Citalopram Treatment for Impulsive Aggression in Children and Adolescents: An Open Pilot Study

Objective: To assess the short-term effect and safety of citalopram in the reduction of impulsive aggression in children and adolescents. Method: Twelve subjects, aged 7 to 15 years, were attending a psychiatric outpatient clinic and had a profile of impulsive aggression. Subjects were treated in an open trial with citalopram for 6 weeks after a 1-week washout period. Dosage was regulated individually over a period of 4 weeks. The starting dose was 10 mg/ day followed by 10 mg increments on a weekly basis. The maximum dose was not to exceed 40 mg/day. Outcome measures included the Modified Overt Aggression Scale (MOAS), the Child Behavioral Checklist (CBCL), and the Clinical Global Impressions (CGI). Results: Eleven subjects completed the study. Citalopram produced clinically and statistically significant reductions on target symptoms of impulsive aggression, independent of other behavioral problems, as measured by the MOAS, the CBCL, and the CGI at doses ranging from 20 to 40 mg/day (mean = 27 mg). No major adverse reactions were associated with citalopram use. Conclusion: Citalopram appears to be effective and well tolerated in this sample of children and adolescents with impulsive aggression.