Escitalopram in the treatment of impulsive-compulsive internet usage disorder: An open-label trial followed by a double-blind discontinuation phase

Bernardo Dell'Osso, Salliejo Hadley, Andrea Allen, Bryann Baker, William F. Chaplin, Eric Hollander

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Isolated reports suggest that escitalopram may be effective for impulsive-compulsive Internet usage disorder (IC-IUD), an impulse-control disorder characterized by excessive time spent on the Internet at the expense of occupational, relationship, and social activities. To assess the safety and efficacy of escitalopram in IC-IUD, we conducted a 10-week, open-label trial followed by a 9-week, double-blind, placebo-controlled discontinuation phase. Method: From December 2002 to October 2004, 19 adult subjects with IC-IUD (defined as time consuming, uncontrollable, distressing, and resulting in social, occupational, or financial difficulties) were enrolled. Escitalopram was started at 10 mg/day, then increased and maintained at 20 mg/day for 10 weeks at the end of which completers were randomly assigned to placebo or escitalopram for 9 additional weeks. Two key outcome measures were used: hours spent weekly in nonessential Internet use and overall clinical response (subjects rated "much improved" or "very much improved" on the Clinical Global Impressions-Improvement scale [CGI-I]). Results: Fourteen subjects completed the entire study. At the end of the 10th week of open-label escitalopram, Internet usage decreased significantly from a mean of 36.8 hours/week at baseline to 16.5 hours/week (paired t test: t = 3.58; p = .002). In addition, 64.7% of the sample (N = 11) were considered CGI-I responders. At the end of the double-blind phase, there were no significant differences in outcome measures between patients taking placebo compared to escitalopram (analysis of variance with repeated measures, p > .05). Conclusion: Patients showed a significant improvement of IC-IUD symptoms during the openlabel escitalopram phase. There was no significant difference between the escitalopram and placebo groups at the end of the subsequent double-blind phase; both groups maintained the gains made in the initial open-label treatment. Larger controlled trials are needed to investigate the efficacy of this and other pharmacologic agents in the treatment of IC-IUD. Trial Registration: clinicaltrials.gov Identifier: NCT00565422.

Original languageEnglish (US)
Pages (from-to)452-456
Number of pages5
JournalJournal of Clinical Psychiatry
Volume69
Issue number3
StatePublished - Mar 2008
Externally publishedYes

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Citalopram
Internet
Placebos
Therapeutics
Outcome Assessment (Health Care)
Disruptive, Impulse Control, and Conduct Disorders
Analysis of Variance
Safety

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Escitalopram in the treatment of impulsive-compulsive internet usage disorder : An open-label trial followed by a double-blind discontinuation phase. / Dell'Osso, Bernardo; Hadley, Salliejo; Allen, Andrea; Baker, Bryann; Chaplin, William F.; Hollander, Eric.

In: Journal of Clinical Psychiatry, Vol. 69, No. 3, 03.2008, p. 452-456.

Research output: Contribution to journalArticle

Dell'Osso, Bernardo ; Hadley, Salliejo ; Allen, Andrea ; Baker, Bryann ; Chaplin, William F. ; Hollander, Eric. / Escitalopram in the treatment of impulsive-compulsive internet usage disorder : An open-label trial followed by a double-blind discontinuation phase. In: Journal of Clinical Psychiatry. 2008 ; Vol. 69, No. 3. pp. 452-456.
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abstract = "Background: Isolated reports suggest that escitalopram may be effective for impulsive-compulsive Internet usage disorder (IC-IUD), an impulse-control disorder characterized by excessive time spent on the Internet at the expense of occupational, relationship, and social activities. To assess the safety and efficacy of escitalopram in IC-IUD, we conducted a 10-week, open-label trial followed by a 9-week, double-blind, placebo-controlled discontinuation phase. Method: From December 2002 to October 2004, 19 adult subjects with IC-IUD (defined as time consuming, uncontrollable, distressing, and resulting in social, occupational, or financial difficulties) were enrolled. Escitalopram was started at 10 mg/day, then increased and maintained at 20 mg/day for 10 weeks at the end of which completers were randomly assigned to placebo or escitalopram for 9 additional weeks. Two key outcome measures were used: hours spent weekly in nonessential Internet use and overall clinical response (subjects rated {"}much improved{"} or {"}very much improved{"} on the Clinical Global Impressions-Improvement scale [CGI-I]). Results: Fourteen subjects completed the entire study. At the end of the 10th week of open-label escitalopram, Internet usage decreased significantly from a mean of 36.8 hours/week at baseline to 16.5 hours/week (paired t test: t = 3.58; p = .002). In addition, 64.7{\%} of the sample (N = 11) were considered CGI-I responders. At the end of the double-blind phase, there were no significant differences in outcome measures between patients taking placebo compared to escitalopram (analysis of variance with repeated measures, p > .05). Conclusion: Patients showed a significant improvement of IC-IUD symptoms during the openlabel escitalopram phase. There was no significant difference between the escitalopram and placebo groups at the end of the subsequent double-blind phase; both groups maintained the gains made in the initial open-label treatment. Larger controlled trials are needed to investigate the efficacy of this and other pharmacologic agents in the treatment of IC-IUD. Trial Registration: clinicaltrials.gov Identifier: NCT00565422.",
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T2 - An open-label trial followed by a double-blind discontinuation phase

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AU - Hadley, Salliejo

AU - Allen, Andrea

AU - Baker, Bryann

AU - Chaplin, William F.

AU - Hollander, Eric

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N2 - Background: Isolated reports suggest that escitalopram may be effective for impulsive-compulsive Internet usage disorder (IC-IUD), an impulse-control disorder characterized by excessive time spent on the Internet at the expense of occupational, relationship, and social activities. To assess the safety and efficacy of escitalopram in IC-IUD, we conducted a 10-week, open-label trial followed by a 9-week, double-blind, placebo-controlled discontinuation phase. Method: From December 2002 to October 2004, 19 adult subjects with IC-IUD (defined as time consuming, uncontrollable, distressing, and resulting in social, occupational, or financial difficulties) were enrolled. Escitalopram was started at 10 mg/day, then increased and maintained at 20 mg/day for 10 weeks at the end of which completers were randomly assigned to placebo or escitalopram for 9 additional weeks. Two key outcome measures were used: hours spent weekly in nonessential Internet use and overall clinical response (subjects rated "much improved" or "very much improved" on the Clinical Global Impressions-Improvement scale [CGI-I]). Results: Fourteen subjects completed the entire study. At the end of the 10th week of open-label escitalopram, Internet usage decreased significantly from a mean of 36.8 hours/week at baseline to 16.5 hours/week (paired t test: t = 3.58; p = .002). In addition, 64.7% of the sample (N = 11) were considered CGI-I responders. At the end of the double-blind phase, there were no significant differences in outcome measures between patients taking placebo compared to escitalopram (analysis of variance with repeated measures, p > .05). Conclusion: Patients showed a significant improvement of IC-IUD symptoms during the openlabel escitalopram phase. There was no significant difference between the escitalopram and placebo groups at the end of the subsequent double-blind phase; both groups maintained the gains made in the initial open-label treatment. Larger controlled trials are needed to investigate the efficacy of this and other pharmacologic agents in the treatment of IC-IUD. Trial Registration: clinicaltrials.gov Identifier: NCT00565422.

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