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Citalopram

Brand names: CELEXA

Therapeutic Indications

Citalopram is indicated for:

Depression

Irrespective of gender only Elderly (65 years old or older)

Treatment of depressive illness in the initial phase and as maintenance against potential relapse/recurrence.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 10-20 mg once daily

Panic disorder with or without agoraphobia

Irrespective of gender only Elderly (65 years old or older)

Citalopram is also indicated in the treatment of panic disorder with or without agoraphobia.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 5-20 mg once daily

Depression

Irrespective of gender only Adults (18 - 65 years old)

Treatment of depressive illness in the initial phase and as maintenance against potential relapse/recurrence.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 20-40 mg once daily

Treatment 2: Intravenous - 20 mg once daily

Panic disorder with or without agoraphobia

Irrespective of gender only Adults (18 - 65 years old)

Citalopram is also indicated in the treatment of panic disorder with or without agoraphobia.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 10-40 mg once daily

Contraindications

Active ingredient Citalopram is contraindicated in the following cases:

Medicinal products that prolong the QT interval

No gender/age discrimination

Citalopram is contraindicated together with medicinal products that are known to prolong the QT interval.

Pharmacokinetic and pharmacodynamic studies between citalopram and other medicinal products that prolong the QT interval have not been performed. An additive effect of citalopram and these medicinal products cannot be excluded. Therefore, co-administration of citalopram with medicinal products that prolong the QT interval, such as Class IA and III antiarrhythmics, antipsychotic (e.g. phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial agents (e.g. sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, anti-malarial treatment particularly halofantrine), certain antihistamines (astemizole, mizolastine), is contraindicated.

Monoamine oxidase inhibitors (MAOIs)

No gender/age discrimination

Some cases presented with features resembling serotonin syndrome.

Citalopram should not be given to patients receiving Monoamine Oxidase Inhibitors (MAOIs) including selegiline in daily doses exceeding 10 mg/day. Citalopram should not be given for fourteen days after discontinuation of an irreversible MAOI or for the time specified after discontinuation of a reversible MAOI (RIMA) as stated in the prescribing text of the RIMA. MAOIs should not be introduced for seven days after discontinuation of citalopram.

Symptoms of a drug interaction with a MAOI include: hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, mental status changes that include confusion, irritability and extreme agitation progressing to delirium and coma.

Linezolid

No gender/age discrimination

Citalopram is contraindicated in the combination with linezolid unless there are facilities for close observation and monitoring of blood pressure.

Pimozide

No gender/age discrimination

Co-administration of a single dose of pimozide 2 mg to subjects treated with racemic citalopram 40 mg/day for 11 days caused an increase in AUC and Cmax of pimozide, although not consistently throughout the study. The co-administration of pimozide and citalopram resulted in a mean increase in the QT interval of approximately 10 msec. Due to the interaction noted at a low dose of pimozide, concomitant administration of citalopram and pimozide is contraindicated.

QT-interval prolongation, congenital long QT syndrome

No gender/age discrimination

Citalopram is contraindicated in patients with known QT-interval prolongation or congenital long QT syndrome.