EFFECTS OF CITALOPRAM AND BRIEF PSYCHOSOCIAL INTERVENTION ON ALCOHOL INTAKE, DEPENDENCE AND PROBLEMS

Citalopram (C) decreased alcohol intake and desire to drink in short-t erm (2-4 weeks) studies with no other treatment. We tested the long-te rm effects of C combined with a brief psycho-social intervention. Afte r a 2-week baseline, mildly/moderately dependent alcoholics (35 males, 27 females) were randomized, double-blind to 12 weeks of C 40 mg/day (n = 31) or placebo (P) (n = 31) and a brief psycho-social interventio n with follow-ups at 4 and 8 weeks post-treatment. Alcohol intake was monitored daily and alcohol dependence (ADS) and problems (MAST) were assessed at intake and post-treatment. During the first week, the decr ease (%) from baseline daily alcoholic drinks (xBAR +/- SEM) was great er with C (47.9 +/- 5.1 from 6.5 +/- 0.6) than with P (26.1 +/- 4.2 fr om 5.8 +/- 0.4) (p < 0.01). However, the 12-week decreases with C (35. 1%) and P (38.8%) were similar. There were gender differences within t he C group. The males had higher MAST scores at intake (xBAR +/- SEM = 10.4 +/- 0.8; n = 15) than the females (6.4 +/- 0.9, n = 16) (p < 0.0 1) and were slightly heavier drinkers during baseline (7.1 +/- 0.9 vs. 5.9 +/- 0.9 drinks/day, NS). The response to C was greater in males ( 44% decrease) than females (26%) (p < 0.05) and correlated with MAST s cores (r = 0.44, p = 0.01), but not with baseline alcohol intake (r = 0.2, NS). Craving and liking for alcohol and alcohol dependence (ADS) and problems (MAST) decreased similarly with C and P (p < 0.01). Thus, the short-term effects of C were replicated but no long-term effect w as detected. Tolerance to citalopram, perhaps through some adaptive ne urobiological changes, may have developed. The potential therapeutic u se of C as a useful pharmacological adjunct in alcoholics remains to b e determined.