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Citalopram (Citalopram Hydrobromide) - Summary



Suicidality and Antidepressant Drugs
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of citalopram tablets or any other antidpressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyone age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the ned for close observation and communication with the prescriber. Citalopram is not approved for use in pediatric patients. (See WARNINGS: Clinical Worsening and Suicide Risk,PRECAUTIONS: Information for Patients, andPRECAUTIONS: Pediatric Use.)



Citalopram hydrobromide 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.

Citalopram tablets are indicated for the treatment of depression.

The efficacy of citalopram tablets 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 citalopram tablets in hospitalized depressed patients has not been adequately studied.

The efficacy of citalopram tablets 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 citalopram tablets for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.

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Published Studies Related to Citalopram

Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial. [2015]
CONCLUSIONS: These results indicate that escitalopram has clinically meaningful

Augmentation of citalopram with aspirin for treating major depressive disorder, a double blind randomized placebo controlled clinical trial. [2014]
There are contradictory reports about the association of cytokines levels and major depressive disorder and the possible therapeutic role of aspirin for treating major depressive disorder (MDD). A clinical sample of adult out-patients with MDD was recruited...

A double-blind, randomized, placebo-controlled clinical trial of S-adenosyl-L-methionine (SAMe) versus escitalopram in major depressive disorder. [2014]
CONCLUSIONS: The results fail to support an advantage over placebo for either the

Citalopram and escitalopram in the treatment of major depressive disorder: a pooled analysis of 3 clinical trials. [2014]
disorder (MDD) using pooled analyses... CONCLUSIONS: The pooled analysis showed that over a 6-week treatment period,

Effects of escitalopram on markers of bone turnover: a randomized clinical trial. [2014]
CONCLUSIONS: Although the study was limited to 8 weeks, these results suggest

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Clinical Trials Related to Citalopram

Brain Effects of Escitalopram and Citalopram Using fMRI [Completed]
Escitalopram (Lexapro) and citalopram (Celexa) are similar selective serotonin reuptake inhibitors that alter blood flow to the amygdala and other brain structures involved in regulating mood. Escitalopram consists of S-citalopram while citalopram contains both S-citalopram and R-citalopram (racemic citalopram). There is evidence that R-citalopram may block the effects of S-citalopram. The hypothesis being tested is that because of the antagonist effect of R-citalopram, S-citalopram will have a greater effect on the mood circuit than racemic citalopram when equal doses of S-citalopram are administered. The study design consists of a two week medication period followed by blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) while viewing affective visual stimuli.

Pharmacokinetic Drug-drug Interaction Study Between RaltEgravir and CITALopram in Healthy Subjects (RECITAL). [Completed]
Depression is the most common mental health disorder among HIV-patients. Recognizing and treating depression is important in order to improve quality of life and health outcomes in those living with HIV. In clinical practice selective serotonin reuptake inhibitors (SSRIs) are used most frequently in HIV patients with depressive symptoms. A complicating factor in the concomitant use of antiretroviral agents and antidepressant therapy is the occurrence of drug-drug interactions. Citalopram can be seen as one of the preferred SSRIs in HIV-infected patients because citalopram has a relatively favourable drug interaction profile compared to other SSRIs. Raltegravir is an HIV-1 integrase inhibitor and is frequently being used as antiretroviral agent in combination with tenofovir/emtricitabine in HIV-patients. Raltegravir has shown sustained antiretroviral activity, is generally well tolerated and has little propensity to interact with other drugs because it does not inhibit or induce CYP450 enzymes. Theoretically, no clinically relevant drug interaction is expected between raltegravir and citalopram as raltegravir is not a CYP2D6 substrate and thus will not be affected by the possible inhibition of CYP2D6 by citalopram. Raltegravir is metabolized by UGT but citalopram is not known to influence UGT. A possible interaction may occur through inhibition of P-gp mediated transport of raltegravir by citalopram. However, even when no drug interaction is expected theoretically, it may be recommended to collect sufficient clinical evidence to support this hypothesis because unexpected interactions with raltegravir have been observed in the past. In order to be able to recommend raltegravir and citalopram concomitant use, a pharmacokinetic study in healthy volunteers is proposed.

Citalopram to Enhance Cognition in HD [Completed]
This research plan proposes to conduct a double-blind, placebo-controlled pilot clinical trial in 36 adults with mild Huntington's disease (HD) to address the following research aims: 1. To determine the effect of citalopram compared to placebo in patients with early HD on executive function and other outcome variables including functional measures (health-related quality of life, work productivity, and self-reported attention), motor performance, and psychiatric status, 2. To study the relationship between executive function and functional status in patients with early HD after selective serotonin reuptake inhibitor (SSRI) treatment, and 3. To examine the effect of citalopram treatment on volumetric and metabolic (i. e, N-acetyl-aspartate concentration) measures in the neostriatum among patients with recently diagnosed Huntington's disease.

