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. 1.0 1.1 Forest Pharmaceuticals
  2. 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. 6.0 6.1 Prescriber's Letter 9(7):38 2002
  7. 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A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data.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. 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. 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. 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. 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. 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. 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. 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. 16.0 16.1 16.2 Deprecated Reference
  17. 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. 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. 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. 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. 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. 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. 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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