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Citalopram
Crucial facts
- it normally takes 4 to 6 months for citalopram to get the job done.
- Negative effects such as fatigue, dry skin and sweating are common. They go off after a few weeks and are generally mild.
- Citalopram could affect an unborn infant. If you are attempting to become pregnant, tell your doctor right away or become pregnant while still taking it.
- Citalopram may cause withdrawal symptoms and thus don’t stop taking it without speaking to your physician.
- Citalopram is known as the brand name Cipramil.
The active ingredient Citalopram hydrobromide is used to treat depression and other mental disorders, is the group of SSRIs (selective serotonin reuptake inhibitors) to. It was developed in 1989, approved in Germany in 1996 and is now included in many medications. In 2011, Citalopram was the most frequently prescribed psychotropic in Germany. Despite the generally good tolerability, Citalopram may cause fatigue, weight changes and other side effects. Here you can read everything about the drug Citalopram.
Mechanism of action
Citalopram is an antidepressant Neurotransmitters, the chemicals that nerves inside the brain use to communicate with one another. Neurotransmitters are manufactured and released by nerves and then traveling and attach to nerves. Thus, neurotransmitters can be thought of as the brain’s communication system. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it’s been released. Considering that uptake is an important mechanism for removing released neurotransmitters and terminating their actions the uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of medications known as selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Citalopram was approved by the FDA in July 1998.
Citalopram is well known for treating depression. It’s also used off-label for healing:
- Alcoholism
- Binge-eating disease
- Generalized anxiety disorder
- Panic disorder
- Hot flashes
- Obsessive compulsive disorder
The active ingredient Citalopram intervenes in cerebral metabolism, more specifically in the metabolism of neurotransmitters (such as serotonin). These messengers transmit nerve signals between brain cells in that they are distributed by a cell and bind to specific docking sites (receptors) of the next cell. Then the messengers are resumed in the nerve cell and inactivates it.
Experts suggest that for the emergence of depressive symptoms to a small amount of released serotonin plays a role. At this point, put drugs with Citalopram or other SSRIs: You selectively inhibit the reuptake of serotonin in the cells, whereby the messenger longer can develop its mood and angstlindernde effect. In addition to increasing the concentration of the neurotransmitter occurs by a permanently higher irritation but also reduce the number of receptors. This acts during and after therapy, an equal amount messenger of the target structure stronger.
Even if the relationships are not fully understood, can get pretty well under control with Citalopram depression often. Note, however, that the effect of Citalopram does not begin until a few weeks after starting treatment, because the processes described occur immediately.
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Uses
Citalopram is used to treat depression. It might enhance feelings of well-being and your own energy level. Citalopram is called a selective serotonin reuptake inhibitor (SSRI). This medicine works by helping to restore the equilibrium of a certain all-natural chemical (serotonin) from the mind.
The best way to use Citalopram HBR
Read the Medication Guide and, even if accessible, the Patient Information Leaflet provided by your pharmacist before you begin taking citalopram and every time you get a refill. Ask your health care provider or pharmacist in case you have any queries.
Require This medicine with or without food as instructed by your doctor. The dose is based on your medical condition, response to therapy, age, lab evaluations, and medicines you might be taking. Make sure you inform your doctor and pharmacist about all the products that you use (such as prescription medications, nonprescription medications, and herbal products). The dose for citalopram is 40 mg daily.
If you’re using the liquid form of the medication assess the dose using a measuring device/spoon. Don’t use a household spoon because you might not receive the appropriate dose.
To Lower your chance of unwanted effects, your physician may direct you to begin taking this medication at a low dose and gradually increase your dose. Follow your physician’s instructions. Don’t increase your dose or use this drug. Your condition won’t improve any faster, and your risk of unwanted effects will increase. Take this medication for the maximum benefit. To assist you remember, take it.
