Generic Name: Citalopram hydrobromide
Brand Names: Celexa, Cipramil
Drug Class: Selective serotonin reuptake inhibitor
Similar Class Drugs: Escitalopram, Sertraline
Available Dosage Forms: Oral tablet and solution
What is Citalopram?
Selective serotonin Reuptake inhibitors (SSRIs) are a class of drugs employed to treat depression in adults. The principal role of serotonin is in mood regulation. Not only does it stabilize mood, but it is also implicated in the regulation of appetite, sleep, cognitive and emotional behaviors.
The synaptic clefts serve as a connection between two neurons in continuity. Serotonin, a neurotransmitter, is released into the synaptic clefts after the transmission of impulses from the brain stem. Citalopram is an SSRI that delays the uptake of serotonin from these synaptic clefts. FDA approved indication for Citalopram is depression in individuals aged 18 and above.1
Off label indications include:
– Sexual dysfunction
– Ethanol abuse
– Obsessive-compulsive disorder (OCD)
– Diabetic neuropathy
How to use Citalopram?
Oral formulations (tablets) with various dosages are available. A certified doctor determines the dosages after a patient’s thorough assessment. The tablet can be swallowed with a sip of water and can be taken at mealtimes. Purchase a measuring spoon if your doctor prescribes the solution form. It takes around 1-4 weeks for Citalopram to induce euthymia.2
20mg is the minimum dose for all patients. It is also the maximum dosage that is given to patients above 60 years.2
All anti-depressants are to be administered after a doctor’s prescription. Patients are encouraged to avoid missing their doses to prevent changes in the drug’s plasma levels. Consult your doctor if your symptoms remain or worsen. The dosages of Citalopram and other anti-depressants are tapered down to avert the worsening of the condition.1 This is why patients are advised to follow the instructions of their health care professional instead of discontinuing the intake of the drug by themselves.
Patients who have a documented history of liver injury and kidney issues are advised to inform their doctors about their conditions beforehand. Dosage is stringently monitored in pregnant women, especially in their third trimester.
What are the side effects of Citalopram?
The use of SSRIs in the treatment of depression comes with inherent risks of suicidality and worsening of depression. Based on research data, the likelihood for young patients less than 24 years to develop suicidal inclination is greater than those nearer to the old age spectrum.2 Therefore, neuro physicians keep a strict follow-up of patients undergoing therapy with Citalopram.
Potential side effects of Citalopram are:
– Nausea, vomiting
– Appetite loss
– Sweating
– Dry mouth
– Dizziness, headache
It may also cause adverse effects that warrant a visit to your doctor. Such effects are as follows:
– Persistent increase in heart rate
– Seizures
– Tingling or numbness in extremities
– Excessive sleepiness
– Difficulty breathing
– Muscle twitching
– Suicidal inclination
– Pneumonia or flu-like symptoms
– Prolonged and painful penile erection
– Diminished sexual arousal
A rare but possible side effect of Citalopram in the elderly is SIADH (syndrome of inappropriate anti-diuretic hormone). This condition is characterized by a severe lack of sodium in the plasma, also called hyponatremia.1. Symptoms of hyponatremia are muscle weakness, lethargy, confusion, and seizures. Consult your doctor immediately if you notice any of these symptoms.
Who should not use Citalopram?
– Anyone without a prescription
– Those with hypersensitivity to Citalopram
– Patients undergoing psychiatric therapy with MAOIs (monoamine oxidase inhibitors) such as linezolid.
– Those undergoing treatment for Methemoglobinemia with intravenous methylene blue
References
- Sharbaf Shoar N, Fariba K, Padhy RK. Citalopram. [Updated 2021 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482222/
- Rxlist.com. Available from: https://www.rxlist.com/celexa-drug.htm#description. [Updated: 2020 Jan 6]. Accessed July 17, 2021
