The drug "Citalopram": reviews of doctors

How effective is a medication like "Citalopram"? The doctors' comments about this drug are examined in the materials of this article. It also contains information on what side effects the above agent causes, how to properly administer it, what pharmacodynamic characteristics it has.

Composition, description of the medicinal product, its form and packaging

In what form is it possible to purchase the drug "Citalopram"? The patients' comments state that in the pharmacy chains this product is sold in the form of biconvex and round tablets coated with a white film membrane. On the cross-section this drug has a slightly yellowish inner layer.

What is included in the preparation of "Citalopram"? Instruction, reviews report that the active ingredient of this drug is the same substance - citalopram, which is presented in the form of hydrobromide. As for the auxiliary components, microcrystalline cellulose, pregelatinized starch and magnesium stearate are used as such .

It should also be noted that the film shell of this agent consists of polyvinyl alcohol, opadrai II, macrogol, talc and titanium dioxide.

The drug in question is sold in contour cells made of PVC or aluminum, which are packaged in carton boxes.

Pharmacodynamic features of antidepressant

What is a "Citalopram" medication? The reviews say it is an antidepressant. Its mechanism of action is associated with the suppression (selective) of the reuptake of the neurotransmitter mediator located in the synapses of nerve cells, and 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, adrenoreceptors, m-cholinergic receptors, GABA receptors and benzodiazepine receptors).

One can not help saying that the drug "Citalopram", the reviews described below, helps to improve the mood of the patient, suppresses the feeling of anxiety, weakens the sense of fear, stress, eliminates dysphoria, and also relieves obsessive states. In addition, it almost never causes a hypnotic effect.

According to experts, the stable effect of this medication is observed 7-10 days after a constant intake.

Kinetic ability of a medicinal product

What is the pharmacokinetics characteristic of the drug "Citalopram"? The reviews report that the peak concentration of its active substance in the blood comes four hours after admission. At the same time, changes in its level are linear.

Biological availability of this drug is close to 80%, and the connection with plasma proteins is 79%.

In the blood citalopram is present in its original form. This substance is transformed by oxidation, demethylation and deamination. The half-life of this component is 1.5 days. It is evacuated together with urine and through the intestinal tract.

Indications for the appointment of an antidepressant

What is the use of such a tool as "Citalopram"? The doctors' comments state that this medication is indicated for admission when:

• Panic disorders;
• Depressive episodes of severe and moderate degree.

Also it should be noted that only an experienced specialist should prescribe this medicine.

Contraindications to the appointment of a medicament

Under what conditions can not use the drug "Citalopram"?

The reviews indicate the following contraindications to the use of this medication:

• The patient's minor age (according to the instructions, the safety and efficacy 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;
• With concomitant administration with monoamine oxidase inhibitors, including moclobemide, selegiline, linezolid (within two weeks after stopping their intake);
• With simultaneous administration of drugs that extend the QT period on the ECG (including with pimozide), as well as with the innate lengthening of this interval).

Antidepressant "Citalopram": instructions for use

Experts say that the drug should be administered depending on the patient's condition. "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).

With depression, therapy starts with taking 20 mg of the drug a day. Depending on the patient's personal reaction, as well as the severity of depression, the dosage can be increased to a maximum, that is, up to 40 mg per day.

How in case of panic disorders should you take the medicine "Citalopram"? The patients' reviews say that in this case the drug is prescribed at 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 medication may depend on the patient's personal reaction. In the future, this amount of the drug can be increased to 40 mg per day.

Persons over 65 years of age "Citalopram" are prescribed in a dose of 10 mg. Depending on the severity of depression and 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 moderate and mild severity, adjustment of the dosing regimen of this drug is not required. For persons with severe renal insufficiency, special care is required in selecting a therapeutic dose.

In case of impaired liver function, including moderate and mild liver failure, the initial dosage of this drug is 10 mg per day (within the first 2 weeks). Depending on the personal reaction, it can be increased to 20 mg. Persons with hepatic insufficiency of a serious nature require special care in the selection of a dose.

People with a low activity of such an isoenzyme 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 under consideration is manifested after 2-4 weeks. The duration of the course of therapy is determined by the patient's condition and the tolerability of the treatment. As a rule, this drug is recommended to take about 6 months.

Cancellation of medicinal product

What do they say about the reactions that occur with the abrupt withdrawal of the drug "Citalopram", reviews? Who took this remedy, reports that the symptomatology that occurs after a sudden discontinuation of the use of this medication is not characteristic. Most often, patients report mild dizziness, nausea, asthenia, headache, sleep disturbance, paresthesia, nervousness, vomiting and tremor.

