Objective: To examine the differential effects of citalopram on alcohol con
sumption in nondepressed women and men with mild to moderate alcohol depend
ence. Design: Prospective, placebo-controlled study. Participants: Sixty-on
e subjects (34 men and 27 women), interventions: After a 2-week baseline, s
ubjects were randomly assigned to 12 weeks of citalopram (40 mg per day) (n
= 15 women, 16 men) or placebo (n = 12 women, 18 men). All received brief
standard psychosocial interventions. Outcome measures: Alcohol Dependence S
cale, Montgomery-Asberg Depression Scale, Michigan Alcohol Screening Test,
State-Trait Anxiety Inventory and daily alcohol intake. Results: Pretreatme
nt sex differences were evident in alcohol consumption, alcohol dependence,
alcohol-related problems and on anxiety and depression measures. After tre
atment, analyses of covariance with depression and anxiety scores as covari
ates revealed a differential benefit of citalopram for men. Men receiving c
italopram reduced average drinks per day by 44%, whereas women exhibited a
27% decrease (p < 0.05). Conclusions: Men may benefit more than women from
citalopram in the treatment of alcohol dependence. These findings highlight
the importance of examining sex as a significant variable in evaluating re
sponse to pharmacotherapy.