The Effectiveness and Tolerability of Citalopram in a Turkish Sample of Children with Obsessive Compulsive Disorder

Anxiety disorders (OCD, social phobia, selective mutism, panic disorder, separation anxiety, generalized anxiety disorder, simple phobia and post-traumatic stress disorder) are the most prevalent psychiatric disorders in children and adolescents, effecting as many as 10% of children (1,2). Current estimates suggest that 2% and 3% of children and adolescents are affected by OCD (3). Generally, symptoms exist an average of 7-8 years before reaching clinical attention (4). Main associated psychopathology with severe primary childhood OCD are major depression, Gilles de la Tourette syndrome (GTS), anxiety disorders, attention deficit/hyperactivity disorder (ADHD), conduct/oppositional disorder, eating disorders and alcohol substance abuse (5,6,7). In children and adolescents, drug treatment for anxiety disorders have been seldom studied compare to adults. However, the effective and commonly used treatment of OCD is a combination of behavioral therapy and pharmacological treatment with a serotonin reuptake inhibitor (8). The selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs), which are a new group of antidepressants used in mild to moderate cases of a spectrum of childhood psychiatric disorders (e.g. OCD, depression, eating disorders, GTS, ADHD, anxiety disorders, elective mutism, Asperger Syndrome), because of their efficacy, good side-effect profile, tolerability, and safety in overdose, as well as patient compliance (9-17). The best-documented SSRI to this area is sertraline. However, fluoxetine and fluoxamine have been studied in systematic trials in children and adolescents. Clomipramine has been proven effective, however, side effects caused by this agent would suggest that an SSRI is a better choice (18). In addition, although SSRIs are first-line pharmacological agents in children and adolescents with OCD, refractory symptoms can be treated by augmentation with neuroleptics or other agents (3,19). Citalopram is the most selective of the SSRIs, and The Effectiveness and Tolerability of Citalopram in a Turkish Sample of Children with Obsessive Compulsive Disorder