Citalopram Effects on Craving and Dopamine Receptor Availability in Alcoholics [Recruiting]
Alcohol use disorders (AUDs) are highly prevalent among U. S. civilians, and even more prevalent in the U. S. Veteran population. AUDs are frequently co-morbid with depressive symptoms in psychiatric clinical populations, resulting in an increased severity of both conditions. Indeed, returning OEF/OIF Veterans have extraordinarily high rates of alcohol misuse and co-morbid psychiatric symptoms, indicating that future Veteran clinical populations will be particularly affected by AUDs. While FDA-approved medications are available to treat AUDs, their efficacy is low compared to available psychosocial treatments. Despite the lack of evidence for efficacy from controlled trials, antidepressants are frequently prescribed to clinical populations (including Veterans) with active AUDs. A better understanding of patient-level clinical variables that may confer poor response to treatment with antidepressants would allow clinicians better tools to distinguish those alcohol-dependent Veterans likely to do worse with antidepressant treatment.

Bioequivalence Study of Citalopram Hydrobromide Tablets 40 mg of Dr.Reddy's Laboratories Limited Under Fed Conditions [Completed]

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Reports of Suspected Citalopram Side Effects

Completed Suicide (64)Toxicity TO Various Agents (60)Cardiac Arrest (26)Cardio-Respiratory Arrest (24)Respiratory Arrest (18)Overdose (16)Drug Abuse (15)Death (12)Electrocardiogram QT Prolonged (11)Dizziness (11)more >>


Based on a total of 33 ratings/reviews, Citalopram has an overall score of 6.76. The effectiveness score is 7.27 and the side effect score is 6.55. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.

Citalopram review by 43 year old female patient

Overall rating:  
Effectiveness:   Highly Effective
Side effects:   Mild Side Effects
Treatment Info
Condition / reason:   depression
Dosage & duration:   20 mg taken once per day for the period of two months
Other conditions:   anxiety
Other drugs taken:   none
Reported Results
Benefits:   I no longer felt depressed. I felt back to "my old self" and able to function normally in everyday activities.
Side effects:   When I first began taking this medication I had urgent need to urinate throughout day and night. This effect went away after about a month of taking the medication.
Comments:   I took one pill every morning.


Citalopram review by 28 year old female patient

Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Moderate Side Effects
Treatment Info
Condition / reason:   Depression and anxiety
Dosage & duration:   40mg taken 1 time per day for the period of started fall 2007; still taking it
Other conditions:   NONE
Other drugs taken:   NONE
Reported Results
Benefits:   The number one benefit was that it helped with the mood swings. I no longer felt like I was having a mental breakdown. I felt like I have had more control over my emotions, being that I could be upset and crying one minute and then just fine the next.
Side effects:   I had headaches for several weeks after taking this med. Along with insomnia. I also had some mild weight gain. After being on it for several months I lost my urge to be sexual active.
Comments:   I was instructed to take one pill a day, keep track of the side effects I was experiencing, then go back in for a re-check to make sure everything was going better. Everything had gotten alot better, so I continued at the same dosage and am still doing well today.


Citalopram review by 40 year old male patient

Overall rating:  
Effectiveness:   Ineffective
Side effects:   Severe Side Effects
Treatment Info
Condition / reason:   suicidal feelings
Dosage & duration:   10 mg taken once a day for the period of 3 days
Other conditions:   alcoholism
Other drugs taken:   alcohol
Reported Results
Benefits:   None. When I was last encountering depression 10 years ago, my Doctor gave me some round green pills whose name I can't rememeber. They worked well, helping numb my depression as I sorted out my life. After recent suicidal feelings regarding a reactive depression to losing my job, my GP prescribed me Citalopram. I just wanted something to numb me again as things got better(which they did) but these tablets nearly sent me crazy.
Side effects:   I took one late at night hoping to feel sleepy at least, but had one of the worst nights sleep of my life. I encountered sweating,shakes, jaw grinding, and horrible hallucinatory dreams whilst still awake. My GP told me I had to take them for at least a fortnight to feel any effect so tried again the following night, but the side effects were even worse. The way my jaw and teeth would involuntairily chatter was scary as hell. If I did this every sleepless night for 2 weeks, I'd have ended up insane, so I stopped after after just 2 nights
Comments:   I never went back to the doctor. I was so desperate for a good nights sleep without teeth-grinding and nightmares, I fell back on alcohol. I've never taken Valium, but feel I should've been given something similar - somthing that would heavily sedate me while I was feeling suicidal. Luckily after a week, my fortunes changed, and I found work again, so the suicidal feelings went. But I would never take Citalopram again.

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Page last updated: 2015-08-10

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