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| |  CINP: Citalopram Effective and Well Tolerated in Children and Adolescents with Depression By Heather Pengelley Special to DG News MONTREAL, QC -- June 27, 2002 -- Citalopram significantly improves symptoms of major depressive disorder (MDD) in children and adolescents within one week. Well known as a safe and effective antidepressant in adults, citalopram was well tolerated in a double-blind, placebo-controlled, flexible-dose study of 83 children and 91 adolescents. These findings were presented June 26th at the 23rd Congress of the Collegium Internationale Neuro-Psychopharmacologicum (CINP). It has been estimated that about 1 percent of children and 5 percent of adolescents are diagnosed with depression. This condition has a significant impact on their school performance, peer relationships, and family life. In an eight-week trial, researchers led by Dr. Karen Wagner of the Department of Psychiatry and Behavioral Sciences, University of Texas, Galveston, Texas, United States, compared 20 mg to 40 mg of citalopram to placebo in children from 7 to 11 years and adolescents from 12 to 17 years who had MDD. All children and adolescents had depression for at least 4 weeks prior to enrollment. The diagnosis of MDD was confirmed by Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) - Present and Lifetime. On the Children’s Depression Rating Scale-Revised (CDRS-R), all participants had baseline scores of 40 or higher. Children with psychiatric disorders other than MDD were excluded from study. After a one-week, single-blind placebo lead-in, children and adolescents were randomized to either citalopram or placebo. Both groups had similar demographic characteristics and a similar history of depression. Evaluations occurred at baseline, one, two, four, six, and eight weeks. "A significant therapeutic benefit was observed in the first week of depression, relative to placebo, in both children and adolescents," the investigators reported. Over the course of the study, citalopram had a significant impact on mean CDRS-R scores vs. placebo. A significant reduction in depressive symptoms occurred within one week in the citalopram group vs. placebo (p<0.02). This improvement persisted at eight weeks (p<0.04). Patients were considered as responders when their CDRS-R scores were 28 or higher. Significantly more children and adolescents responded to citalopram (36 percent) than placebo (24 percent; p<0.05). During the study, citalopram had a tolerability profile similar to that of placebo. The relatively benign symptoms of nausea (14 percent), rhinitis (14 percent), and flu-like symptoms (7 percent) were reported with a frequency of =5 percent in the citalopram group vs. the placebo group. About 20 percent of patients in each group experienced headaches. The discontinuation rates were similar in the two groups: 5.9 percent in patients on citalopram vs. 5.6 percent in patients on placebo. "Citalopram is a safe and effective treatment for depression in children and adolescents," concluded the investigators.
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