Which medication is indicated as a first-line treatment for mild to moderate body dysmorphic disorder?

Citalopram, a selective serotonin reuptake inhibitor (SSRI), is indicated as a first-line treatment for mild to moderate body dysmorphic disorder (BDD). This classification of SSRIs is well-supported by clinical evidence illustrating their efficacy in alleviating symptoms of BDD, which often includes persistent, intrusive thoughts about perceived flaws in appearance and subsequent compulsive behaviors.

Research has shown that SSRIs like citalopram can substantially reduce the severity of dysmorphic symptoms and improve overall functioning in affected individuals. Their mechanism of action, which involves increasing serotonin levels in the brain, is believed to play a crucial role in addressing the emotional and cognitive aspects of BDD.

While other medications can be beneficial in treating various conditions, they do not have the same established role in the treatment of body dysmorphic disorder. For instance, bupropion is primarily used for depression and smoking cessation and does not have significant evidence supporting its use in BDD. Fluoxetine, another SSRI, is also effective for BDD but citalopram is often favored in discussions of first-line treatments due to its safety profile and tolerability. Mirtazapine, which has sedative properties, is generally not indicated for BDD and