Skip to main content
NCBI home page
Journal of Psychiatry & Neuroscience : JPN logoLink to Journal of Psychiatry & Neuroscience : JPN
. 2000 May;25(3):269–275.

Variations in response to citalopram in men and women with alcohol dependence.

C A Naranjo 1, D M Knoke 1, K E Bremner 1
PMCID: PMC1407711  PMID: 10863887

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.

Full text

PDF
269

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Angelone S. M., 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 Mar-Apr;33(2):151–156. doi: 10.1093/oxfordjournals.alcalc.a008371. [DOI] [PubMed] [Google Scholar]
  2. Balldin J., Berggren U., Engel J., Eriksson M., Hård E., Söderpalm B. Effect of citalopram on alcohol intake in heavy drinkers. Alcohol Clin Exp Res. 1994 Oct;18(5):1133–1136. doi: 10.1111/j.1530-0277.1994.tb00093.x. [DOI] [PubMed] [Google Scholar]
  3. Biver F., Lotstra F., Monclus M., Wikler D., Damhaut P., Mendlewicz J., Goldman S. Sex difference in 5HT2 receptor in the living human brain. Neurosci Lett. 1996 Feb 2;204(1-2):25–28. doi: 10.1016/0304-3940(96)12307-7. [DOI] [PubMed] [Google Scholar]
  4. Blume S. B. Women and alcohol. A review. JAMA. 1986 Sep 19;256(11):1467–1470. [PubMed] [Google Scholar]
  5. Charney D. S., Goodman W. K., Price L. H., Woods S. W., Rasmussen S. A., Heninger G. R. 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 Feb;45(2):177–185. doi: 10.1001/archpsyc.1988.01800260095012. [DOI] [PubMed] [Google Scholar]
  6. Chou S. P., Dawson D. A. A study of the gender differences in morbidity among individuals diagnosed with alcohol abuse and/or dependence. J Subst Abuse. 1994;6(4):381–392. doi: 10.1016/s0899-3289(94)90306-9. [DOI] [PubMed] [Google Scholar]
  7. Cornelius J. R., Salloum I. M., Ehler J. G., Jarrett P. J., Cornelius M. D., Perel J. M., Thase M. E., Black A. Fluoxetine in depressed alcoholics. A double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1997 Aug;54(8):700–705. doi: 10.1001/archpsyc.1997.01830200024004. [DOI] [PubMed] [Google Scholar]
  8. Edwards G., Orford J., Egert S., Guthrie S., Hawker A., Hensman C., Mitcheson M., Oppenheimer E., Taylor C. Alcoholism: a controlled trial of "treatment" and "advice". J Stud Alcohol. 1977 May;38(5):1004–1031. doi: 10.15288/jsa.1977.38.1004. [DOI] [PubMed] [Google Scholar]
  9. Fiorentine R., Anglin M. D., Gil-Rivas V., Taylor E. Drug treatment: explaining the gender paradox. Subst Use Misuse. 1997 May;32(6):653–678. doi: 10.3109/10826089709039369. [DOI] [PubMed] [Google Scholar]
  10. Golden R. N., Gilmore J. H., Ekstrom R. D., Knight B., Ruegg R. G., Miller H. L., Carson S. W. The effects of age, gender, and season on serotonergic function in healthy subjects. Prog Neuropsychopharmacol Biol Psychiatry. 1996 Nov;20(8):1315–1323. doi: 10.1016/s0278-5846(96)00128-5. [DOI] [PubMed] [Google Scholar]
  11. Helzer J. E., Pryzbeck T. R. The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud Alcohol. 1988 May;49(3):219–224. doi: 10.15288/jsa.1988.49.219. [DOI] [PubMed] [Google Scholar]
  12. Kranzler H. R., Burleson J. A., Del Boca F. K., Babor T. F., Korner P., Brown J., Bohn M. J. Buspirone treatment of anxious alcoholics. A placebo-controlled trial. Arch Gen Psychiatry. 1994 Sep;51(9):720–731. doi: 10.1001/archpsyc.1994.03950090052008. [DOI] [PubMed] [Google Scholar]
  13. Kranzler H. R., Burleson J. A., Korner P., Del Boca F. K., Bohn M. J., Brown J., Liebowitz N. Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry. 1995 Mar;152(3):391–397. doi: 10.1176/ajp.152.3.391. [DOI] [PubMed] [Google Scholar]
  14. Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol. 1997 Jan;58(1):7–29. [PubMed] [Google Scholar]
