Citalopram 20 mg, 40 mg and 60 mg are all effective and well tolerated compared with placebo in obsessive-compulsive disorder

Serotonin reuptake inhibitors appear to be uniquely effective treatments fo r obsessive-compulsive disorder (OCD). This double-blind, placebo-controlle d study was the first trial to assess the efficacy of the most selective of the serotonin reuptake inhibitors, citalopram, in OCD. A total of 401 pati ents were randomized to receive citalopram 20, 40 or 60 mg/day or placebo f or 12 weeks. All three doses of citalopram were significantly more effectiv e than placebo measured on the Yale-Brown Obsessive Compulsive Scale (Y-BOC S) change score (P < 0.01). The highest response rate, defined as 25% impro vement in Y-BOCS entry score, was observed in the 60 mg group (65%). This c ompared with 52% and 57.4% in the 40 mg and 20 mg groups. Response rate on placebo was 36.6% (P < 0.05 for all three doses of citalopram compared to p lacebo). There was no significant difference between the individual doses o f citalopram. An advantage was seen for citalopram on the Sheehan Disabilit y Scale compared with placebo (P < 0.05 on all three citalopram groups vers us placebo for both the work situation and the family life and home respons ibilities and P < 0.05 on citalopram 60 mg and 20 mg versus placebo for the social life and home activities). Citalopram was well tolerated; only 4 to 6 patients in each dose group discontinued the study prematurely due to ad verse events. (C) 2001 Lippincott Williams & Wilkins.