Talk:Citalopram/Archive 1

Archive 1

Archive 2

Elimination half-life?

Someone might want to change "Elimination half-life -- 85% hepatic clearance, and 15% renally" (in the top-right table), as I'm not sure that "85% hepatic clearance, and 15% renally" has anything to do with the half-life of a compound. I.e., it is describing the means with which the compound is metabolised, but not the duration. In any case, compare with the descriptions for other SSRIs et al., if you're not sure what I mean. --24.141.174.2 05:17, 13 May 2006 (UTC)

Thanks for the heads-up. Done. Regards, musti 06:06, 13 May 2006 (UTC)

Correct dosages?

"Citalopram is safe and well tolerated in the therapeutic dose range of 20 to 60 mg/day."

I take Cipramil daily in a dosage of 900mg/day, and I know of patients who take far more. The above sentence can't be right, can it? Jamyskis Whisper, Contribs 20:33, 22 November 2006 (UTC)

Sorry, I must have been half-asleep when I wrote this. It's Orfaril that I take 900mg/day. I do take 60mg of Cipramil a day. Jamyskis Whisper, Contribs 20:36, 28 November 2006 (UTC)

citalopram---withdrawal

Off-topic discussion
I have stopped taking citalopram, I was hoping someone might be able to tell me where I could find out aboout the withdrawal symptoms and how long it usually lasts. I am experiencing some dizziness and nausea and some lite sensitivity. If anyone has some information please forward to marks_tulbox@msn.com Thank you71.59.204.170 (talk) 03:24, 29 November 2008 (UTC)

citalopram /st. johns work.

It says caution should be exercised when using these two together (citalopram /st.johns wort) but doesn't give any details. Do we have any people out there using both and if so what are the problems or lack of problems ??????????????? —Preceding unsigned comment added by 90.209.231.121 (talk) 19:37, 26 October 2008 (UTC)

I did a little snooping on the web and tried to beef up that part. I hope it helped, although direct research or testimonies on such drug interatcions would be useful. MrPMonday (talk) 22:05, 27 February 2009 (UTC)

Use of the word "safe" & Other issues

I object to the use of the phrase, "Citalopram is safe and well-tolerated" - even if the change is initially to "Citalopram is generally considered safe and well-tolerated by ..."

Saying outright that any drug is safe is ridiculous. Different patients react differently to this drug, as with all others. The FDA warning that SSRIs may cause an increased likelihood of suicide attempts applies to Citalopram also, therefore the broad use of the word "safe" is misleading.

The phrase also leads to thoughts of bias regarding the article.

Moreover, the side effects of Citalopram can be and often are widespread and serious. I disagree that the side effect portion should be de-emphasized. The same is true for withdrawal symptoms, and are not to be taken lightly. Although some people have minor to nil side effects and withdrawal symptoms, that does not negate that some patients have serious side effects and withdrawal symptoms.

This page should provide accurate information that reflects the broad spectrum of experience users have with Citalopram. There is no question that an unbiased pharmacist and psychiatrist should review it.

Shizgirl 14:08, 28 July 2007 (UTC)

I partially reverted your edits. The article mentions negative side effects, and links to lenghty discussions of the issues you mention at SSRI and SSRI discontinuation syndrome. Drugs that have passed FDA trials are designated as "generally considered safe" - if you can find a reliable source that states otherwise for citalopram we can talk about including it. Medical professionals often edit these articles. Cheers, Skinwalker 15:11, 28 July 2007 (UTC)

The advisory note with the medication (and advise given on prescribing) does make clear there is a higher risk of "thoughts of suicide or self-harm" on commencing with citalopram. It describes this as "Occasionally", by which I presume it means a small number of cases. Generally considered safe seems a reasonable description, although that suggests controversy over its safety rather than a consensus (following clinical trials) that it is normally safe, but poses some significant problems for a small proportion of patients. —Preceding unsigned comment added by 90.195.131.216 (talk) 15:41, 2 March 2009 (UTC)

Mechanism of action

The information on mechanism of action is inadequate. Much is known about the receptor activation profile of citalopram, including in comparison with other SSRIs and SRI/NRIs. Someone who is familiar with that research ought to add the information and reference it. 173.52.6.148 (talk) 22:20, 21 June 2009 (UTC)