  15. McBride P. A., Tierney H., DeMeo M., Chen J. S., Mann J. J. Effects of age and gender on CNS serotonergic responsivity in normal adults. Biol Psychiatry. 1990 May 15;27(10):1143–1155. doi: 10.1016/0006-3223(90)90051-3. [DOI] [PubMed] [Google Scholar]
  16. McKay J. R., Rutherford M. J., Cacciola J. S., Kabasakalian-McKay R., Alterman A. I. Gender differences in the relapse experiences of cocaine patients. J Nerv Ment Dis. 1996 Oct;184(10):616–622. doi: 10.1097/00005053-199610000-00006. [DOI] [PubMed] [Google Scholar]
  17. Montgomery S. A., Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979 Apr;134:382–389. doi: 10.1192/bjp.134.4.382. [DOI] [PubMed] [Google Scholar]
  18. Mueller E. A., Murphy D. L., Sunderland T. Neuroendocrine effects of M-chlorophenylpiperazine, a serotonin agonist, in humans. J Clin Endocrinol Metab. 1985 Dec;61(6):1179–1184. doi: 10.1210/jcem-61-6-1179. [DOI] [PubMed] [Google Scholar]
  19. Naranjo C. A., Bremner K. E., Lanctôt K. L. Effects of citalopram and a brief psycho-social intervention on alcohol intake, dependence and problems. Addiction. 1995 Jan;90(1):87–99. doi: 10.1046/j.1360-0443.1995.9018712.x. [DOI] [PubMed] [Google Scholar]
  20. Naranjo C. A., Kadlec K. E., Sanhueza P., Woodley-Remus D., Sellers E. M. Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers. Clin Pharmacol Ther. 1990 Apr;47(4):490–498. doi: 10.1038/clpt.1990.62. [DOI] [PubMed] [Google Scholar]
  21. Naranjo C. A., Poulos C. X., Bremner K. E., Lanctot K. L. Fluoxetine attenuates alcohol intake and desire to drink. Int Clin Psychopharmacol. 1994 Sep;9(3):163–172. doi: 10.1097/00004850-199409000-00004. [DOI] [PubMed] [Google Scholar]
  22. Naranjo C. A., Poulos C. X., Bremner K. E., Lanctôt K. L. Citalopram decreases desirability, liking, and consumption of alcohol in alcohol-dependent drinkers. Clin Pharmacol Ther. 1992 Jun;51(6):729–739. doi: 10.1038/clpt.1992.85. [DOI] [PubMed] [Google Scholar]
  23. Naranjo C. A., Sellers E. M., Roach C. A., Woodley D. V., Sanchez-Craig M., Sykora K. Zimelidine-induced variations in alcohol intake by nondepressed heavy drinkers. Clin Pharmacol Ther. 1984 Mar;35(3):374–381. doi: 10.1038/clpt.1984.46. [DOI] [PubMed] [Google Scholar]
  24. Naranjo C. A., Sellers E. M., Sullivan J. T., Woodley D. V., Kadlec K., Sykora K. The serotonin uptake inhibitor citalopram attenuates ethanol intake. Clin Pharmacol Ther. 1987 Mar;41(3):266–274. doi: 10.1038/clpt.1987.27. [DOI] [PubMed] [Google Scholar]
  25. Naranjo C. A., Sullivan J. T., Kadlec K. E., Woodley-Remus D. V., Kennedy G., Sellers E. M. Differential effects of viqualine on alcohol intake and other consummatory behaviors. Clin Pharmacol Ther. 1989 Sep;46(3):301–309. doi: 10.1038/clpt.1989.142. [DOI] [PubMed] [Google Scholar]
  26. Pettinati H. M., Pierce J. D., Jr, Wolf A. L., Rukstalis M. R., O'Brien C. P. Gender differences in comorbidly depressed alcohol-dependent outpatients. Alcohol Clin Exp Res. 1997 Dec;21(9):1742–1746. [PubMed] [Google Scholar]
  27. Preskorn S. H. 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. [DOI] [PubMed] [Google Scholar]
  28. Selzer M. L. The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971 Jun;127(12):1653–1658. doi: 10.1176/ajp.127.12.1653. [DOI] [PubMed] [Google Scholar]
  29. Single E. W., Brewster J. M., MacNeil P., Hatcher J., Trainor C. The 1993 General Social Survey I: alcohol use in Canada. Can J Public Health. 1995 Nov-Dec;86(6):397–401. [PubMed] [Google Scholar]
  30. Tyas S. L., Rush B. R. Trends in the characteristics of clients of alcohol/drug treatment services in Ontario. Can J Public Health. 1994 Jan-Feb;85(1):13–16. [PubMed] [Google Scholar]

Articles from Journal of Psychiatry and Neuroscience are provided here courtesy of Canadian Science Publishing

RESOURCES