It’s important To keep on taking this drug even in the event that you are feeling good. Don’t stop taking this medicine without consulting your physician. Some conditions may become worse if this drug is stopped. You might experience symptoms like fatigue, headache, mood swings, sleep changes, and feelings that are short much like electrical shock. As you’re quitting treatment with this medication, to protect against these symptoms, your physician may lower your dose. Ask your doctor or pharmacist. Report any new or worsening symptoms away.
It might take before you have the complete benefit to really have a benefit from this medication and up to several months.
Tell your doctor if your condition doesn’t improve or if it worsens.
Citalopram is used for the treatment of depression and panic disorders. Outside of these authorized by the drug authorities Therapeutic indications Citalopram is used even for other mental illnesses (off-label use).
The duration of treatment depends on the recovery and success is always determined by the attending physician. Often it is one to several years.
How to take Citalopram?
In general, Citalopram is taken as a tablet once daily (morning or evening). Since the active ingredient is degraded to be absorbed into the bloodstream after 36 hours by the liver in half, a single daily dose ranges. Rarely, the active ingredient is used as a solution for infusion (in patients hospitalized).
Usual Adult Dose for Anxiety
Dose: 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once per day
Maximum dose: 40 mg orally per day
Opinions:
-The first dose may be increased when required to 40 mg once a day after at least 1 week of treatment.
-Doses of 60 mg/day didn’t show an advantage in efficiency within 40 mg/day doses.
-Intense episodes of depression might need a few months or even more of sustained pharmacologic therapy
Use: Treatment of depression
Usual Geriatric Heal for Anxiety
Over 60 Decades old:
1 dose: 20 mg orally once a day
Remarks:
-Doses of 60 mg/day didn’t show an advantage in efficiency within 40 mg/day doses.
-Intense episodes of depression might require a few months or even more of sustained pharmacologic treatment.
Use: Treatment of depression
Renal Dose Adjustments
Moderate to Moderate Renal Dysfunction: No adjustment
Severe Renal Dysfunction: Use with caution
Liver Dose Adjustments
Liver malfunction:
-Usual dose: 20 mg orally once a day
Dose Adjustments
Poor CYP450 2C19 metabolizers:
Dose: 20 mg orally once a day
Concomitant treatment with another CYP450 2C19 inhibitor or cimetidine:
Dose: 20 mg orally once a day
Treatment withdrawal:
-A dose reduction is recommended Rather than abrupt cessation where potential
-It’s Advised to consider resuming If symptoms occur The previously prescribed to reduce the dose and also dose Gradual speed.
Citalopram treatment: At least 14 days and switching between MAOI should Elapse between beginning another and quitting one of those medicines.
What are the side effects of Citalopram?
Especially in the first two weeks of therapy following Citalopram side effects are observed:
- Increased
- dry mouth
- insomnia
- drowsiness/fatigue
- Nausea/Constipation
Patients who are prone to suicidal ideation should be monitored closely during the first two to four weeks of treatment, until the antidepressant effect of Citalopram occurs.
More Citalopram side effects that (at one to ten percent of patients) or very frequently occur commonly (in more than ten percent of those treated) are:
- Weight loss and decreased appetite
- disturbances and reduction in libido, women orgasm disorders in men and ejaculation
- anxiousness, nervousness, confusion
- sleepiness, insomnia,
- palpitations, blurred vision, hearing loss
Occasionally (from 0.1 to one per cent of those treated) resolves Citalopram weight gain and increased appetite from.
Since the drug acts directly on the central nervous system, are also known to many more in its importance but subordinate side effects. This list is only the most important side effects of Citalopram again.
