A randomized controlled clinical trial of Citalopram versus Fluoxetine in children and adolescents with obsessive-compulsive disorder (OCD)

Objective Several controlled trials have demonstrated the efficacy and safety of Fluoxetine in children and adolescents with Obsessive-Compulsive Disorder (OCD), but there is no controlled study on the effectiveness of Citalopram in this group. This report describes the use of Citalopram in comparison with Fluoxetine in childhood-onset OCD. Method This study is a randomized, double blind, fixed-does (20mg) trial of Fluoxetine versus Citalopram in 29 children and adolescents (17 boys and 12 girls) with OCD, aged 7-18 years (mean 13.8 and SD 3.05). The length of study was 6 weeks. Obsessive-Compulsive symptom severity was measured by Yale-Brown Obsessive-Compulsive-Scale (CY-BOCS) and Clinician's Global Impression Scale (CGI). DICA (Diagnostic Interview of Children and Adolescents) was used to diagnose the psychiatric disorders. Results Each group showed significant improvement over the baseline as measured by the CY-BOCS (p < 0.01) but not by CGI (p = NS). The Comparison between two groups showed no significant differences in efficacy and safety of the drugs. Most common adverse effects were headache for Citalopram and tremor for Fluoxetine. Conclusion The results suggest that Citalopram is as safe and effective as Fluoxetine for children and adolescents with OCD. Further studies are needed to replicate our findings.