Beyond depression: Citalopram for obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) and serotonin reuptake inhibitors became inextricably joined with the discovery of their effectiveness for the treatment of OCD in 1969 and 1976. The specificity of response of OCD to serotonin reuptake inhibitors has provided an important platform for the exploration of the neurobiology of OCD. This knowledge has come from many different areas of investigation, including neuroimaging, neuroimmunology and pharmacologic challenge studies. As the research into the pharmacologic treatment of OCD has progressed, a number of serotonin reuptake inhibitors have been approved and marketed for the treatment of OCD. These agents include clomipramine, sertraline, paroxetine, fluoxetine, and fluvaxamine. Because these agents share the same mechanism of action (serotonin reuptake inhibition), choosing which agent to use must be based on other parameters. These include differences in efficacy, dosing, and side-effect profile. Citalopram, a newly marketed selective serotonin reuptake inhibitor could offer some advantages over those agents currently marketed. Theoretically, it should also be effective in the treatment of OCD. In treating depression, it has been shown to have minimal side-effects, low risk of withdrawal symptoms, and little possibility of interaction with other agents.