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. 2016 Winter;25(1):11-6.
Epub 2016 Feb 1.

A Pilot Study of Citalopram Treatment in Preventing Relapse of Depressive Episode after Acute Treatment

Amy Cheung  1 , Anthony Levitt  1 , Michael Cheng  2 , Darcy Santor  3 , Stan Kutcher  4 , Elyse Dubo  1 , E Jane Garland  5 , Margaret Weiss  5 , Alex Kiss  1
Affiliations

A Pilot Study of Citalopram Treatment in Preventing Relapse of Depressive Episode after Acute Treatment

Amy Cheung et al. J Can Acad Child Adolesc Psychiatry. 2016 Winter.

Abstract
in English, French

Purpose: To examine the benefit of continuation treatment with citalopram in adolescents 13 to 18 years of age with major depression using a multi-site randomized placebo controlled discontinuation design.

Methods: Subjects with depression who responded to open label treatment with citalopram in 12-week acute phase were randomized to continued treatment with citalopram or placebo for 24 weeks.

Results: Twenty five subjects were randomized to either continued treatment with citalopram (n = 12) versus placebo (n = 13). Seventy-five percent of subjects on citalopram (75%) remained well as compared to placebo (62%). Time to relapse was compared between groups using the log rank test and was not found to be significantly different (χ(2)(1) = 0.35, P = 0.55). A Cox proportional hazards model including drug assignment (hazard ratio (HR = 0.51, 95% CI 0.11 to 2.36, P = 0.39), gender (HR = 0.58, 95% CI 0.14 to 2.37, P = 0.44), or HAM-score at entry to continuation phase (HR = 1.33, 95% CI 0.90 to 1.95, P = 0.95) was not significant.

Conclusion: Although we did not find statistically significant differences between citalopram and placebo, the findings suggest a possible benefit of continued treatment with citalopram over placebo. A larger clinical trial with adequate power is required to confirm or disconfirm these findings.

Objectif: Examiner l’avantage d’un traitement de stabilisation par citalopram chez des adolescents de 13 à 18 ans souffrant de dépression majeure au moyen d’un essai d’arrêt randomisé, multicentrique et contrôlé contre placebo.

Méthodes: Les sujets souffrant de dépression qui ont répondu au traitement avec étiquetage en clair par citalopram durant une phase aiguë de 12 semaines ont été randomisés dans le traitement de stabilisation par citalopram ou placebo durant 24 semaines.

Résultats: Vingt-cinq sujets ont été randomisés dans un traitement de stabilisation soit par citalopram (n = 12), soit contre placebo (n = 13). Soixante-quinze pour cent des sujets traités par citalopram (75%) sont demeurés sans rechute comparativement à ceux du placebo (62%). Le délai avant la rechute a été comparé entre les groupes à l’aide du test de Mantel-Haenzel et n’était pas significativement différent (χ2(1) = 0,35; P = 0,55). Un modèle de risques proportionnels de Cox incluant l’assignation des médicaments (rapport des risques (RR = 0,51; IC à 95% 0,11 à 2,36; P = 0,39), le sexe (RR = 0,58; IC à 95% 0,14 à 2,37; P = 0,44), ou le score à l’échelle HAM au départ jusqu’à la phase de stabilisation (RR = 1,33; IC à 95% 0,90 à 1,95; P = 0,95) n’était pas significatif.

Conclusion: Bien que nous n’ayons pas observé de différences statistiquement significatives entre le citalopram et le placebo, les résultats suggèrent un avantage possible du traitement de stabilisation par citalopram plutôt que placebo. Il faut un essai clinique plus vaste de puissance adéquate pour confirmer ou infirmer ces résultats.

Keywords: adolescents; antidepressants; citalopram; depression.

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Figures

Figure 1.
Figure 1.
Patient flow
Figure 2.
Figure 2.
Survival curve for continuation phase
See this image and copyright information in PMC

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