Reactions 1513, p14 - 9 Aug 2014

Citalopram

Pathological gambling: case reportA 58-year-old woman developed pathological gambling

following therapy with citalopram.The woman had history of somatisation disorder and major

depressive disorder. In August 2009, she was admitted to thehospital due to depression, worsening of anxiety andsomatisations. On admission, her Hamilton depression ratingscale (HAM-D) and Hamilton anxiety rating scale (HAM-A)score was 30 and 39; respectively. For 2 weeks, she receivedIV citalopram titrated up to 40 mg/day, later she switched oralcitalopram 40 mg/day. She was discharged after 4 months. HerHAM-D and HAM-A scores reduced to 17 and 21;respectively. She was again hospitalised due to a bone fracturesecondary to a traffic accident. Her condition improved;therefore, dose of citalopram was reduced to 20 mg/day. After4 months, she presented soaring hypochondriac thoughts,dizziness, disabling inner tremor, and worsening of anxietyand somatisation. Concurrently, she also developed gamblingaddiction; this behaviour was started at period of psychiatricdischarge and orthopaedic ward hospitalisation. She describedher mood state at the beginning of gambling as feelingsomewhat alone, but quite self-confident. Her symptoms wereconsidered to be related to antidepressant therapy.

The woman’s citalopram was discontinued over 2 monthsand she was treated with pregabalin and alprazolam. Sheshowed remarkable improvement of somatisations andanxiety with gradual reduction in gambling. She joined self-help group and 2 weeks later, she quitted gambling.

Author comment: "We rated gambling behaviour on theNaranjo ADR Probability Scale (Naranjo et al. 1981) andattributed a score of 8, compatible with probable relation tocitalopram."Cuomo I, et al. Citalopram-associated gambling: a case report. Journal ofGambling Studies 30: 467-73, No. 2, Jun 2014. Available from: URL: http://doi.org/10.1007/s10899-013-9360-2 - Italy 803106571

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Reactions 9 Aug 2014 No. 15130114-9954/14/1513-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved