CITALOPRAM

Indications & Dose:

Depressive illness

•  BY MOUTH USING TABLETS

Adult: 20 mg once daily, increased in steps of 20 mg daily if required, dose to be increased at intervals of 3–4 weeks; maximum 40 mg per day Elderly: 10–20 mg once daily; maximum 20 mg per day

•   BY MOUTH USING ORAL DROPS

Adult: 16 mg once daily, increased in steps of 16 mg daily if required, dose to be increased at intervals of 3–4 weeks; maximum 32 mg per day Elderly: 8–16 mg daily; maximum 16 mg per day Panic disorder

•  BY MOUTH USING TABLETS

Adult: Initially 10 mg daily, increased in steps of 10 mg daily if required, dose to be increased gradually; usual dose 20–30 mg daily; maximum 40 mg per day

Elderly: Initially 10 mg daily, increased in steps of 10 mg daily if required, dose to be increased gradually; maximum 20 mg per day

•  BY MOUTH USING ORAL DROPS

Adult: Initially 8 mg once daily, increased in steps of 8 mg if required, dose to be increased gradually; usual dose 16–24 mg daily; maximum 32 mg per day

Elderly: Initially 8 mg once daily, increased in steps of 8 mg if required, dose to be increased gradually; maximum 16 mg per day

Contraindications:

QT-interval prolongation Concurrent use of MAOIs or use within 2 wk of discontinuation of MAOIs 

Side Effects:

Cautions:

Precautions:

Hepatic insufficiency, cardiolascular disease, seizure disorders,, suicidal tendencies, mania, children and adolescence (no clinical data) 

Interaction:

Drugs

Buspirone: Increased risk of serotonin syndrome

Cimetidine: Increased levels of desmethylcitalopram via inhibition of CYP2D6 by cimetidine

Imipramine: Increased bioBrands Available with Cost and half-life of desipramine (the major metabolite of imipramine) via inhibition of CYP2D6 by citalopram

MAOIs, dexfenf luramine, sibu e: increased risk of sertonin syndrome

Metoprolol: May increase levels of metoprolol, but no clinically signficant changes in blood pressure or heart rate have been observed

Naratriptan, rizatriptan, sumatriptan, zolmatriptan 4: Increased risk of weakness, hyperreflexia, and incoordination 

Warnings:

Adverse Effects:

Lactations:

Breastfeeding: unknown, 2 cases of infants experiencing excessive somnolence, decreased feeding, and weight loss have been reported 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Migraine, parethesia, somnolence, impaired concentration, fatigue, drowsiness, sleep disturbance, confusion, restlessness, amnesia, apathy, suicidal attempt, seizures

CV: Hypotension, postural hypotension, palpitations

EENT: Visual changes

GI: Nausea, vomiting, xerostomia, taste perversion, constipation, dyspepsia; anorexia, increased appetite, flatulence

GU: Polyuria, dysuria, amenorrhea, abnormal ejaculation (>5%)

MS: Myalgia

RESP: Cough

 SKIN: Increased sweating, rash 

Patient And Carer Advice: