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Citalopram is in a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which work on neurotransmitters (the chemicals that nerves in the brain use to communicate with each other).
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Depression in patients whose diagnosis corresponds most closely to the DSM-III and DSM-III-R category of major depressive disorder Initial dose: 20 mg PO q Day If needed, may increase to 40 mg/day after at least 1 week Doses above 40 mg/day are not recommended, because of risk for QT prolongation without additional benefit for treating depression Poor CYP2C19 metabolizers or coadministration with CYP2C19 inhibitors (eg, cimetidine, fluconazole, omeprazole): Do not exceed 20 mg/day Hepatic impairment decreases clearance and therefore increases risk of QT prolongation; do not exceed 20 mg/day 5 mg PO on the estimated day of ovulation; increase dose by 5 mg each day thereafter to maximum 30 mg; continue thereafter until menstruation begins; decrease dose to 20 mg on the first day of menstruation; the next day, decrease to 10 mg; stop the treatment from day 3 until ovulation begins Tremor (8%) Diarrhea (8%) Ejaculation disorder (6%) Rhinitis (5%) Upper respiratory infection (5%) Dyspepsia (5%) Fatue (5%) Vomiting (4%) Anxiety (4%) Anorexia (4%) Abdominal pain (3%) Agitation (3%) Impotence (3%) Sinusitis (3%) Dysmenorrhea (3%) Decreased libido (2%) Yawning (2%) Arthralgia (2%) Myalgia (2%) Amenorrhea (65 years In children and young adults, the risks must be wehed against the benefits of taking antidepressants Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments The patient’s family should communicate any abrupt changes in behavior to the health-care provider Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy Not FDA approved for the treatment of bipolar disorder This drug is not FDA approved for use in pediatric patients Pregnancy: Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn, or PPHN (see Pregnancy) Neonates exposed to SNRIs/SSRIs late in third trimester: Risk of complications such as feeding difficulties, irritability, and respiratory problems Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 years) Risk of mydriasis; may trger angle closure attack in patients with angle closure glaucoma with anatomiy narrow angles without a patent iridectomy Risk of hyponatremia, abnormal bleeding (increased if concomitant aspirin, NSAIDs, or anticoagulants, or hemorrhagic diathesis), and impairment of cognitive and motor functions Risk of serotonin syndrome or neuroleptic malnant syndrome (NMS)-like reactions have been reported with SSRIs alone or with concomitant use of serotonergic drugs, with drugs that impair metabolism of serotonin, or with antipsychotics or other dopamine antagonists Activation of mania/hypomania has been reported; use caution when treating patients with history of mania Increased risk of bone fractures reported with antidepressant use; use caution; consider possibility of fracture it patient presents with bone pain May cause or exacerbate sexual dysfunction Use caution when treating patients with history of seizure disorder Rare cases of hyponatremia and development of SIADH reported with either SSRI or SNRI use Not recommended in patients with uncompensated heart failure The above information is provided for general informational and educational purposes only.
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Citalopram (brand names: Celexa, Cipramil and others) is an antidepressant drug of the selective serotonin reuptake inhibitor (SSRI) class. In Australia, the UK, Germany, Portugal, Poland, and most European countries, it is licensed for depressive episodes and panic disorder with or without agoraphobia.
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