Citalopram chemical structure
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Celexa

Citalopram or nitalapram is an antidepressant drug used to treat depression associated with mood disorders. It is also used on occasion in the treatment of body dysmorphic disorder and anxiety. more...

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Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It is sold under the brand-names Celexa™ (U.S., Forest Laboratories, Inc.), Cipramil™ (Europe and Australia) and Talohexane (Australia).

Citalopram was originally created by the pharmaceutical company Lundbeck although the patent for it expired in 2003, allowing other companies to legally produce generic versions.

Lundbeck has recently released a new SSRI drug called escitalopram oxalate (also known as Cipralex or Lexapro) derived from the citalopram molecule.

Reported side effects

Over 10% of patients

  • Feeling sick or tired
  • Drowsiness
  • Dry mouth
  • Sweating
  • Trembling
  • Headache
  • Dizziness
  • Difficulty sleeping
  • Feeling agitated or nervous
  • Constipation or diarrhoea
  • Blurred vision
  • Missed heartbeats
  • Feeling of weakness
  • Difficulty ejaculating

Over 1% of patients

  • Itchiness
  • Rashes
  • Migraine
  • Strange dreams
  • Changes in taste
  • Decreased libido or impotence
  • Failure to orgasm
  • Painful menstruation
  • Tingling in fingers or toes
  • Loss of memory or concentration
  • Changes in appetite (increase or lack of)
  • Mood changes
  • Anxiety
  • Confusion
  • Yawning
  • Indigestion
  • Vomiting
  • Stomach ache
  • Flatulence
  • Increased saliva
  • Change in weight
  • Dizziness on standing up
  • Fast heartbeat
  • Changes in blood pressure
  • Runny nose
  • Sinusitis
  • Changes in passing urine

Rare (under 1% of patients)

  • Muscle pain
  • Convulsions
  • Increased libido
  • Coughing
  • Abnormal movement of the face or body
  • Ringing in the ears
  • Mood changes
  • Slowing of the heartbeat
  • Photosensitivity
  • Allergic reactions
  • Fainting
  • Suicidal ideation

Other side effects

Occasionally, panic attacks, thoughts of suicide or self-harm may occur or increase in the first few weeks, before the antidepressant effect starts.

Other occasional effects include leaking of milk from the breasts, changes in heart rhythm, swelling of the skin, joint pain or severe allergic reactions.

Overdose

Citalopram is considered relatively safe in overdose; although coma at a dosage of 400mg has been observed. It is important to seek medical attention if an overdose of this medication has occurred.

Read more at Wikipedia.org


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'Rookie' antidepressant users at risk for poor adherence
From OB/GYN News, 11/15/05 by Doug Brunk

SAN DIEGO -- Patients who are new to antidepressant therapy are at the greatest risk of discontinuing therapy, and that risk is greatest at the time of first prescription refill, Mark Vanelli, M.D., reported during a poster session at the American Psychiatric Association's Institute on Psychiatric Services.

"The implication is that we need to spend more money and time on patient education, and less on effective physician prescribing behavior," said Dr. Vanelli, chief medical officer for Burlington, Mass.--based Adheris Inc., a provider of patient adherence intervention programs.

Physicians "need to emphasize the length of time patients need to be on antidepressant therapy," he said in an interview. "Six months or more is common. They probably also need to talk about possible side effects and how they can be managed, to help patients anticipate the side effects they may have, such as insomnia or agitation.

"It's also important to connect medication use with helping them solve a problem in their life that they're going to be able to fix. That's often connecting with their chief complaint."

Using records from 1,157 pharmacies in the United States, Dr. Vanelli and his associates identified 211,565 patients who filled a prescription for fluoxetine, sertraline (Zoloft), paroxetine (Paxil), venlafaxine (Effexor), citalopram (Celexa), or escitalopram (Lexapro) from Oct. 1, 2003 through March 31, 2004. They defined "rookies" as patients who had never used an antidepressant in the 180 days prior to the index fill. "Veterans" were defined as patients who had a history of antidepressant use in the preceding 180 days.

The investigators followed the patients for 360 days to calculate the number of days to therapy discontinuation. Of the 211,565 patients, 74% were female, and the mean age was 51. More than one-third of those in the sample (37%) were rookies.

The mean number of days to medication discontinuation was 67 for rookies and 184 for veterans. The likelihood of discontinuing therapy after the initial fill, which was 30-45 days after the onset of therapy, was about 40% for rookies and 20% for veterans.

Proportional hazards model analysis revealed that veterans were 37% less likely to discontinue therapy, compared with their rookie counterparts.

BY DOUG BRUNK

San Diego Bureau

COPYRIGHT 2005 International Medical News Group
COPYRIGHT 2005 Gale Group

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