How effective is a medication such as Citalopram? Reviews of doctors about this drug are considered in the materials of this article. It also contains information about what side effects the mentioned remedy causes, how to properly administer it, and what pharmacodynamic characteristics it has.
Composition, description of the drug, its form and packaging
In what form can I buy the medicine “Citalopram”? Patient reviews claim that in pharmacy chains this product is sold in the form of biconvex and round tablets coated with a white film coating. In cross section, this medicine has a slightly yellowish inner layer.
What is a part of the drug “Citalopram”? Instructions, reviews report that the active ingredient of this medicine is the substance of the same name - citalopram, which is presented in the form of hydrobromide. As for auxiliary components, microcrystalline cellulose, pregelatinized starch and magnesium stearate are used as them .
It should also be noted that the film coating of this product consists of polyvinyl alcohol, Opadry II, macrogol, talc and titanium dioxide.
The medicine in question goes on sale in contour cells made of PVC or aluminum, which are packaged in cardboard boxes.
Pharmacodynamic features of an antidepressant
What is the medicine “Citalopram”? Reviews claim that it is an antidepressant. Its mechanism of action is associated with the suppression of (selective) reuptake of the mediator serotonin located in the synapses of nerve cells, as well as with a minimal effect on the reuptake of mediators of dopamine and norepinephrine. It should be noted that this agent does not show the ability to react with a number of receptors (with some serotonin, dopamine, H1-histamine, adrenergic receptors, m-cholinergic receptors, GABA receptors and benzodiazepine receptors).
It is impossible not to say that the drug “Citalopram”, reviews of which are listed below, helps to improve the patient’s mood, suppresses feelings of anxiety, weakens feelings of fear, tension, eliminates dysphoria, and also stops obsessive states. In addition, it almost never causes a sleeping pill.
According to experts, the stable effect of this medication is observed 7-10 days after constant administration.
Kinetic ability of a drug
What pharmacokinetics is characteristic for the drug “Citalopram”? Reviews report that the peak concentration of its active substance in the blood occurs four hours after administration. At the same time, changes in its level are linear.
The bioavailability of this drug is approaching 80%, and the connection with plasma proteins is 79%.
Citalopram is present in the blood in its original form. This substance is transformed by oxidation, demethylation and deamination. The half-life of this component is 1.5 days. He is evacuated with urine and through the intestinal tract.
Indications for the appointment of an antidepressant
Why is such a tool as “Citalopram” necessary? Reviews of doctors say this medication is indicated for use with:
- panic disorders;
- severe and moderate depressive episodes.
It should also be noted that only an experienced specialist should prescribe this medicine.
Contraindications to the prescription of the medication
In what conditions can I not use the drug "Citalopram"?
Reviews indicate the following contraindications to the use of this medication:
- the minor age of the patient (according to the instructions, the safety and effectiveness of the use of such tablets at this age have not been established);
- high sensitivity of the patient to citalopram, as well as to any of its auxiliary substances;
- while taking monoamine oxidase inhibitors, including moclobemide, selegiline, linezolid (within two weeks after stopping their use);
- while taking drugs that extend the QT period on the ECG (including with pimozide), as well as with congenital lengthening of this interval).
Antidepressant "Citalopram": instructions for use
Experts say that the drug in question should be prescribed depending on the condition of the patient. “Citalopram” is taken orally, once a day. In this case, the tablets are not chewed and washed down with a small amount of liquid.
This medication can be used at any time of the day, regardless of the meal (preferably at the same time).
For depression, therapy begins with 20 mg of the drug per day. Depending on the personal reaction of the patient, as well as the severity of depression, the dosage can be increased to the maximum, that is, up to 40 mg per day.
How should you take the Citalopram medication for panic disorders ? Reviews of patients say that in this case, this drug is prescribed in a dosage of 10 mg per day (for 1 week), and then it rises to 20 mg per day. In this case, the daily dose of this medicine may depend on the personal reaction of the patient. In the future, the specified amount of the drug can be increased to 40 mg per day.
Persons over 65 years of age, "Citalopram" is prescribed in a dose of 10 mg. Depending on the severity of the depression and the individual reaction, it can be increased to a maximum of 20 mg per day.
In case of impaired renal function, including chronic renal failure of a moderate to weak severity, adjustment of the dosage regimen of this agent is not required. For persons with severe renal failure, special care is required in the selection of a therapeutic dose.
In case of impaired liver function, including moderate to mild hepatic insufficiency, the initial dosage of this drug is 10 mg per day (for the first 2 weeks). Depending on the personal reaction, it can be increased to 20 mg. Persons with severe hepatic insufficiency require special care in the selection of the dose.
For people with low activity of an isoenzyme such as CYP2C19, the initial dosage is 10 mg per day (for 2 weeks). Depending on the personal reaction, it can be increased to 20 mg.
According to the instructions, the therapeutic effect after taking the antidepressant in question appears after 2-4 weeks. In this case, the duration of the course of therapy is determined by the patient's condition and tolerance of the treatment. As a rule, this drug is recommended to be taken for about 6 months.
Drug withdrawal
What do they say about what reactions occur with a sharp cancellation of taking the drug “Citalopram”, reviews? Who took this remedy reports that the symptomatology that occurs after the sudden cessation of use of this medication is not characteristic. Most often, patients report slight dizziness, nausea, asthenia, headache, sleep disturbance, paresthesia, nervousness, vomiting, and tremor.