Serious Unwanted effects
Serious side effects are rare and occur in less than 1 in 1,000 individuals. Inform a doctor right away if you get:
- Headache, trouble focusing, memory Issues, not thinking clearly, fatigue, seizures, or losing your balance – those can be signs of low sodium levels
- ideas about harming yourself or end your life
- chest pain or stress or shortness of breath
- severe dizziness or passing out
- placing on or losing weight without trying to
- changes in your periods like heavy bleeding, spotting, or bleeding between periods
- painful erections that last more than 4 hours – that may happen even when you’re not having sex
Or, should you develop any signs of abnormal bleeding including:
- Vomiting blood or dark vomit, coughing up blood, blood on your pee, black or red poo – these may be signs of bleeding in the gut
- bleeding in the gums or bruises that arise without a reason or which get larger
- any bleeding that Is Quite bad or that you Can’t stop
Serious allergic response
In rare situations, it is possible to have a serious allergic reaction.
Before taking Citalopram
The active ingredient Citalopram should not be used in children and adolescents under 18 years. Persons over 65 years should receive only half the dose normally amount used.
Because Citalopram is metabolised by the liver, treatment with hepatic impairment should be started with a low dose. This is followed by a slow increase in dose under observation in liver function tests until the final dose of Citalopram individually acceptable.
Pregnancy
During pregnancy, Citalopram should only be used when absolutely necessary, and taken after careful benefit-risk assessment. Because the drug overcomes the placenta and can cause especially when used in the last third of pregnancy neonatal withdrawal symptoms.
Such withdrawal symptoms (such as malaise, nausea, headache) may after abrupt discontinuation of therapy even when adult patients occur. Will you settle Citalopram, should the dose be reduced gradually (“tapering”). Often the temporal dose reduction at weaning from the doctor will be planned and monitored in order to keep any Citalopram side effects as low as possible.
Interaction with other substances
The concomitant use of Citalopram and alcohol should be avoided, because during treatment, the sensitivity for alcohol increases. Patients report after consuming alcohol under common amounts Citalopram therapy about severe hangover experiences and violent discomfort.
Citalopram must not (also antidepressants) are used together with so-called MAO inhibitors. Otherwise, the life-threatening serotonin syndrome may develop. This is manifested by symptoms such as overheating, muscle rigidity, tremors, confusion, irritability progressing to delirium and coma.
It should also be dispensed medications during treatment, which also act on the serotonin budget. Some other medicines for migraine (triptans), opioid painkillers (Tramadol, Fentanyl), serotonin precursors as a mild sleeping pill or to uplift the mood (tryptophan, 5-HTP) should be applied only after consultation with the doctor or pharmacist, as it here you can also come to serotonin syndrome.
Citalopram causing several people to a change of the heartbeat (known as QT prolongation). It must not be taken with other drugs that also prolong the QT interval. Overloading can lead to serious cardiac arrhythmia and consequently to cardiac arrest. Common drugs that lead to QT prolongation, for example, certain antibiotics (Azithromycin, Erythromycin, Ciprofloxacin, Clarithromycin, cotrimoxazole), asthma agents (Salbutamol, terbutaline), medicines for fungal infections (Fluconazole, ketoconazole) and cold (ephedrine , pseudoephedrine, phenylephrine, phenylpropanolamine). Should notice the patients themselves irregular heartbeats or similar side effects, a doctor should be informed.
How to receive medication with the drug Citalopram
The active ingredient Citalopram is usually prescribed after an examination by a specialist in psychiatry or neurology, which usually also recommends a therapy-accompanying psychotherapy. After the drug affects the central nervous system, this is only available from the pharmacy. Because Citalopram can interact with many other drugs, patients should tell the doctor and pharmacist about all other medications applied.
Since when Citalopram is known?
Looking for a new anticonvulsant agents (antiepileptic) was developed Citalopram by the Danish company Lundbeck. When it was discovered that the drug but not antiepileptic but exerts an antidepressant effect, it has been patented 1989th In 2003, the patent expired, prompting numerous other pharmaceutical companies developed drugs with Citalopram. However, Lundbeck countered with one in the world of the pharmaceutical industry is not unusual maneuver: Because Citalopram is present in two forms that are mirror images of each structurally, which usually only the (stronger) is effective, Lundbeck has again the stronger acting form (esCitalopram) patented and thus effectively extending its patent protection to Ettlich years.
