Escitalopram in the Treatment of Impulsive-Compulsive Internet Usage Disorder: An Open-Label Trial Followed by a Double-Blind Discontinuation Phase
J Clin Psychiatry 2008;69(3):452-456
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Isolated reports suggest that escitalopram may be
effective for impulsive-compulsive Internet usage disorder (ICIUD), an
impulse-control disorder characterized by excessive time spent on the Internet
at the expense of occupational, relationship, and social activities. To assess
the safety and efficacy of escitalopram in IC-IUD, we conducted a 10-week, open-label trial followed by a 9-week, double-blind, placebo-controlled
Method: From December 2002 to October 2004, 19 adult subjects
with IC-IUD (defined as time consuming, uncontrollable, distressing, and
resulting in social, occupational, or financial difficulties) were enrolled.
Escitalopram was started at 10 mg/day, then increased and maintained at 20
mg/day for 10 weeks at the end of which completers were randomly assigned to
placebo or escitalopram for 9 additional weeks. Two key outcome measures were
used: hours spent weekly in nonessential Internet use and overall clinical
response (subjects rated "much improved" or "very much improved" on the
Clinical Global Impressions-Improvement scale [CGI-I]).
Results: Fourteen subjects completed the entire study. At the
end of the 10th week of open-label escitalopram, Internet usage decreased
significantly from a mean of 36.8 hours/week at baseline to 16.5 hours/week
(paired t test: t = 3.58; p = .002). In addition, 64.7% of the sample (N = 11)
were considered CGI-I responders. At the end of the double-blind phase, there
were no significant differences in outcome measures between patients taking
placebo compared to escitalopram (analysis of variance with repeated measures,
p > .05).
Conclusion: Patients showed a significant improvement of
IC-IUD symptoms during the open-label escitalopram phase. There was no
significant difference between the escitalopram and placebo groups at the end
of the subsequent double-blind phase; both groups maintained the gains made in
the initial open-label treatment. Larger controlled trials are needed to
investigate the efficacy of this and other pharmacologic agents in the
treatment of IC-IUD.