Reactions 1411 - 21 Jul 2012

SCitalopram

Major depressive disorder: case reportA 31-year-old woman developed major depressive

disorder following treatment with citalopram for panicdisorder.

The woman presented with major depression in additionto panic disorder; three weeks prior, citalopram wasstarted for panic disorder with an initial dose of 10 mg/day,in the morning, for 2 weeks followed by 1 week of 20mg[route not stated]. Two days following citalopram initiation,depressed mood with impaired concentration and reducedenergy levels ensued; she also experienced low self-esteem, feelings of worthlessness and reduced pleasure.Weight loss, disturbed sleep patterns, and the new onset ofimpulsive thoughts accompanied with anxiety were alsoreported. She was diagnosed with major depressivedisorder and panic disorder following a structured clinicalinterview for DSM-IV Axis I disorders (SCID-I). Anincreased raw score (27 points) was noted following Beckdepression inventory (BDI) analysis.

After 28 days of treatment, citalopram was withdrawn.The woman’s condition later improved with increasedenergy levels and feelings of initiative within 3 days; herobsessive thoughts also resolved. Within 1 week, repeattesting by SCID-I and BDI corroborated completeresolution of major depressive disorder. At follow-up, after2 weeks, she remained free of depressive symptoms.

Author comment: "In summary, citalopram-induceddepression could be explained by the activation ofpresynaptic autoreceptors leading to a decrease of post-synaptic serotonin response."Hofmann P, et al. Citalopram-induced major depression in a patient with panicdisorder - A case report. Psychiatria Danubina 24: 94-96, No. 1, Jan 2012 -Germany 803073958

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Reactions 21 Jul 2012 No. 14110114-9954/10/1411-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved