Generic Name: Citalopram Hydrobromide
Brand Names: Celexa, Cipramil, Cipram, Nitalapram
Citalopram HBr, one of the most selective serotonin reuptake inhibitors, is used to treat depression. It works by helping to restore the balance of certain natural chemicals in the brain. Citalopram has also been used to treat eating disorders (e.g., anorexia nervosa, bulimia), social anxiety, premenstrual dysphoric disorder, alcohol dependence, irritable bowel syndrome.
Citalopram may be more tolerable than some other antidepressants. Due to its low liability for interactions, Celexa is quite suitable for elderly. The adverse effects are usually mild and of sedative nature, which makes it especially suitable for continual therapy.
Initiate with 20 mg once daily and titrate up to 40 mg/day; max, 60 mg/day. Increase the dose in increments of 20 mg at intervals of no less than one week. Doses above 40 mg are not ordinarily recommended. Citalopram is administered once daily, in the morning or evening, without regard to food.
Panic disorder: the most effective dosage for panic disorder is 20 to 30 mg per day. [2, 3]
Irritable Bowel Syndrome (IBS): 20-40 mg per day .
Elderly: initiate with 20 mg once daily and titrate up to 40 mg/day if needed. Citalopram is usually well tolerated by elderly.
Hepatic impairment: initiate with 20 mg once daily and titrate up to 40 mg/day only if needed.
Maintenance: Periodically reevaluate long-term usefulness if used for extended periods.
Celexa usually takes about 4-6 weeks before you start noticing any marked improvement.
You may suffer discontinuation symptoms if you stop taking citalopram suddenly. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. Many patients tolerate 50% dose reduction for 3 days, then further 50% reduction for 3 days, and then total discontinuation.
If intolerable symptoms emerge during citalopram discontinuation, then resuming the previously prescribed dose may be considered. Subsequently, you may continue decreasing the dose but at a more gradual rate.
The most frequent:
There are case reports of citalopram-induced bruxism .
Although Citalopram has relatively low potential for interactions, do not start new prescription and over-the-counter medicine without informing your doctor. It is a weak inhibitor of liver cytochrome P450 enzymes.
Pregnancy & Lactation:
Some animal studies show adverse effects on embryo/fetal and postnatal development. There are no controlled studies in pregnant women and so far has not been proven to be harmful to the fetus. Not generally recommended for use during pregnancy, especially during first trimester.
Citalopram is excreted in human breast milk. If child becomes irritable or sedated, breast feeding or citalopram may need to be discontinued.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include: tiredness, weakness, sedation, irregular heartbeat, fainting, severe dizziness or lightheadedness.
Last modified: February, 2015