Escitalopram Treatment of Compulsive-Impulsive Computer Use Disorder

David L. Ginsberg, MD

Director of Outpatient Services, Tisch Hospital’s Department of Psychiatry, New York University Medical Center

Compulsive-impulsive computer usage disorder (CI-CUD) is characterized by excessive time spent on the Internet at the expense of occupational, relationship, and social activities. CI-CUD shares features of impulse control disorders, obsessive-compulsive disorder (OCD), and substance abuse.

A study suggested efficacy of escitalopram for the treatment of CI-CUD. Nineteen subjects with CI-CUD received open-label escitalopram for 10 weeks and then were randomized to a 9-week double-blind discontinuation phase. Primary response measures included hours spent per week in non-essential Internet use; obsessive, compulsive, and total scores on the Internet Addiction-Yale-Brown Obsessive-Compulsive Scale; and Clinical Global Improvement scores.

Fifteen subjects (78.9%) completed both phases of the study. Early on during the first phase of the study, significant improvement occurred on all measures of response (P=0.0 for all domains). More specifically, behavioral changes in internet usage that occurred early in the first phase of the study were sustained later on. During the second phase of the trial from weeks 10–19, there were no significant differences between the escitalopram and placebo groups. In addition, throughout the study, escitalopram was well tolerated with minimal side effects.

Overall, escitalopram resulted in significant improvement in CI-CUD. Additional controlled trials are indicated to confirm and expand upon these preliminary findings.

REFERENCES

Hadley SJ, Baker BR, Hollander E. Efficacy of escitalopram in the treatment of compulsive-impulsive computer use disorder (abstract). Biological Psychiatry 2006; 59:261S, No. 854.