Celexa (Citalopram Hydrobromide) - Summary

CELEXA SUMMARY

Celexa® (citalopram HBr) is an orally administered selective serotonin reuptake inhibitor (SSRI) with a chemical structure unrelated to that of other SSRIs or of tricyclic, tetracyclic, or other available antidepressant agents.

Celexa (citalopram HBr) is indicated for the treatment of depression.

The efficacy of Celexa in the treatment of depression was established in 4-6 week, controlled trials of outpatients whose diagnosis corresponded most closely to the DSM-III and DSM-III-R category of major depressive disorder (see CLINICAL PHARMACOLOGY).

A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.

The antidepressant action of Celexa in hospitalized depressed patients has not been adequately studied.

The efficacy of Celexa in maintaining an antidepressant response for up to 24 weeks following 6 to 8 weeks of acute treatment was demonstrated in two placebo-controlled trials (see CLINICAL PHARMACOLOGY). Nevertheless, the physician who elects to use Celexa for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.

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CELEXA NEWS HIGHLIGHTS

Media Articles Related to Celexa (Citalopram)

escitalopram, Lexapro
Source: MedicineNet citalopram Specialty [2008.12.17]
Title: escitalopram, Lexapro
Category: Medications
Created: 3/16/2003 8:41:00 PM
Last Editorial Review: 12/17/2008

Antidepressant Does Not Appear To Reduce Repetitive Behaviors In Children With Autism Spectrum Disorders
Source: Autism News From Medical News Today [2009.06.05]
The antidepressant citalopram does not appear to reduce the occurrence of repetitive behaviors in children and teens with autism spectrum disorders, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Although the U.S.

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Published Studies Related to Celexa (Citalopram)

A randomized controlled clinical trial of Citalopram versus Fluoxetine in children and adolescents with obsessive-compulsive disorder (OCD). [2009.02.03]
CONCLUSION: The results suggest that Citalopram [generic for Celexa] is as safe and effective as Fluoxetine for children and adolescents with OCD. Further studies are needed to replicate our findings.

Escitalopram for older adults with generalized anxiety disorder: a randomized controlled trial. [2009.01.21]
CONTEXT: Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders in older adults; however, few data exist to guide clinicians in efficacious and safe treatment. Selective serotonin reuptake inhibitors (SSRIs) are efficacious for younger adults with GAD, but benefits and risks may be different in older adults. OBJECTIVE: To examine the efficacy, safety, and tolerability of the SSRI escitalopram [generic for Celexa] in older adults with GAD... CONCLUSIONS: Older adults with GAD randomized to escitalopram had a higher cumulative response rate for improvement vs placebo over 12 weeks; however, response rates were not significantly different using an intention-to-treat analysis. Further study is required to assess efficacy and safety over longer treatment durations. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00105586.

Citalopram augmentation for subsyndromal symptoms of depression in middle-aged and older outpatients with schizophrenia and schizoaffective disorder: A randomized controlled trial. [2008.12.23]
CONCLUSIONS: Subsyndromal symptoms of depression in middle aged and older patients with schizophrenia responded to treatment with citalopram [generic for Celexa] with lessening of depressive symptoms and improved functioning and quality of life. It may be important for clinicians to identify and treat SSD in middle-aged and older patients with chronic schizophrenia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00047450. (c) Copyright 2008 Physicians Postgraduate Press, Inc.

No effect of six weeks of treatment with escitalopram on mood in healthy volunteers--irrespective of genotype for the promoter of the serotonin transporter. [2008.12.15]
Data on emotional effects of chronic antidepressants in normal subjects are scarce and contradictory. Thirty healthy men were given 10 mg/day of escitalopram [generic for Celexa] for 6 weeks in a double-blind, placebo-controlled, within-subject cross-over study.No significant effect on negative affect, positive affect, or state anxiety was detected, irrespective of serotonin transporter gene-linked polymorphism.

Kinetics of omeprazole and escitalopram in relation to the CYP2C19*17 allele in healthy subjects. [2008.12]
PURPOSE: Ultrarapid drug metabolism of antidepressants has been associated with therapeutic failures. The CYP2C19*17 allele has been associated with higher levels of CYP2C19 gene transcription and increased rates of omeprazole and mephenytoin metabolism. The aim of this study was to compare the impact of the CYP2C19*17 allele on omeprazole single-dose kinetics with escitalopram [generic for Celexa] exposure at steady state in volunteers genotyped as either CYP2C19*17/*17 or CYP2C19*1/*1... CONCLUSION: Based on our investigation using two different CYP2C19 substrates, we concluded that a clinically significant difference in escitalopram or omeprazole kinetics between the genotypes appears unlikely.