Taking with an antidepressant

Off-topic discussion

Does anyone take this with the generic of Wellbutrin? If so, how does it affect you? —Preceding unsigned comment added by 97.112.103.94 (talk) 14:27, 15 May 2009 (UTC) I found that bupropion would make me extremely nervous, sweaty and give me tremors, but that initially it counteracted the sexual side effects of citalopram. Overall though I would say that bupropion is not good for anxious depression, and citalopram on its own can sometimes be activating. Davidmedin (talk) 10:46, 28 October 2009 (UTC)

with alcohol

From what I've observed, avoiding the intake of alcohol is extremely important when taking this medication. Is that mentioned in the article? I didn't notice it. --Neptunerover (talk) 06:29, 26 January 2010 (UTC)

alcohol and citalopram

Off-topic discussion

Just some advice, if you are on citalopram be careful, you cannot drink as much as you did normally. I am 26 year old male, and I've been a party animal and I've drank 5 litres of alcohol with a group of friends, to the point where you just fall a sleep. And when you are on cit, once shot of vodka and it screws your head up, you cant even balance, its happened to me, I ended up in hospital. In fact, I've stopped taking citalopram it has been about 4 months, and only now can I drink without doing something stupid. Citalopram does work, but I love alcohol more then wanting to cure depression. I think I am addicted to my depression. I am starting to like it. Maybe I've just mentally lost it. —Preceding unsigned comment added by 92.8.137.23 (talk) 05:29, 10 February 2010 (UTC)

Hot flushes (during menopause)

My doctor has prescribed Citalopram for my menopausal hot flushes - and it works! (They used to wake me 2-3 times a night, and that has now stopped.) They are still there but far fewer and less noticeable. I'm surprised this isn't mentioned in the article? Jaycey (talk) 18:28, 17 February 2010 (UTC)

Done. But I have no idea why it actually works, so if anyone wants to add to it, go for it. Persephone12 (talk) 20:01, 9 July 2010 (UTC)

Pronunciation

I think the pronunciation listed for citalopram perhaps reflects US usage but isn't how we say it in the UK (sit-AL-o-pram). I don't know how to add an extra pronunciation though - may be someone else could? Moggyland (talk) 18:57, 13 July 2010 (UTC)

Apathy

SSRI-induced apathy or amotivation syndrome has not been addressed in the article yet. Would someone who is familiar with that literature amend the section on adverse effects? 173.52.6.148 (talk) 22:20, 21 June 2009 (UTC)

I added a little in about this. Persephone12 (talk) 20:41, 9 July 2010 (UTC)

I was going to but I couldn't be bothered. ;-) --88.15.124.59 (talk) 17:49, 4 September 2010 (UTC)

Citalopram vs. escitalopram

As the choice of one drug vs. the other is of therapeutic and economic concern, this needs to be elaborated further. 173.52.6.148 (talk) 22:20, 21 June 2009 (UTC)

The cit vs escit question keeps cropping up on support websites, but there doesn't seem to be any clear answer which is better in any way. All I know is escitalopram is newer and more concentrated, it's supposedly taken as a liquid rather than tablets, doses are lower on escitalopram than they are on the citalopram, and side effects are not supposed to be as bad -- however that's all from original research. —Preceding unsigned comment added by 82.47.192.150 (talk) 21:40, 24 March 2010 (UTC)

Under the heading "Stereochemistry", the article states: "Only the (S)-(+) enantiomer has the desired antidepressant effect." I am not aware of research support for this, and no citation was given. If this were true, then Citalopram would produce the same effects as taking half as much Escitalopram, but that does not seem to be the case. Escitalopram is considerably more "stimulating" -- that is, it is experienced as more likely to induce anxiety. I have been half-expecting the introduction of the other enantiomer as an patented anxiolytic. Janice Vian, Ph.D. (talk) 22:12, 13 January 2011 (UTC)

Citalopram and driving

Off-topic discussion
I am a driving instructor and one of my pupils is taking 20mg/daily and has asked if she can still drive? —Preceding unsigned comment added by 94.6.97.50 (talk) 19:47, 15 January 2011 (UTC)

Impotence and Ejaclatory Problems.

i have problems with the later. These problems are causing problems with my sex life and i think my health. At the time prior to ejaculation i get an extremely sharp pain up the back of my neck into my head! It feels like my head is going to explode! therefore i can not reach ejaculation because of this excruciating pain. would like more info on this please? Thank you, Carl Pickard —Preceding unsigned comment added by 216.209.144.42 (talk) 17:04, 24 February 2009 (UTC)

well yes, look in the "off label and contraversial uses".. actually its why I am here.. looking to see if dysfunction is a known side effect. Since it known to treat premature ejaculation by reducing sensitivity and the ejaculation mechanism, then for people who were normal before, it might cause dysfunction by reducing sensitivy to near zero,

actually ejaculation may be controlled by oxgyen levels.. the tolerated oxygen levels may be reduced to really really low.... which is dangerous (dont put a rope or belt around your neck..! (auto-erotic asphyxiation). you could do brain damage if it doesnt kill you ) —Preceding unsigned comment added by 202.92.40.8 (talk) 10:48, 9 April 2009 (UTC)

