Combination of citalopram plus paliperidone is better than citalopram alone in
the treatment of somatoform disorder: results of a 6-week randomized study.
Author(s): Huang M, Luo B, Hu J, Wei N, Chen L, Wang S, Zhou W, Hu S, Xu Y.
Affiliation(s): Departments of aPsychiatry bNeurology, First Affiliated Hospital, College of
Medicine, Zhejiang University, Hangzhou, China.
Publication date & source: 2012, Int Clin Psychopharmacol. , 27(3):151-8
The objective of this study was to evaluate the effectiveness and tolerability of
citalopram versus citalopram plus paliperidone combination therapy in patients
with somatoform disorders (SDs). In this 6-week, randomized, fixed-dose study, 60
patients with SD (ICD-10 F45.0), undifferentiated SD (F45.1), and somatoform
autonomic dysfunction (F45.3) were randomly assigned to receive citalopram (20
mg/day) with or without paliperidone (3 mg/day). Four scales were used to
evaluate effectiveness and tolerability at baseline and at the end of the second,
fourth, and sixth week after treatment: Somatoform Disorders Screening Symptoms-7
(SOMS-7), Hamilton Anxiety Scale (HAMA), 17-item Hamilton Depression Scale
(HAMD-17), and Treatment Emergent Symptom Scale (TESS). The rater was blinded to
the kind of treatment patients received. (i) In the intention-to-treat population
(N = 51), the overall response ratio (50% reduction in SMOS-7 scores) was
significantly higher in the citalopram-paliperidone group compared with the
citalopram group after a 6-week treatment (71.4 vs. 38.10%, χ² = 4.71, P = 0.03).
(ii) The SOMS-7 and somatic subscore of the Hamilton Anxiety Scale (HAMA-SOM)
total score of the citalopram plus paliperidone group decreased more
significantly than that of the citalopram group, and a significant difference
could be observed at the end of 4 weeks of treatment. (iii) There was no
significant difference between the two groups in adverse effects, and no serious
adverse event was reported in both groups. Our findings indicate that a
combination with paliperidone is significantly better than monotherapy with
citalopram whether synergistic or add-on for patients with SDs. Our results call
for future studies with larger sample sizes and a longer duration to draw more
definitive conclusions.
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