citalopram (Celexa, nitalapram)

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Introduction

Citalopram HBr. Tradename: Celexa. C20H22BrFN2O

Indications

* on list of drugs to avoid for treatment of depression[24]

Contraindications

Dosage

Tabs: 10, 20, 40 mg

* dose reductions from average dose of 64 mg/day to <= 40 mg/day among veterans resulted in greater risk for all-cause death or hospitalizations (RR=4.5) & for principal depression diagnosis with death or depression-related hospitalization (RR=2.2)[23]

* principal arrhythmia diagnoses were not different at doses of citalopram > or < 40 mg/day[23]

Pharmacokinetics

elimination via liver

protein binding = 80 %

1/2life = 35 hours

Adverse effects

Drug interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

References

  1. Jump up to: 1.0 1.1 Forest Pharmaceuticals
  2. Jump up to: 2.0 2.1 Prescriber's Letter 8(3):16-17 2001
  3. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  4. Department of Veterans Affairs, VA National Formulary
  5. Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
  6. Jump up to: 6.0 6.1 Prescriber's Letter 9(7):38 2002
  7. Jump up to: 7.0 7.1 7.2 Journal Watch 24(11):85, 2004 Whittington CJ, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet. 2004 Apr 24;363(9418):1341-5. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15110490
    Jureidini JN, Doecke CJ, Mansfield PR, Haby MM, Menkes DB, Tonkin AL. Efficacy and safety of antidepressants for children and adolescents. BMJ. 2004 Apr 10;328(7444):879-83. Review. No abstract available. Erratum in: BMJ. 2004 May 15;328(7449):1170. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15073072 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7444/879
  8. Lespoerance F et al, Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 2007, 297:367 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17244833
    Glassman AH and Bigger JT Antidepressants in coronary artery disease: SSRI reduce depression, but do they save lives? JAMA 2007, 297:411 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17244839
  9. Jump up to: 9.0 9.1 Pedersen LH et al Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study BMJ 2009;339:b3569 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19776103 <Internet> http://www.bmj.com/cgi/content/full/339/sep23_1/b3569
    Chambers C Selective serotonin reuptake inhibitors and congenital malformations BMJ 2009;339:b3525 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19776102 <Internet> http://www.bmj.com/cgi/content/extract/339/sep23_1/b3525
  10. Jump up to: 10.0 10.1 10.2 FDA MedWatch - 08/24/2011 Celexa (citalopram hydrobromide): Drug Safety Communication - Abnormal Heart Rhythms Associated With High Doses http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm269481.htm
  11. Jump up to: 11.0 11.1 Prescriber's Letter 18(10): 2011 Celexa (Citalopram) and QT Interval Prolongation Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=271002&pb=PRL (subscription needed) http://www.prescribersletter.com
  12. Jump up to: 12.0 12.1 Prescriber's Letter 19(1): 2012 Drug Interactions With Citalopram (Celexa) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280107&pb=PRL (subscription needed) http://www.prescribersletter.com
  13. Jump up to: 13.0 13.1 FDA MedWatch: March 28, 2012 Celexa (citalopram hydrobromide) - Drug Safety Communication: Revised Recommendations, Potential Risk of Abnormal Heart Rhythms http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm297624.htm
  14. Jump up to: 14.0 14.1 14.2 14.3 14.4 14.5 14.6 Castro VM et al QT interval and antidepressant use: a cross sectional study of electronic health records. BMJ 2013;346:f288 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23360890 <Internet> http://www.bmj.com/content/346/bmj.f288
  15. Jump up to: 15.0 15.1 Zivin K et al. Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg. Am J Psychiatry 2013 May 3; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23640689 <Internet> http://ajp.psychiatryonline.org/article.aspx?articleid=1685280
  16. Jump up to: 16.0 16.1 16.2 Deprecated Reference
  17. Jump up to: 17.0 17.1 17.2 17.3 17.4 Porsteinsson AP, Drye LT, Pollock BG et al Effect of Citalopram on Agitation in Alzheimer Disease. The CitAD Randomized Clinical Trial. JAMA. 2014;311(7):682-691 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24549548 https://jama.jamanetwork.com/article.aspx?articleid=1829989
    Small GW Treating Dementia and Agitation. JAMA. 2014;311(7):677-678 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24549545 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1829969
  18. Trivedi MH, Rush AJ, Wisniewski SR et al Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006 Jan;163(1):28-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16390886
  19. Jump up to: 19.0 19.1 Yager J Might SSRIs Reduce the Risk for Alzheimer Disease? NEJM Journal Watch. May 27, 2014 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
    Sheline YI et al. An antidepressant decreases CSF Abeta production in healthy individuals and in transgenic AD mice. Sci Transl Med 2014 May; 6:236re4 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24828079 <Internet> http://stm.sciencemag.org/content/6/236/236re4?ijkey=4d44f88a853621ff2f0f2212954925a3b3d7adf8&keytype2=tf_ipsecsha
  20. Jump up to: 20.0 20.1 20.2 Reefhuis J et al Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. BMJ 2015;351:h3190 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26156519 <Internet> http://www.bmj.com/content/351/bmj.h3190
  21. Jump up to: 21.0 21.1 Jakubovski E et al. Systematic review and meta-analysis: Dose-response relationship of selective serotonin reuptake inhibitors in major depressive disorder. Am J Psychiatry 2015 Nov 10; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26552940 <Internet> http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15030331
  22. Jump up to: 22.0 22.1 Schneider LS et al. Heterogeneity of treatment response to citalopram for patients with Alzheimer's disease with aggression or agitation: The CitAD randomized clinical trial. Am J Psychiatry 2016 Jan 15 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26771737 <Internet> http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15050648
  23. Jump up to: 23.0 23.1 23.2 Rector TS et al. Outcomes of citalopram dosage risk mitigation in a veteran population. Am J Psychiatry 2016 May 10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27166093
  24. Jump up to: 24.0 24.1 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/

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