Could we have some citations for these claims and also how long lasting (after quitting the medication) these effects are supposed to be ? 213.40.219.90 (talk) 18:31, 4 May 2009 (UTC)

I call bullshit on the decreased sex drive shit. My girlfriend cheated on me while she was on this.

Why is it recommended that only males talk to their provider if experiencing anorgasmia associated with citalopram? 132.162.85.142 (talk) 00:29, 4 March 2011 (UTC)

Off Label

The citation given does not mention ADHD as an off label use let alone whether it is "frequently" used for this. Given that Non of the pahrmacological properties of citalopram suggest it may be of any benefit to someone with ADHD I am going to remove that from the list. I also consider the website cited to be of questionable reliability as a source. DrSparticle (talk) 23:05, 16 June 2011 (UTC)

Side-effects

This article seems to overemphasize side-effects greatly. I suggest decreasing the length of the side-effects lists. Condensing them into a summary would increase readability. --Muugokszhiion 04:12, 9 May 2006 (UTC)

Yeah but how? To be complete, we should include all side effects. I completely agree this looks out-of-place and like an academic piece. Do you have a suggestion? Or, if you want, go ahead and make the changes you suggest. If someone does not like it, they can always revert...Regards, musti 06:35, 9 May 2006 (UTC)

Have you seen the list of possible side-effects in the leafelet with a box of citalopram? I don't think there's a condition under the sun they missed off... hypotension, hypertension, oedema, weight gain, weight loss, euphoria, depression, suicidal tendancies, hyposensitivity, hypersensitivity... (those aren't actual quotes, but its all kinds of things and their exact oposites)--KX36 19:56, 3 February 2007 (UTC)

Where are the references for the incidence of side-effects in clinical trials? The figure of 10% is thrown around casually in the paragraph yet no link is provided. Having read extensively about the efficacy and side-effects of citalopram these figures seem false and consideration needs to be made about the similar levels of side-effects reported by those on placebo in clinical trials.58.172.248.145 (talk) 00:10, 31 March 2008 (UTC)

Well, all I know is that this had better be an exageration on the side effects cuz I'd rather not be in the 10% of the "side-affected" as my doctor prescribed it earlier today as a substitute for Lexapro. --John R. Sellers 04:15, 10 May 2006 (UTC)

Completely Off-topic, but I wonder why would your doctor do that...in any case, don't worry, Celexa and Lexapro are generally very well received by the body (SSRIs are generally well tolerated compared to MAOI or other class of ADs). You have to give it some time (like 2 weeks) though. And I am sure you got the usual talk fm your doctor, re: come back if you have side effects, etc etc. All the best, John :-) musti 04:39, 10 May 2006 (UTC)

Thanks Musti. The reason he switch was cuz for some reason Medicaid stopped paying for my Lexapro.

It is worth noting that there is little clinical difference between Celexa (citalopram) and Lexapro (escitalopram) but that the patent has expired on Celexa and hence it is available generically much cheaper. Lexapro is heavily promoted as a superior (and much more expensive) product by the manufacturer. Just go to the official Celexa website; it's hard to find anything on Celexa because it keeps trying to direct you to Lexapro. 149.68.73.19 23:09, 11 February 2007 (UTC)

Anyway, I know these "Discuss" pages are really meant for discusasing the associated articles themselves, so I'll shutup now. --John R. Sellers 04:54, 10 May 2006 (UTC)

I'd like it if a long term side effect were added to this article; namely the reduction of serotonin naturally produced by the body after a few months of treatment. This is due to the drug's effect of increasing serotonin levels and can be attributed to habituation. It's something i'm concerned about and I was a little dissapointed there was no mention of it in this article. I recieved this information from my pharmacology professor and it's in my textbook... i'm having difficulty providing a reliable source to link you guys on the internet.

here's something- http://en.wikipedia.org/wiki/PSSD

At the cerebral molecular level there are profound and permanent reductions in both the 

rate-limiting serotonin synthetic enzyme, tryptophan hydroxylase, in dorsal raphe and in serotonin transporter (SERT) expression in cortex. It is not known whether PSSD in rodents exactly recapitulates the human condition, but the long term neurobehavioral consequences are very similar.[9][10]. Long-term alterations in gene expression may result from disturbances in 5-HT neurotransmission in the brain of the animals[11].

