Results of the citalopram to enhance cognition in Huntington disease trial

Background: The objective of this study was to evaluate citalopram for executive functioning in Huntington's disease (HD). Methods: The study was randomized, double-blind, and placebo-controlled. Thirty-three adults with HD, cognitive complaints, and no depression (Hamilton Depression [HAM-D] rating scale ≤12) were administered citalopram 20 mg or placebo (7 visits, 20 weeks), with practice and placebo run-ins. The primary outcome was change in executive functioning. Results: The intent to treat analysis was controlled for practice effects, comparing visits 1 and 2 to visits 5 and 6 for citalopram versus placebo. There were no significant benefits on the executive function composite (treatment-placebo mean difference -0.167; 95% confidence interval [CI], -0.361 to 0.028; P=.092). Citalopram participants showed improved clinician-rated depression symptoms on the HAM-D (t=-2.02; P=0.05). There were no group differences on motor ratings, self-reported executive functions, psychiatric symptoms, or functional status. Conclusions: There was no evidence that short-term treatment with citalopram improved executive functions in HD. Despite excluding patients with active depression, participants on citalopram showed improved mood, raising the possibility of efficacy for subsyndromal depression in HD.