The half of the participants withdrew from the


The Poorer
Drinking Outcomes with Citalopram Treatment for Alcohol Dependence: A
Randomized, Double-Blind, Placebo-Controlled Trial studied if the Selective
Serotonin Receptor Inhibitor (SSRI) citalopram, an antidepressant medication, would
aid individuals in the treatment of alcohol abuse. The study was conducted at
McGill University Health Center’s addiction unit. Patients enrolling in the addiction
treatment could participate in the study if they were between the years of
18-65 and were diagnosed with alcohol dependency using the Structured Clinical
Interview criteria. Those excluded from the trial were individuals with a
secondary substance abuse problems, individuals suffering from psychotic
disorders, those already taking psychiatric medications including SSRIs or anti-craving
drugs, individuals needing further detoxification or psychiatric admission, individuals
with a family history of adverse reactions to SSRIs, or if they were pregnant
or breastfeeding. Any new prescriptions were also not allowed.1

            A total of 265 subjects enrolled in
the program were randomized into two groups: the placebo and the intervention
group. After the 12 weeks, almost half of the participants withdrew from the
study, leaving the intervention group with 72 subjects and 69 in the placebo
group. The SSRI intervention used was
citalopram 20 mg daily for the first two weeks followed by 40 mg daily for the
remainder of the 12 weeks. To keep the study double blinded, no group distinguishers
were revealed to the clinical research coordinator (CRC) or any participating physicians
and all patients received identical opaque capsules for the treatment. During
the trial, patients were required to attend biweekly appointments with the CRC
for medication distribution, adverse reaction reporting, review of alcohol/drug
diaries, and depression screenings. They were also required to attend one 50-minute
individual psychotherapy appointment as well as one 90 minute group session;
Alcoholics Anonymous was not required but attendance was encouraged. Patients
were monitored for sever adverse reactions, withdrawal symptoms, and mental stability
by the CRC and were removed from the study if further medical attention was
needed. Of the 265 participants 14 or 5% were removed for these reasons.

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Drinking related variables including the number
of drinking days, time to relapse, and abstinence time were measured as primary
outcomes. After completion of the 12-week study, drinks per drinking day, total
number of drinking days during the 12-week period, survey scores, and the patient’s
current status on abstinence were also measured. The results proved that citalopram
in the treatment of alcohol abuse was no more effective than placebo. Subjects
in the citalopram group presented with more heavy drinking days (p=0.007,) more
drinks per day (p=0.03), spent more money on alcohol (p= 0.041), consumed
alcohol more frequently (p= 0.016), and had overall less of a decrease in total
alcohol consumed per drinking day (p=0.025) than those in the placebo group. After
the 12 week assessments, the intervention group also didn’t differ from the
placebo groups in Addiction Severity Index (ASI) scores or psychiatric assessments
either (p > 0.05).