Okay, so I've always had quite a few anxieties for most of my life and may even have GAD. I'm rather prone to analysis paralysis from time to time and to procrastination, but historically some structure has limited the adverse effects of various anxieties I have and channeled positively (or, as positively as is possible with such a level of anxiety) into constructive areas. Now, however, I've suffered from quite a bit of anxiety of a ubiquitous variety, perhaps resulting from some disruptions in my historical routine, seem to get very stressed out over necessary tasks, and have become more ineffectual, procrastinating , and overwhelmed by anxiety than usual.
I've been prescribed some citalopram to deal with matters. Specifically
Quote:
stat citalopram 10 g QAM x4d + then 20 mg QAM x 30 d Rs TT
Now, I'm relatively new to the (psychiatric) medication game, having never taken medication for mood issues in my life before. I'm certainly aware that every medication comes with some risk (including my life-saving insulin), but that it can be outweighed by potential benefits. I've heard that some of the risks involve sleep problems and arousal difficulties. But, doing five minutes of research, I've also heard that some studies state that citalopram is ineffectual in Autistic Spectrum Conditions cases.
www.medscape.com/viewarticle/705232 Quote:
Summary
Although no medications are currently approved by the US Food and Drug Administration for core symptoms of autism spectrum disorders (ASDs), selective serotonin reuptake inhibitors are widely prescribed for children with these conditions. The goal of this National Institutes of Health-sponsored, randomized, controlled trial was to evaluate the efficacy and safety of citalopram hydrobromide therapy for repetitive behavior in children with ASDs.
At 6 US academic centers, 149 children aged 5 to 17 years old with ASDs were randomly assigned to receive oral citalopram (10 mg/5 mL; n = 73) or placebo (n = 76) for 12 weeks. At baseline, illness severity ratings were at least moderate on the Clinical Global Impressions (CGI) severity of illness scale, as were compulsive behaviors measured with the Children's Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders. The mean maximum dosage of citalopram was 16.5 ± 6.5 mg/day (maximum, 20 mg/day).
A score of much improved or very much improved on the CGI improvement subscale constituted a positive response, and the score on the Children's Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders was the secondary endpoint. The Safety Monitoring Uniform Report Form allowed systematic determination of adverse events.
Neither the CGI improvement subscale nor the secondary endpoint showed any significant difference between groups. Positive response occurred in 32.9% of the citalopram group and in 34.2% of the placebo group. Adverse events were significantly more common with citalopram than with placebo; notably, increased energy level, impulsiveness, decreased concentration, hyperactivity, stereotypy, diarrhea, insomnia, and dry skin or pruritus.
Viewpoint
Based on these findings, there is no support for citalopram treatment of repetitive behavior in children and adolescents with ASDs. This lack of effect is not explained by attrition, small sample size, or poor treatment compliance. Inadequate dosing is also unlikely because high rates of adverse events would have precluded use of higher citalopram dosing. A possible study limitation is the selection of repetitive behavior as the major treatment focus. Given the high positive response rate in the placebo group, other medications often used off-label for children with ASDs should also be tested in randomized, placebo-controlled trials to evaluate their risk-benefit ratio.
Of course, citalopram may not be effective against autistic repetitive behaviours, but could still be effective against comorbid anxiety synonyms (depending on whether said study, which I don't have enough statistical training to really analyze, somehow managed to isolate "anxiety disorders" from "repetitive behaviours", as a lot of such behaviours result from peserverative worry). Of course, citalopram is apparently also effective in dealing with certain diabetes complications.
So, I'm wondering if anyone is more learned in this subject than myself and if said person or people could provide advice.
17 Oct 2011, 12:19 am
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