Mental Health

Citalopram

What is Citalopram?

Citalopram is an antidepressant medication that belongs to the class of selective serotonin reuptake inhibitors (SSRIs). It is primarily used to treat depression, but it may also be prescribed for other conditions such as panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.

How Does Citalopram Work?

Citalopram works by increasing serotonin levels in the brain. Serotonin is a neurotransmitter that plays a key role in regulating mood, appetite and sleep. By inhibiting serotonin reuptake, Citalopram increases the amount of serotonin available to neurons, which can help improve mood and alleviate symptoms of depression and anxiety.

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Indications for Use

Citalopram is administered as a tablet or oral solution and the dosage varies depending on the condition being treated and the patient's individual response. It is common to start with a low dose that is gradually increased to minimize side effects.

Side Effects

Like all medicines, Citalopram can cause side effects. Some of the more common ones include:

  • Nausea
  • Dry mouth
  • Sleepiness
  • Insomnia
  • Weight gain
  • Sexual Dysfunction

Serious Side Effects

Citalopram, although generally well tolerated, can cause serious side effects in some cases. It's important to watch for these symptoms and seek immediate medical attention if they occur. Some of the serious side effects of Citalopram include:

  • Serotoninergic Syndrome: Confusion, agitation, hallucinations, loss of coordination, rapid heart rate, hyperactive reflexes, fever, nausea, vomiting, diarrhea.
  • Heart Problems: Irregular heartbeat, fainting, severe dizziness
  • Serious Allergic Reactions: Skin rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, trouble breathing.
  • Bleeding Problems: Unusual bruising or bleeding, black or bloody stools, bloody vomit, or the appearance of ground coffee.
  • Seizures: Although rare, seizures can occur and require immediate medical attention.
  • Manic Symptoms: Excessive increase in energy, reckless behavior, racing thoughts, extreme euphoria.
  • Psychomotor Hyperactivity and Agitation: Anxiety, extreme agitation, inability to sit still.
  • Withdrawal symptoms: Dizziness, sensations of “electric shocks”, irritability, insomnia, confusion, anxiety.

Contraindications and Precautions

  • Interactions: Citalopram can interact with other medications, so it's important to tell your doctor about all medications and supplements you're taking.
  • Serotoninergic syndrome: Rarely, the use of Citalopram can lead to an excessive accumulation of serotonin in the body, causing serotonin syndrome, a potentially dangerous condition.
  • Warnings for pregnancy and breastfeeding: Women who are pregnant or breastfeeding should consult their doctor before using Citalopram, as it may have effects on the fetus or infant.

Interactions with Other Medications

Citalopram can interact with several other medications, which may increase the risk of serious side effects or decrease the effectiveness of treatment. Here are some of the most important interactions to consider:

  • Monoamine Oxidase Inhibitors (MAOIs): Citalopram should not be used together with MAOIs (such as selegiline, phenelzine, tranylcypromine) or within 14 days of stopping an MAOI due to the risk of serotonin syndrome.
  • Other SSRIs and SNRIs (serotonin and noradrenaline reuptake inhibitors): The combination may increase the risk of side effects, including serotonin syndrome.
  • Antipsychotics: Some antipsychotics may increase the risk of cardiac side effects.
  • Drugs that Extend the QT Interval: Antiarrhythmics (such as amiodarone, sotalol), some antipsychotics (such as haloperidol), certain antibiotics (such as levofloxacin), and others.
  • Anticoagulants: Like warfarin and dabigatran.
  • Antiplatelet agents: Like aspirin and clopidogrel.
  • NSAIDs (nonsteroidal anti-inflammatory drugs): Like ibuprofen and naproxen.
  • Triptans: Used to treat migraines (such as sumatriptan).
  • Tramadol: Pain reliever that can increase serotonin levels.
  • St. John's Wort: An herbal supplement that can increase serotonin levels.
  • Drugs Metabolized by the Liver: Drugs that are metabolized by cytochrome P450 enzymes, especially CYP2C19 and CYP3A4.
  • Alcohol and Recreational Drugs: Alcohol may increase some of the side effects of Citalopram, such as drowsiness and dizziness. Some recreational drugs can interact dangerously with Citalopram.

How to Take Citalopram

  • It should always be taken under the supervision and prescription of a doctor.
  • It is recommended to take citalopram at the same time every day. It can be taken with or without food.
  • It is important not to stop taking citalopram suddenly without consulting a doctor, as it could cause withdrawal symptoms.
  • Although symptoms may improve within a few weeks, it's important to keep taking the medication as directed by your doctor to prevent a relapse.

Conclusion

Citalopram is an effective antidepressant that helps many people manage depression and other anxiety-related disorders. However, as with any medication, its use must be supervised by a healthcare professional to ensure its safety and efficacy.