Celexa (Citalopram)

Celexa (Citalopram hydrobromide) is in a class of drugs called selective serotonin reuptake inhibitors. It is indicated for the treatment of depression. Citalopram has also been used to treat certain eating disorders (e.g., anorexia nervosa, bulimia). Citalopram is effective in the treatment of other depressive and panic disorders. It has the potential to effectively treat anxiety and substance use disorders.

Citalopram is effective in the treatment of moderate-to-severe major depression, especially symptoms of depressed mood and melancholia, with particularly robust effects at doses of 40 and 60 mg/day 1.

Nausea is the most common early side effect, however it is usually transient.

• Steady state: reached in about 1 week.
• Metabolism: Citalopram is metabolized in the liver by the cytochrome P450 enzyme system to demethylcitalopram, didemethylcitalopram, citalopram N-oxide and a deaninated propionic acid derivative. These metabolites are not thought to contribute to the therapeutic action since both metabolites are less potent serotonin reuptake inhibitors than the parent compound, are present in lower concentrations and enter the brain less readily.
• Elimination half-life: 37 hours (range 30-42 hours). The half-life of demethylcitalopram being 2 days and 4 days for didemethylcitalopram.
• Excretion: eliminated primarily via the liver (85%) and the remainder via the kidneys. Approximately 12% of the daily dose is excreted in urine as unchanged citalopram.

• less risk of drug interactions than with some other antidepressants 3
• probably safe to use on a long-term basis
• causes less withdrawal symptoms than other SSRIs
• absorption is not affected by food
• fewer side effects than with other SSRIs
• low incidence of activating side effects
• less likely than other antidepressants to cause sexual dysfunction 4
• anxiolytic effects 15
• suitable alternative for fluoxetine intolerant individuals
• elicit relaxation of intestinal smooth muscle 16

• craving for carbohydrate 6
• weight gain
• sexual side effects

• social anxiety disorder 11
• premature ejaculation 5
• premenstrual dysphoric disorder (PMDD) 12
• alcohol dependence 9
• binge-eating disorder 14
• anorexia nervosa 7
• diabetic neuropathy 8
• panic disorder 10
• irritable bowel syndrome 13

Citalopram represents a racemic mixture of two enantiomers - molecules that have the same atomic framework but different spatial arrangements.

Citalopram is an antidepressant that selectively inhibits serotonin reuptake thereby potentiating serotonin neurotransmission. It is the most selective serotonin reuptake inhibitor currently available 2. It has only minimal effects on norepinephrine and dopamine neurotransmission with 3,400 times more serotonin (5-HT) activity than norepinephrine.

Citalopram also has mild antagonist actions at H1 histamine receptors.

• Celexa Reviews, Ratings by Patients on DrugLib.com
• Celexa Reviews on Psych Central
• User Reviews for Celexa on Drugs.com
• Celexa User ratings and reviews - Revolution Health

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