Thus, upon completion of treatment with this agent, it should be withdrawn gradually, over several weeks. This will allow patients to avoid withdrawal syndrome. As a rule, two weeks is enough for this, although in each individual case this question should be decided only by the doctor individually. So, for some people this may take 3 months or more.
Adverse Reactions After Taking Antidepressant
What negative reactions should patients be aware of before taking Citalopram? Reviews of side effects say that, as with the use of other drugs of the SSRI group, undesirable effects are also observed in patients with the use of Citalopram. However, it should be noted that they are all very weakly expressed and have a transitory character.
As a rule, adverse reactions after taking the drug in question are observed during the first 2 weeks of therapy. However, they noticeably weaken as the patient's condition improves.
So, “Citalopram” can cause such side effects as:
- high sensitivity, agitation, anaphylactic reactions, headache, nervousness, depersonalization, decreased libido, amnesia;
- aggression, orgasm in women, mania, strange dreams, anxiety, suicidal thoughts, confusion, dizziness;
- drowsiness, tremor, impaired concentration of attention, psychomotor agitation, hallucinations, convulsions;
- euphoria, extrapyramidal disorders, migraine, hemorrhage, increased libido;
- nausea, gynecological bleeding, paresthesia, vomiting, palpitations, serotonin syndrome, panic attacks, sleep disorder, bruxism, flatulence, drowsiness, diarrhea;
- akathisia, gastrointestinal bleeding, arterial hypertension, dry mouth, tachycardia, dyspnea, constipation, bradycardia, abdominal pain, cough;
- tinnitus, hepatitis, orthostatic hypotension, rhinitis, taste disturbance, decreased blood pressure, visual impairment, arrhythmia, ejaculation disturbance, sinusitis, accommodation disturbance, galactorrhea, sexual dysfunction, decreased appetite, hyponatremia;
- weight loss, polyuria, increased appetite, bruising, insufficient secretion of ADH, changes in the electrocardiogram, skin rash, alopecia, weight gain, angioedema, hypokalemia, painful urination, itching;
- photosensitivity, increased sweating, increased risk of injuries and fractures, urticaria, hyperthermia, purpura, myalgia, yawning, arthralgia and others.
Cases of drug overdose
The drug “Citalopram”, analogues of which are indicated below, can cause the following symptoms of an overdose: tremor, convulsions, vomiting, tachycardia, drowsiness, dilated pupils, bradycardia, muscle hypotension or hypertension, nausea, blueness of the skin, serotonin syndrome, blockade of the bundle branch block, azh , dizziness, heart failure, stupor, hyperventilation of the lungs, sweating, ventricular arrhythmia, atrial arrhythmia, coma.
Drug interaction
The drug in question interacts quite well with other medicines. Therefore, its joint administration is contraindicated with the following means:
- MAO inhibitors (serious side effects may develop, including serotonin syndrome).
- Drugs that lengthen the QT period (can lead to heart rhythm disturbance, which will ultimately prove fatal).
- “Pimozide” (prolongation of the QT interval is possible).
It should also be noted that co-administration of Citalopram with other drugs can reduce the threshold of convulsive readiness. In addition, this drug is undesirable to combine with serotonergic drugs, medicines containing perforated St. John's wort, indirect anticoagulants, Warfarin, alcohol, desipramine.
Similar drugs
What analogues does the medication in question have? What's better? "Citalopram"? Reviews say that this drug can be replaced with the following drugs: Paxil, Citol, Pram, Sedopram, Oprah, Umorap, Siozam, Citalorin, Tsipramil, Citalek , “Citalit”, “Citalon”. All listed funds should be prescribed only by an experienced doctor.
Many patients are interested in the question of which is better: “Citalopram” or “Paxil”? Reviews of experts report that the first medication is much more effective than the second. It should also be noted that side effects that occur after the use of Paxil are more pronounced. Therefore, most doctors recommend the use of Citalopram.
Pregnancy and Feeding
Mentioned antidepressant should not be prescribed to pregnant women and nursing mothers. The use of this medication in the third trimester can adversely affect the psychophysical development of the baby. The following disorders are also possible: cyanosis, respiratory failure, hypoglycemia, shortness of breath, vomiting, convulsions, tremors, temperature instability, nervousness, difficulty in feeding, irritability, muscle hypertension, insomnia, hyperreflexia, constant crying, lethargy, drowsiness.
Antidepressant Citalopram: reviews
With IBS, this drug is prescribed with extreme caution. This is due to the fact that its administration can aggravate the patient’s already difficult condition.
What do consumers say about the product in question? Many patients talk about the successful results of treatment with Citalopram. After starting therapy, their emotional state improved very soon. However, some users claim that they did not wait for therapeutic results, since the drug caused the development of many side effects.
As for doctors, they also argue that the antidepressant "Citalopram" is a very effective and effective tool, but only in cases where it does not contribute to the development of side effects. Therefore, many doctors try to prescribe this medicine only in extreme cases and in minimum dosages. If no negative reactions were detected in the first week of treatment, then therapy with this drug is continued with a slight increase in its doses (if necessary).