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Clinical Trials Related to Celexa (Citalopram)

Escitalopram (Lexapro®) In Patients With Major Depression With Atypical Features [Completed]
Aims of Study:

The aims of this study are 1) to examine the clinical utility of escitalopram in patients with major depression with atypical features; 2) to evaluate the tolerability of escitalopram in major depression with atypical features.

Study hypothesis and objectives. This study is proposed as an open-label study to gather pilot data to examine whether escitalopram has clinical utility in the treatment of major depression with atypical features. Because of the exploratory nature of the design, no specific study hypotheses can be generated regarding efficacy of the drug. Our primary hypothesis is that the effect size of escitalopram in atypical depression will be similar to the effect size of escitalopram in major depression, its FDA approved indication.

Food Study of Escitalopram Oxalate Tablets 20 mg to Lexapro® Tablets 20 mg [Completed]
The objective of this study was to investigate the bioequivalence of Mylan's escitalopram oxalate 20 mg tablets to Forest's Lexapro® 20 mg tablets following a single, oral 20 mg (1 x 20 mg) dose administered under fed conditions.

Fasting Study of Escitalopram Oxalate Tablets 20 mg and Lexapro® Tablets 20 mg [Completed]
The objective of this study was to investigate the bioequivalence of Mylan's escitalopram oxalate 20 mg tablets to Forest's Lexapro® 20 mg tablets following a single, oral 20 mg (1 x 20 mg) dose administered under fasting conditions.

Efficacy of Escitalopram in the Treatment of Internet Addiction [Completed]
The purpose of this study was to determine whether Lexapro (Escitalopram) is safe and effective in treating problematic internet use.

Escitalopram as a Treatment for Pain in Polyneuropathy [Completed]
Many people with polyneuropathy suffer from pain which is difficult to treat. Escitalopram is a relatively new drug used in the treatment of depression. Escitalopram’s action mechanism on the brain suggests that escitalopram also may have an effect on neuropathic pain. This study will test the efficacy of escitalopram in patients with painful polyneuropathy.

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CELEXA PATIENT REVIEWS / RATINGS / COMMENTS

Celexa review by 27 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		Panic disorder
Dosage & duration:		20 mg/day taken daily for the period of 2 years
Other conditions:		none
Other drugs taken:		birth control
		Reported Results
Benefits:		I had debilitating panic attacks and agoraphobia and Celexa completely saved me, allowed me to go live my life again. I even took a low dose and it still worked amazingly well, though it did take nearly a month to "kick in."
Side effects:		In the beginning I had nightmares and some nausea, but that all passed within a few weeks. When I stopped taking the medication, I did suffer some side effects.
Comments:		I took 20/mg a day each day for some number of years.

Celexa review by 34 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		anxiety & depression
Dosage & duration:		60mg taken lx/day for the period of 1 year
Other conditions:		none
Other drugs taken:		wellbutrin
		Reported Results
Benefits:		helped improve mood, and made me more sociable and able to participate in treatment
Side effects:		anorgasmia, zombie-like effect
Comments:		I took 60mg for severe depression & anxiety. However, after 1 year, I decided to quit taking due to the sexual side effects. So far I just take wellbutrin for depression & am doing well.

Celexa review by 49 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		depression
Dosage & duration:		10 mg taken 1/day for the period of 3 weeks
Other conditions:		Hypothyroidism
Other drugs taken:		Levothyroxine
		Reported Results
Benefits:		There were no benefits. It did not solve the organic issues and created new problems.
Side effects:		Firstly, this medication made me drowsy, and I often took involuntary naps mid-afternoon. Secondly, I had carbohydrate cravings, and felt hungry all the time. Lastly, after a couple of weeks I became weepy, irrational and anxious. I can't imagine how magnified these symptoms would have been on a higher dose.
Comments:		I began taking Celexa after Lexapro made me sleepy and hungry. The Lexapro did indeed calm my anxieties. It was thought that an isomer of Lexapro might be better tolerated. This was not the case, and now I am off all medications for a short period to re-evaluate my baseline needs.