Variations in Response to Citalopram in Men and Women with Alcohol Dependence

Overview

Journal J Psychiatry Neurosci

Specialty Psychiatry

Date 2000 Jun 23

PMID 10863887

Citations 3

Authors

C A Naranjo

D M Knoke

K E Bremner

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the differential effects of citalopram on alcohol consumption in nondepressed women and men with mild to moderate alcohol dependence.

Design: Prospective, placebo-controlled study.

Participants: Sixty-one subjects (34 men and 27 women).

Interventions: After a 2-week baseline, subjects were randomly assigned to 12 weeks of citalopram (40 mg per day) (n = 15 women, 16 men) or placebo (n = 12 women, 18 men). All received brief standard psychosocial interventions.

Outcome Measures: Alcohol Dependence Scale, Montgomery-Asberg Depression Scale, Michigan Alcohol Screening Test, State-Trait Anxiety Inventory and daily alcohol intake.

Results: Pretreatment sex differences were evident in alcohol consumption, alcohol dependence, alcohol-related problems and on anxiety and depression measures. After treatment, analyses of covariance with depression and anxiety scores as covariates revealed a differential benefit of citalopram for men. Men receiving citalopram reduced average drinks per day by 44%, whereas women exhibited a 27% decrease (p < 0.05).

Conclusions: Men may benefit more than women from citalopram in the treatment of alcohol dependence. These findings highlight the importance of examining sex as a significant variable in evaluating response to pharmacotherapy.

Citing Articles

Alcohol use disorder: pathophysiology, effects, and pharmacologic options for treatment.

Wackernah R, Minnick M, Clapp P Subst Abuse Rehabil. 2014; 5:1-12.

PMID: 24648792 PMC: 3931699. DOI: 10.2147/SAR.S37907.

Alcohol, nicotine, caffeine, and mental disorders.

Crocq M Dialogues Clin Neurosci. 2011; 5(2):175-85.

PMID: 22033899 PMC: 3181622.

Neurodevelopmental liabilities in alcohol dependence: central serotonin and dopamine dysfunction.

Naranjo C, Chu A, Tremblay L Neurotox Res. 2003; 4(4):343-61.

PMID: 12829424 DOI: 10.1080/10298420290034231.

References

Biver F, Lotstra F, Monclus M, Wikler D, Damhaut P, Mendlewicz J . Sex difference in 5HT2 receptor in the living human brain. Neurosci Lett. 1996; 204(1-2):25-8. DOI: 10.1016/0304-3940(96)12307-7. View

McKay J, Rutherford M, Cacciola J, Alterman A . Gender differences in the relapse experiences of cocaine patients. J Nerv Ment Dis. 1996; 184(10):616-22. DOI: 10.1097/00005053-199610000-00006. View

. Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol. 1997; 58(1):7-29. View

Golden R, Gilmore J, Ekstrom R, Knight B, Ruegg R, Miller H . The effects of age, gender, and season on serotonergic function in healthy subjects. Prog Neuropsychopharmacol Biol Psychiatry. 1996; 20(8):1315-23. DOI: 10.1016/s0278-5846(96)00128-5. View

Preskorn S . Clinically relevant pharmacology of selective serotonin reuptake inhibitors. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism. Clin Pharmacokinet. 1997; 32 Suppl 1:1-21. DOI: 10.2165/00003088-199700321-00003. View

Fiorentine R, Anglin M, Gil-Rivas V, Taylor E . Drug treatment: explaining the gender paradox. Subst Use Misuse. 1997; 32(6):653-78. DOI: 10.3109/10826089709039369. View

Cornelius J, Salloum I, Ehler J, Jarrett P, Cornelius M, Perel J . Fluoxetine in depressed alcoholics. A double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1997; 54(8):700-5. DOI: 10.1001/archpsyc.1997.01830200024004. View

Pettinati H, Pierce Jr J, Wolf A, Rukstalis M, OBrien C . Gender differences in comorbidly depressed alcohol-dependent outpatients. Alcohol Clin Exp Res. 1998; 21(9):1742-6. View

SELZER M . The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971; 127(12):1653-8. DOI: 10.1176/ajp.127.12.1653. View

10.

Edwards G, Orford J, Egert S, Guthrie S, Hawker A, Hensman C . Alcoholism: a controlled trial of "treatment" and "advice". J Stud Alcohol. 1977; 38(5):1004-31. DOI: 10.15288/jsa.1977.38.1004. View

11.

Montgomery S, Asberg M . A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979; 134:382-9. DOI: 10.1192/bjp.134.4.382. View

12.

Naranjo C, Sellers E, Roach C, Woodley D, Sykora K . Zimelidine-induced variations in alcohol intake by nondepressed heavy drinkers. Clin Pharmacol Ther. 1984; 35(3):374-81. DOI: 10.1038/clpt.1984.46. View

13.

Mueller E, Murphy D, Sunderland T . Neuroendocrine effects of M-chlorophenylpiperazine, a serotonin agonist, in humans. J Clin Endocrinol Metab. 1985; 61(6):1179-84. DOI: 10.1210/jcem-61-6-1179. View

14.

Blume S . Women and alcohol. A review. JAMA. 1986; 256(11):1467-70. View

15.

Naranjo C, Sellers E, Sullivan J, Woodley D, Kadlec K, Sykora K . The serotonin uptake inhibitor citalopram attenuates ethanol intake. Clin Pharmacol Ther. 1987; 41(3):266-74. DOI: 10.1038/clpt.1987.27. View

16.

Charney D, Goodman W, Price L, Woods S, Rasmussen S, Heninger G . Serotonin function in obsessive-compulsive disorder. A comparison of the effects of tryptophan and m-chlorophenylpiperazine in patients and healthy subjects. Arch Gen Psychiatry. 1988; 45(2):177-85. DOI: 10.1001/archpsyc.1988.01800260095012. View

17.

Angelone S, Bellini L, Di Bella D, Catalano M . Effects of fluvoxamine and citalopram in maintaining abstinence in a sample of Italian detoxified alcoholics. Alcohol Alcohol. 1998; 33(2):151-6. DOI: 10.1093/oxfordjournals.alcalc.a008371. View

18.

Helzer J, Pryzbeck T . The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud Alcohol. 1988; 49(3):219-24. DOI: 10.15288/jsa.1988.49.219. View

19.

Naranjo C, Sullivan J, Kadlec K, Kennedy G, Sellers E . Differential effects of viqualine on alcohol intake and other consummatory behaviors. Clin Pharmacol Ther. 1989; 46(3):301-9. DOI: 10.1038/clpt.1989.142. View

20.

Naranjo C, Kadlec K, Sanhueza P, Sellers E . Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers. Clin Pharmacol Ther. 1990; 47(4):490-8. DOI: 10.1038/clpt.1990.62. View