Efficacy of adjunct therapy with citalopram to improve health-related quality of life and associated symptoms in patients with endometriosis: A randomized clinical trial

Abstract

Author(s): Rayhaneh Hosseini, Samira Mirzaei*, Zahra Asgari*, Nasrin Hajiloo and Lida Garros

Aims and Objectives: Given the impact of SSRIs on chronic pain and inflammation in endometriosis pathogenesis, the hypothesis is that incorporating an SSRI drug into the treatment of women with endometriosis may result in a reduction in inflammation and pain. This study aimed to integrate Citalopram into the treatment of endometriosis patients to assess the effects of these medications on endometriosis symptoms and overall health-related quality of life.

Materials and Methods: The first group received a dose of citalopram (20 mg to 40 mg) alongside Verogest 2 mg daily for three months. The placebo group received only a daily dosage of 2 mg Verogest. Medications were administered for 12 weeks. Pelvic pain, dysmenorrhea, and dyspareunia, were assessed using a visual pain ruler and the ENDOPAIN-4D questionnaire before and after the intervention. Additionally, participants completed the EHP30 for Health-related quality of life evaluation. The final analysis compared changes in pelvic pain and health-related quality of life scores between the two groups.

Results: In total, 40 patients were included in both the control and intervention groups, with no discernible differences regarding basic characteristics. Analysis of the EHP-30 questionnaire revealed significant differences between the placebo and intervention groups in control and powerlessness (p=0.013), emotional well-being (p=0.001), and social support (p=0.005). The VAS test demonstrated significant differences in dysmenorrhea (p=0.006), dyschezia (p=0.040), and chronic pelvic pain (p=0.004), while dyspareunia (p=0.081) did not exhibit a significant difference. Evaluation of the ENDOPAIN-4D questionnaire indicated significant improvement in all domains for the intervention group, except for pain-related disability (p=0.117). Moreover, the total score difference was significantly higher (p=0.002) in the intervention group.

Conclusion: In summary, our study indicated citalopram therapy results in a significant decrease in overall pain and associated outcomes, along with a notable improvement in the health-related quality of life compared to the placebo group. Future research should focus on determining the optimal dosage of citalopram and comparing its effectiveness with other SSRIs.

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