Indications |
Oral Depression Adult: Initially, 20 mg daily, increased to 40 mg once daily after at least 1 wk or 60 mg daily if necessary. Hepatic impairment: Recommended dose: 20 mg daily. Oral Depressive phase of bipolar disorder Adult: Initially, 20 mg daily, increased to 40 mg once daily after at least 1 wk or 60 mg daily if necessary. Hepatic impairment: Recommended dose: 20 mg daily. Oral Panic disorder with or without agoraphobia Adult: Initially, 10 mg daily, increased to 20 mg daily after 1 wk. Max: 60 mg daily. Hepatic impairment: Recommended dose: 20 mg daily. Special Populations: Patients with reduced hepatic function should receive dosages of no more than 30 mg/day. |
Contraindications |
Hypersensitivity, concomitant admin with MAOIs or within 14 days of discontinuing MAOI treatment; children and adolescents <18 yr; treatment of depressive illness; lactation. |
Warnings / Precautions |
Gradual discontinuation of treatment if patient enters into manic phase; pregnancy. Increased risk of hyponatraemia and SIADH. May reduce convulsant threshold thus, citalopram should be used with care in epileptic patients. |
Adverse Reactions |
Increased sweating, headache, tremor, fatigue, asthenia, dizziness, abnormal accommodation, somnolence, insomnia, agitation, nervousness, nausea, dry mouth, constipation, diarrhoea, palpitation, rash, pruritus, abnormal vision, decreased libido, anxiety, increased appetite, anorexia, apathy, impotence, suicide attempt, confusion, yawning, dyspepsia, vomiting, abdominal pain, flatulence, increased saliva, weight decrease or increase, postural hypotension, tachycardia, rhinitis, ejaculation failure, fatigue, extrapyramidal disorders. Potentially Fatal: Increased risk of suicidal thinking and behaviour especially in child and adolescents. Monitor closely for signs of clinical worsening, suicidality or unusual changes in behaviour. |
Overdose Reactions |
Symptoms include dizziness, sweating, nausea, vomiting, tremor, somnolence and sinus tachycardia. In rare cases, amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis and ECG changes may occur. Treatment includes maintaining airway to ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Careful observation and cardiac and vital sign monitoring are recommended, along with general symptomatic and supportive care. |
Drug Interactions |
Do not start MAOI therapy until at least 2 wk after SSRIs withdrawal; serotonergic effects are suspected to be enhanced by SSRIs. May increase anticoagulant effect when used with warfarin. See Below for More citalopram Drug Interactions |
Mechanism of Actions |
Citalopram is a selective serotonin re-uptake inhibitor, with little or no effect on noradrenaline, dopamine and γ aminobutyric acid (GABA) re-uptake. It has no or very low affinity for 5-HT1A, 5-HT2, D1 and D2 receptors, α1, α2, β-adrenoceptors, histamine H1, muscarine, cholinergic, benzodiazepine and opioid receptors. Absorption: Readily absorbed from the GI tract (oral); peak plasma concentrations after 2-4 hr. Distribution: Widely distributed; enters breast milk (small amounts). Protein-binding: Low. Metabolism: Undergoes demethylation, deamination and oxidation to active and inactive metabolites. Excretion: Urine (as unchanged drug); 33 hr (elimination half-life). |
Administration |
May be taken with or without food. |
Storage Conditions |
Oral: Store at 25°C. |
ATC Classification |
N06AB04 - citalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression. |
Storage |
Oral: Store at 25°C. |
Available As |
|
Citalopram
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Citalopram Containing Brands
Citalopram is used in following diseases
Drug - Drug Interactions of Citalopram
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