An Open-Label Study of Citalopram in Body Dysmorphic Disorder
J Clin Psychiatry 2003;64(6):715-720
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Body dysmorphic disorder (BDD), a
preoccupation with an imagined or slight defect in appearance, is
a relatively common and impairing disorder. While available data
suggest that serotonin reuptake inhibitors are effective for BDD,
investigation of this disorder's response to pharmacotherapy is
limited, and there are no published reports on the efficacy of
the selective serotonin reuptake inhibitor citalopram. In
addition, there are no published reports on change in quality of
life and multiple domains of psychosocial functioning with
pharmacologic treatment for patients with BDD.
Method: Fifteen subjects with DSM-IV BDD or its
delusional variant were prospectively treated in a 12-week
open-label trial of citalopram. Subjects were assessed at regular
intervals with the Yale-Brown Obsessive Compulsive Scale Modified
for BDD (BDD-YBOCS; the primary outcome measure), the Clinical
Global Impressions scale (CGI), the Brown Assessment of Beliefs
Scale, measures of quality of life and multiple domains of
psychosocial functioning, and other scales. Data were collected
from Dec. 28, 1999, to March 1, 2001.
Results: On the BDD-YBOCS, scores decreased from
a mean ± SD of 30.7 ± 4.9 at baseline to 15.3 ± 10.6 at
endpoint (p < .001), and 73.3% (N = 11) of subjects were
responders. On the CGI, 40.0% of patients (N = 6) were very much
improved, and 26.7% (N = 4) were much improved. Psychosocial
functioning and mental health-related quality of life also
significantly (p < .05) improved. The mean dose of citalopram
was 51.3 ± 16.9 mg/day, and the mean time to response was 4.6 ±
2.6 weeks. Citalopram was generally well tolerated.
Conclusion: Citalopram appears safe and
effective for BDD. Psychosocial functioning and quality of life
also significantly improved with citalopram.