Long-term experience with citalopram in the treatment of adolescent OCD

Objective: The primary purpose of the study was to describe tolerability and effectiveness of citalopram in the treatment of adolescent obsessive-compulsive disorder (OCD). Method: Thirty nondepressed patients (15 females, 15 males) with a mean age of 13.7 years (range 13-18 years) were treated for their OCD with citalopram in an open-label, flexible-dose study (range of dose 20-70 mg; mean dose 46.5 mg). All patients were referred to Aarhus University Hospital. The patients were monitored for 1 to 2 years. The mean total score on the Yale-Brown Obsessive Compulsive Scale (child or adult version) was 28.7 at baseline, 23.3 after 10 weeks of treatment, 20.0 after 6 months, 18.4 after 1 year, and 17.9 after 2 years (from baseline to 2 years of treatment: t = 11.65; p < .001). Results: Seventy percent showed a decrease in total Yale-Brown Obsessive Compulsive Scale score in excess of 35% from baseline to 1 year of treatment. Twenty percent still had a score of greater than 20 after 1 year of treatment, indicating that clinically they still had OCD. Side effects were similar to those reported from the use of other selective serotonin reuptake inhibitors (SSRIs). No patient was excluded because of serious side effects during the 1 year of observation. Conclusions: The clinical effectiveness and tolerability of citalopram in the long-term treatment seem to be comparable with the observations of other SSRIs in childhood and adolescent OCD. A further, statistically significant reduction is provided by an extended treatment period of up to 1 year.