Summary

A study has tested the effects of citalopram and how it can be used to treat depression and pain in fibromyalgia (FM) patients.

Citalopram (brand name Celexa) is one of several anti-depressants in a class of drugs called SSRIs, or selective serotonin reuptake inhibitors. It has been documented in numerous clinical trials as effective and well-tolerated by patients. According to the deputy director of the New York State Psychiatric Institute in New York City, it has no known drug-drug interactions.

In the randomized, double-blind, placebo-controlled study, 40 female FM patients were given daily doses of citalopram. Placebos were given to 19 patients. (In a double-blind study, it is important to note that neither doctors or patients know who is given the drug versus the placebo.) Patients’ depression and physical health levels were assessed using the Visual Analogue Scales (VAS), the Montgomery Asberg Depression Rating Scale (MADRS), and the Fibrositis Impact Questionnaire (FIQ).

After just 1 month of treatment, citalopram helped alleviate depression – this result increased by the end of the trial. In fact, of the patients completing the test, 52.9% of the citalopram group noted improvement in overall feelings of well being, compared to only 22.2% of the placebo group.

After 2 months of treatment, citalopram had a significant effect on pain; however, after 4 months, no additional improvements were noted.

Abstract

Anderberg UM, Marteinsdottir I, von Knorring L. Department of Neuroscience Psychiatry, University Hospital, Uppsala University, Uppsala, Sweden.

The effect of the selective serotonin reuptake inhibitor citalopram was studied in a randomized, double-blind, placebo-controlled, 4-month trial in patients with the fibromyalgia syndrome (FMS) who all fulfilled the American College of Rheumatology criteria. The citalopram doses varied between 20-40 mg daily. Forty female patients, 21 patients in the citalopram and 19 in the placebo group, participated. Assessment of pain, depressive symptoms and physical functioning were made using Visual Analogue Scales (VAS), the Montgomery Asberg Depression Rating Scale (MADRS) and the Fibrositis Impact Questionnaire (FIQ). In the global judgement of improvement, no significant changes were found between the citalopram and placebo groups as concerns pain or well-being, either in the Intention to Treat (ITT) analysis or in the completer analysis. However, among the completers, it was a tendency that more patients in the citalopram group (52.9%) were improved as compared to the placebo group (22.2%) concerning well-being. Furthermore, the results indicated that treatment with citalopram had a significant effect on pain on the VAS after 2 months of treatment compared to baseline. After 4 months, however, the effect had diminished. Measured with the FIQ, significant differences in the pain ratings were seen at the end of the trial. Significant effects on the depressive symptomatology measured by means of the MADRS were seen already after 1 month of treatment and were increasing further at the end of the trial, when a significant difference between the groups was also found.