SSRI May Improve Metabolic Risk Factors, Hostility: Citalopram's Benefits Include Weight Loss

Article excerpt

BALTIMORE -- For individuals who have high levels of hostility, treatment with citalopram not only reduces hostility but improves the cardiovascular risk factors that make up metabolic syndrome, according to data presented at the annual meeting of the American Psychosomatic Society.

The findings suggest a role for central serotonergic function in the association of hostility with cardiovascular risk factors, said Thomas W. Kamarck, Ph.D., a professor of psychology at the University of Pittsburgh.

"We concluded that it's plausible that individual difference in serotonergic function may in part drive the association between hostility and metabolic risk factors observed in the literature," Dr. Kamarck said.

This analysis draws on data from the larger Stress Treatment and Health Risk (STAHR) project. This placebo-controlled study is aimed at assessing the effect of a selective serotonin re-uptake inhibitor on hostility and cardiovascular measures.

In the study on hostility, 229 healthy adults aged 30-50 years with elevated hostility levels measured using standardized scales were recruited. Exclusion criteria included a history of cardiovascular conditions, a DSM-IV Axis I diagnosis, or use of medication for elevated cholesterol, hypertension, diabetes, or psychiatric disorders.

Participants visited the laboratory five times during a 6-week prerandomization period. During these visits, they were assessed for waist circumference, fasting glucose and insulin, blood pressure, and fasting HDL cholesterol and triglycerides.

The Buss Perry Aggression scale was used to assess hostility. The scale is a self-report measure of hostility that involves four subscales, measuring behavioral (verbal and physical aggression), cognitive (suspiciousness), and affective (angry emotions) aspects of hostility.

In all, 160 participants were then randomized to citalopram (Celexa) or to placebo. During the first 6 weeks of treatment, the subjects randomized to citalopram were titrated up to a maximum dose of 40 mg/day During the next 5 weeks, treatment continued, and the pretreatment assessments were repeated.

The intention-to-treat analysis included 81 participants in the citalopram group and 79 in the placebo group. …


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