Citalopram Hydrobromide

Citalopram is indicated for-

• Depressive illness
• Panic disorder

Citalopram is bicyclic phthalane derivative and a selective serotonin re-uptake inhibitor, with little or no effect on noradrenaline, dopamine and GABA re-uptake. The inhibitory activity explains the antidepressant property of citalopram. It has no or very low affinity for 5-HT_1AA, 5-HT_2A, D₁ and D₂ receptors, α₁, α₂, β-adrenergic, histamine H₁, muscarinic, cholinergic, benzodiazepine and opioid receptors.

Depressive illness:

• Adult: 20 mg daily as a single dose in the morning or evening increased if necessary to max. 60 mg daily
• Elderly: Max 40 mg daily.
• Child: Not recommended.

Panic disorder:

• Adult: Initially 10 mg daily increased to 20 mg after 7 days, usual dose 20-30 mg daily; max. 60 mg daily
• Elderly: Max 40 mg daily
• Child: Not recommended.

Citapram should not be taken cocurrently with MAOIs, Serotonin agonists, Neuroleptics, Cimetidine, Alcohol, Ketoconazole, Itraconazole, Macrolide antibiotics.

Citalopram should not be used if the patient enters a manic phase.

Palpitation, postural hypotension, coughing, yawning, confusion, impaired concentration, amnesia, migraine, taste disturbance, increased salivation, rhinitis, tinnitus, micturition disorders.

Pregnancy: There are on adequate and well-controlled studies in pregnant women; therefore, Citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Lactation: Citalopram is excreted in human breast milk. So, the decision whether to continue or discontinue either nursing or Citalopram therapy should take into account the risks of Citalopram exposure for the infants and the benefits of Citalopram treatment for the mother.

Citalopram should be used with caution in patients with epilepsy, concurrent electroconvulsive therapy, history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, history of bleeding disorders, hepatic and renal impairment, pregnancy and breast feeding.

Doses as high as 2000 mg have been taken without signs of alternation in cardiovascular parameters. Respiratory depression, convulsion may occur.

SSRIs & related anti-depressant drugs

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.