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Citalopram is an antidepressant drug used to treat depression associated with mood disorders. It is also used on occasion in the treatment of body dysmorphic disorder and anxiety. Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It is sold under the brand-names Celexa (U.S., Forest Laboratories, Inc.), Cipramil , Seropram (Europe and Australia), Celepram and Ciazil (Australia). History Lundbeck has recently released an updated formulation called escitalopram oxalate (also known as Cipralex or Lexapro), which is simply the S-enantiomer of the racemic citalopram (see below), and acquired a new patent for it. Indications Unapproved/Off-label/Investigational Side effects and drug interactions Citalopram can have a number of adverse effects. In clinical trials, over 10% of patients reported fatigue, drowsiness, dry mouth, increased sweating (Hyperhidrosis), trembling, headache and/or dizziness, sleep disturbances, arrythmia, blood pressure, nausea/vomiting, heightened orgasmic latency in females, impotence and ejaculatory problems. In rare cases (around over 1% of cases), some allergic reactions, convulsions, mood changes, anxiety and confusion have been reported. Occasionally, panic attacks, thoughts of suicide or self-harm may occur or increase in the first few weeks, before the antidepressant effect starts. Citalopram is contraindicated in individuals taking MAOIs. It is considered relatively safe in overdose, although fatal cases of dosages 840 mg to 1960 mg have been reported. Stereochemistry Citalopram is sold as a racemic mixture, consisting of 50% R-(−)-citalopram and 50% S-(+)-citalopram. Only the S-(+) enantiomer has the desired antidepressant effect. Lundbeck now markets the S-(+) enantiomer, the generic name of which is escitalopram. Whereas citalopram is supplied as the hydrobromide, escitalopram is sold as the oxalate salt.The salt form makes these otherwise lipophilic compounds watersoluble.
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