Thus, upon completion of treatment with this drug, it should be canceled gradually, within a few weeks. This will allow patients to avoid withdrawal syndrome. Typically, this is sufficient for two weeks, although in each individual case this issue should be decided only by the doctor individually. So, some people may need 3 months or more for this.

Adverse reactions after taking an antidepressant

What negative reactions should patients know before taking Citalopram? Feedback on side effects says 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 weak and transient in nature.

As a rule, adverse reactions after taking the drug in question are observed during the first 2 weeks of therapy. In this case, 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, violation of orgasm in women, mania, strange dreams, anxiety, suicidal thoughts, confusion, dizziness;
• Drowsiness, tremor, impaired concentration, psychomotor agitation, hallucinations, convulsions;
• Euphoria, extrapyramidal disorders, migraine, hemorrhages, 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, dyspnoea, constipation, bradycardia, abdominal pain, cough;
• Ringing in the ears, hepatitis, orthostatic hypotension, rhinitis, impaired taste, decreased blood pressure, visual impairment, arrhythmia, ejaculation, sinusitis, accommodation disorder, galactorrhea, impaired sexual function, decreased appetite, hyponatremia;
• Weight loss, polyuria, increased appetite, bruising, insufficient secretion of ADH, alteration of the electrocardiogram, skin rash, alopecia, weight gain, angioedema, hypokalemia, painful urination, itching;
• Photosensitization, increased sweating, increased risk of injuries and fractures, hives, hyperthermia, purpura, myalgia, yawning, arthralgia and others.

Cases of drug overdose

The drug "Citalopram", the analogues of which are indicated below, can cause the following symptoms of an overdose: tremor, convulsions, vomiting, tachycardia, drowsiness, pupil dilating, bradycardia, muscle hypotension or hypertension, nausea, cyanotic skin, serotonin syndrome, blockade of the bundle's legs, agitation , Dizziness, heart failure, stupor, hyperventilation of the lungs, sweating, ventricular arrhythmia, atrial arrhythmia, to whom.

Drug Interactions

This means interacts quite well with other medicines. Therefore, his joint intake is contraindicated with the following means:

• MAO inhibitors (serious side effects may occur, including serotonin syndrome).
• Drugs that prolong the period of QT (may lead to a violation of the heart rate, which eventually turns out to be fatal).
• "Pimozide" (possible prolongation of the QT interval).

It should also be noted that the joint reception of "Citalopram" with other drugs can reduce the threshold of convulsive readiness. In addition, this drug is undesirable to combine with serotonergic drugs, drugs containing perforated St. John's Wort, indirect anticoagulants, "Warfarin", alcohol, desipramine.

Similar drugs

What are the analogues of this medication? What's better? Citalopram? The reviews state that this drug can be replaced with the following medicines: Paxil, Citol, Pram, Sedopram, Oprah, Uromorap, Siozam, Tsitalanolin, Tsipramil, Citalek , "Citalift", "Citalon". All listed funds should be prescribed only by an experienced doctor.

Very many patients are interested in the question of what is better: "Citalopram" or "Paxil"? Experts say that the first drug is much more effective than the second. It should also be noted that the side effects that occur after using Paxil are more pronounced. Therefore, most doctors recommend using "Citalopram".

Pregnancy and Feeding

This antidepressant should not be given to pregnant women and nursing mothers. The use of this drug in the third trimester can adversely affect the psychophysical development of the baby. The following disorders are also possible: cyanosis, respiratory failure, hypoglycemia, dyspnea, vomiting, convulsions, tremor, temperature instability, nervousness, feeding difficulties, irritability, muscle hypertension, insomnia, hyperreflexia, constant crying, lethargy, drowsiness.

Antidepressant "Citalopram": reviews

In IBS, this drug is prescribed with extreme caution. This is due to the fact that his reception can aggravate the patient's uneasy condition.

What do consumers say about the facility in question? Many patients talk about the successful results of treatment with the drug "Citalopram". After the beginning of therapy, their emotional state very soon improved. 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 remedy, but only in those cases when it does not contribute to the development of side effects. Therefore, many doctors try to prescribe this medicine only in extreme cases and in minimal dosages. If no negative reactions were detected in the first week of treatment, then therapy with this drug is continued with some increase in its doses (if necessary).