Citalopram

Citalopram, also known by its brand name Celexa, is a selective serotonin reuptake inhibitor (SSRI) used as an antidepressant medication. It is primarily prescribed for the treatment of major depressive disorder (MDD) in adults and adolescents aged 12 and above. Citalopram works by increasing the levels of serotonin, a neurotransmitter in the brain, which helps to improve mood, relieve symptoms of depression, and restore a sense of well-being. It comes in the form of tablets or oral solution and is typically taken once daily.

Important Precautions

Citalopram should not be taken by individuals who have a known hypersensitivity to the drug or any of its components. It is also contraindicated in patients who are taking or have recently taken a monoamine oxidase inhibitor (MAOI) or pimozide due to the risk of serotonin syndrome, a potentially life-threatening condition characterized by agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, tremor, and in severe cases, seizures or loss of consciousness. Caution is advised in patients with a history of seizures, bipolar disorder, or bleeding disorders, as citalopram may worsen these conditions. Additionally, it is important to monitor for suicidal thoughts or behaviors, particularly in younger individuals, as antidepressants may increase the risk of these events.

Possible Side Effects

Common side effects of citalopram include nausea, dry mouth, increased sweating, drowsiness, insomnia, dizziness, tremor, diarrhea, and sexual dysfunction. In some cases, these side effects may diminish over time, but if they persist or worsen, it is recommended to consult a healthcare professional. Rare but potentially serious side effects include serotonin syndrome, allergic reactions, abnormal bleeding or bruising, changes in heartbeat, severe dizziness or fainting, and severe or persistent vomiting or diarrhea. It is essential to seek immediate medical attention if any of these adverse reactions occur.

Dosage Guide

The recommended starting dose of citalopram in adults is 20 mg once daily, which can be increased to a maximum of 40 mg per day if necessary. For elderly patients and those with liver impairment, a lower starting dose of 10 mg once daily is generally recommended. In children and adolescents aged 12 to 17, the usual starting dose is 10 mg once daily, which can be increased to a maximum of 20 mg per day. It is important to take this medication as prescribed and to follow the instructions provided by the healthcare professional. If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next dose. In case of an overdose, immediate medical attention should be sought. Symptoms of overdose may include nausea, vomiting, dizziness, rapid heartbeat, seizures, and loss of consciousness.

Citalopram and Concomitant Drugs

Citalopram may interact with various medications, including other antidepressants, antipsychotics, antiplatelet drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, antiarrhythmics, anticonvulsants, certain antibiotics, and herbal products. Combining citalopram with these medications can increase the risk of serotonin syndrome or may affect the safety and effectiveness of either drug. It is important to inform the healthcare professional about all medications, supplements, and herbal products being taken prior to starting citalopram to avoid any potential drug interactions.

Questions Answered

• 1. Can citalopram be used during pregnancy? Citalopram is generally not recommended during pregnancy due to the potential risk of harm to the developing fetus. However, the decision to use this medication during pregnancy should be made in consultation with a healthcare professional, weighing the potential benefits against the potential risks.
• 2. Can citalopram be used while breastfeeding? Small amounts of citalopram may pass into breast milk, but the risk to the nursing infant is considered low. It is important to discuss the potential risks and benefits with a healthcare professional before using citalopram while breastfeeding.
• 3. How long does it take for citalopram to start working? It may take several weeks for the full therapeutic effect of citalopram to be observed. Improvement in symptoms of depression may be gradual, and it is important to continue taking the medication as prescribed, even if symptoms improve.
• 4. Can citalopram cause weight gain? Weight gain is a possible side effect of citalopram, although it is not very common. Monitoring weight and discussing any significant changes with a healthcare professional is recommended.
• 5. Can citalopram be abruptly stopped? Abruptly stopping citalopram may lead to discontinuation symptoms, which can include dizziness, headache, nausea, fatigue, irritability, and sleep disturbances. It is generally recommended to gradually reduce the dose under the guidance of a healthcare professional.