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Citalopram in the treatment of dysthymic disorder

Hellerstein, David J.a b; Batchelder, Saraib; Miozzo, Rubenc; Kreditor, Davidd; Hyler, Stevenb; Gangure, Dinub; Clark, Joyb

International Clinical Psychopharmacology: May 2004 - Volume 19 - Issue 3 - p 143-148

This study aimed to provide preliminary data on the tolerability and effectiveness of citalopram for patients with dysthymic disorder. Twenty-one adult subjects meeting DSM-IV criteria for dysthymic disorder were enrolled in this 12-week open-label study, of whom 15 had pure dysthymia (e.g. no major depression in the past 2 years). Citalopram was initiated at 20 mg/day, and increased to a maximum of 60 mg/day. Response was defined as 50% or greater drop in score on the Hamilton Depression Rating Scale (HDRS) and a Clinical Global Impressions-I score of 1 (‘very much improved’) or 2 (‘much improved’). Of these 15 pure dysthymic disorder subjects, all completed the trial, and 11 (73.3%) were treatment responders. All paired sample t-tests were highly significant, demonstrating significant average improvement on all measures of symptomatology and functioning. Scores on the 24-item HDRS decreased from 22.3±4.3 at baseline to 9.1±7.8 at week 12 [t(14)=6.1, P<0.001]. In addition, improvement was noted in self-reported measures of temperament and social functioning. The average final dose of citalopram was 39 mg/day. Side-effects were reported by nine of 15 subjects (60%), most frequently gastrointestinal symptoms (n=5), dry mouth (n=5) and sexual side-effects (n=3). These findings suggest the effectiveness and tolerability of citalopram in treating dysthymic disorder. Double-blind prospective studies are needed comparing citalopram both to placebo and to other medications, assessing both initial and sustained response to treatment.

aNew York State Psychiatric Institute, New York

bDepartment of Psychiatry, St Luke's–Roosevelt Hospital Center, New York

cUniversity of Massachusetts Memorial Hospital, Amherst, Massachusetts

dBeth Israel Medical Center, New York, USA

Correspondence and requests for reprint to David Hellerstein, Clinical Director, NY State Psychiatric Institute, 1051 Riverside Drive, Unit ♯101, New York, NY 10032, USA

Tel: +1 212 5435790; fax: +1 212 543 5674;


Received 3 April 2003 Accepted 8 January 2004

Conflict of interest: This study was supported by a research grant from Forest Laboratories.

© 2004 Lippincott Williams & Wilkins, Inc.