Citalopram for Compulsive Shopping Disorder: An Open-Label Study Followed by Double-Blind Discontinuation
J Clin Psychiatry 2003;64:793-798
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Open-label trials suggested that
fluvoxamine and citalopram may be effective for compulsive
shopping disorder, but 2 double-blind fluvoxamine trials failed
to confirm this. To test the hypothesis that citalopram is a
safe, effective treatment for this disorder, we conducted a
7-week, open-label trial followed by a 9-week, double-blind,
placebo-controlled discontinuation trial.
Method: From Jan. 2001 to Jan. 2002, we enrolled
adult outpatients meeting diagnostic criteria suggested in a
prior study for compulsive shopping disorder and having a score
of >= 17 on the Yale-Brown Obsessive Compulsive Scale-Shopping
Version (YBOCS-SV). Open-label citalopram was started at 20
mg/day and increased, absent marked response and limiting side
effects, to 60 mg/day. Responders (subjects rated "much
improved" or "very much improved" on the Clinical
Global Impressions-Improvement scale [CGI-I] and having a >=
50% decrease in YBOCS-SV score) were randomized to double-blind
citalopram treatment at the week 7 dose or placebo for 9 weeks.
Results: We enrolled 24 subjects (23
women and 1 man). Mean ± SD YBOCS-SV scores decreased
significantly from 24.3 ± 4.6 at baseline to 8.2 ± 8.1 at week
7 (Wilcoxon signed rank: z = 4.20, p < .001). Fifteen of 24
subjects (63%) met the responder criteria. Three subjects (13%)
discontinued for adverse events (1 each for headache, rash, and
insomnia). Of the 15 responders who entered the double-blind
treatment phase, 5 of 8 (63%) randomized to placebo relapsed
(YBOCS-SV score >= 17 and "minimally improved" or
less on the CGI-I) compared with none of 7 randomized to continue
taking citalopram (Fisher exact test p = .019).
Conclusion: Citalopram appears to be a safe and
effective treatment for compulsive shopping disorder. Further
trials of citalopram and other selective serotonin reuptake
inhibitors are warranted.