Biopsychiatry Illuminated

THE CANDLELIGHT PROJECT
by Bob Collier

18 August 2003
Issue 55

This is an article I read in The Canberra Times, Friday August 15 2003:

Drug May Be Ticket For Binge Buyers

Compulsive shopping leads to financial hardship and guilt, reports Michelle Guido.

Most people wouldn't think twice about going to the mall to pick up some towels, makeup or a new outfit. But few would blow their rent money on 16 pairs of shoes they didn't want - or need.

Stanford University Medical Centre researchers claim that a drug commonly prescribed as an antidepressant may be able to curb the uncontrollable urges of those who suffer from compulsive shopping disorder - a condition marked by extreme binge buying that leads to financial hardship and feelings of guilt.

Their study, published in the July issue of the Journal of Clinical Psychiatry, linked citalopram, an antidepressant, with a decline in the urge to compulsively shop. The trial, which involved 24 subjects with the disorder, was based on a small sample and requires more research.

Still, the study provides hope for relief from the disorder, estimated to affect between 2 and 8 per cent of the US population - most of them women.

Dr Lorrin Koran, professor of psychiatry and behavioural sciences at Stanford and lead author of the study said, "compulsive shopping leads to serious psychological, financial and family problems, including depression, overwhelming debt and the breakup of relationships."

"People don't realize the extent of damage it does to the sufferer."

There are skeptics, however, who say drug companies have an incentive to redefine "normal" behaviour as "compulsive" in order to spur sales.

Alan Horwitz, a professor of sociology at Rutgers University and author of the book Creating Mental Illness said, "compulsive shopping is a very rare condition, but if it's defined liberally enough it could encompass millions of people who like to shop.

"Just because people shop a lot and are distressed by it doesn't necessarily mean it's a disorder."

Adrianne Harrington of Pleasant Hill, California, hits the mall every weekend - and some weekdays - but hardly describes herself as a compulsive shopper.

"I'm the queen of returns," Harrington, 31, said. "If it's an impulse buy, and I don't really need it, I bring it right back."

But one woman who took part in Koran's study at Stanford said she never had that kind of control. The woman said she has spent 15 years battling the obsession that landed her more than $A15,245 in debt.

Within days of beginning the trial, she felt calm and her compulsion to shop nearly disappeared. She now has a prescription for a drug called Lexapro, which was derived from citalopram.

"I've had such phenomenal shame about it; I was withdrawn and overwhelmed and in a financial mess," said the woman, 58, whose significant other doesn't know about her disorder.

"I haven't told anyone, partly because I'm a person who's in control, and I was perplexed by this one area of my life that was just so out of control."

It's common for sufferers to wind up with closets filled with unwanted items. One study participant amassed more than 2000 wrenches. Another owned 55 cameras. In the 58-year-old woman's case, the trunk of her car, desk at work, and the dark corners of her bedroom closet were filled with the bounty from her binges.

Koran and his team began their study with a seven-week trial last year in which all 24 participants took citalopram. Fifteen of them continued to a nine-week trial, in which seven took the drug while the rest received a placebo. Two- thirds of the patients who took the placebo relapsed. Those who continued the medication didn't, and said they were able to shop normally without making impulsive purchases.

"They've been doing this for decades, and now their urge to shop is gone," Koran said. "I've never seen anything like that."

Copyright (c) The Canberra Times

This the text of the email I sent to Dr. Koran the same day:

Dear Dr. Koran

Please find attached a text copy of an article that appeared today in my daily newspaper, The Canberra Times.

You're pulling my leg, aren't you?

How on earth can you propose this kind of nonsense on this kind of basis?

This is a closing quote from the article:

"Koran and his team began their study with a seven-week trial last year in which all 24 participants took citalopram. Fifteen of them continued to a nine-week trial, in which seven took the drug while the rest received a placebo. Two-thirds [five?] of the patients who took the placebo relapsed. Those who continued the medication didn't, and said they were able to shop normally without making impulsive purchases."

Fifteen participants in your double blind trial? Are you serious? So you end up with seven people on the drug and eight on a placebo and you call that a scientific experiment? It wasn't when I went to school. How did you choose the meagre sample of 24 in the first place, anyway? That's such an insignificant number, they could be a bunch of mums from your local playgroup or even employees at Stanford University for all I know. This particular problem behaviour allegedly affects "between 2 and 8 per cent of the US population". Are you telling me that you could get only 24 people out of a potential 5.5 to 22 MILLION to participate in your study? That's incredible! In fact, that's beyond incredible. And why did nine of them drop out? Was that something to do with the side effects of the drug?

No wonder the article says "requires more research". You're not kidding!

You'll have to do a lot better than this, Dr. Koran. I'm sorry to disappoint you, if you expect me to take your work seriously, but unfortunately for you I didn't come down in the last shower.

Have a great day!

Bob Collier
Publisher, Parental Intelligence
Canberra, Australia

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