283:Citalopram; D007555:Isoxazoles; D000068882:Paliperidone Palmitate; D011743:Pyrimidines; D017367:Selective Serotonin Reuptake Inhibitors