For example, chronic treatment with fluoxetine (Prozac) has been shown to cause persistent desensitization of 5HT1A receptors even after removal of the SSRI[12].

There is a line in the side effects section that seems to suggest that patients on Citalopram become obsessed with porn: "Citalopram... [has] been shown to cause a preoccupation with sexual content in some patients..." Also the reference, an article titled "Burden of phase-specific sexual dysfunction with SSRIs." is an investigation into the disruption of SSRIs and SNRIs of sexual arousal in men and women, which makes no sense in context. Can someone help clarify this? MrPMonday (talk) 21:34, 27 February 2009 (UTC)

I know it's kind of rude, to but in anonymously - but I've been having loads of hair loss since, I started the drug about a week back and I love my hair - and I was never anxious about my long luscious hair before, (I had my breakages!) but it is really freaking me out...I knew drugs weren't right for me. I was wondering if this is an unofficial side-effect...I am defo stopping them, my hair is my life, don't want to look like some narc, I want to look like Robert Plant!...Dood —Preceding unsigned comment added by 217.42.21.75 (talk) 20:43, 7 August 2009 (UTC)

Should a more general explanation of side effect causes be added? Should something be added in here about the relevance of citaprolam's antihistamine properties (suspected to be a contributer to sedation and fatigue issues)? It also might be good to include some mention of activation in those with undiagnosed bipolar. Persephone12 (talk) 18:56, 9 July 2010 (UTC)

It seems to me that it would be a good idea to have side effects and drug interactions in seperate sections. This would improve readability in my opinion. DrSparticle (talk) 23:15, 16 June 2011 (UTC)

FDA ALART

Editor Edgar181 has repeated removed at urgent FDA ALERT citing copyright. Please can he identify himself so that in the event of a patient dying because they didn't get this urgent warning, their family know who to blame. Although reposted from WEB MD - that item was itself taken from the FDA alart which was intended for worldwide and speedy distribution. Furthermore WEB MD have been alerted to the use of the post. Even if it were copyright, someone's life is more important Edgar181 should NOT be permitted to edit any page with potentially lifesaving or life-threatening information on it.

Fatal Changes to Heart's Rhythm Possible From Antidepressant Aug. 24, 2011 -- The antidepressant Celexa can cause possibly fatal changes to the heart's electrical activity, the FDA today warned. Celexa should no longer be used at doses higher than 40 milligrams per day. The drug's new label will remove a statement suggesting that some patients may need 60 milligrams per day. It will also warn of the drug's risk to the heart. According to the FDA, Celexa "can cause abnormal changes to the electrical activity of the heart." These changes, known as prolongation of the QT interval, can lead to fatal changes in the heart's rhythm. "Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium in the blood," the FDA warns. The higher the Celexa dose, the greater the risk to the heart. Celexa should no longer be used by people who were born with long QT syndrome. Any side effects linked to Celexa should be reported to the FDA's MedWatch Safety Information and Adverse Event Reporting Program online at fda.gov/medwatch/report.htm or by phone at 800-332-1088.

WIKIPEDIA puts patients lives at risk - CITALOPRIM FDA WARNING deleted http://www.facebook.com/note.php?note_id=273554879337608 201.252.101.227 (talk) 20:10, 24 August 2011 (UTC) Brian Grove

Used for IBS symptoms too

This article doesn't mention the fact that Citalopram is sometimes used to treat Irritable Bowel Syndrome (IBS). There is lots of information about this on the web and I being a patient of IBS have been prescribed Citalopram for the past 3 years. Even the IBS article of wikipedia mentions that SSRI's are sometimes used for treatment. The reason why SSRI's are used for IBS patients is because seratonin is produced in the brain and the gut. The gut contains 95% seratonin whereas the brain contains 5% seratonin. Gastroenterologists think that manipulation of seratonin levels in the gut may improve IBS symptoms. So its only for depression or mental health related issues that Citalopram is prescribed — Preceding unsigned comment added by 98.169.175.146 (talk) 17:57, 28 January 2012 (UTC)

Etymology

Is there a reliable source on how the name Celexa was chosen? It would be useful to include this information for the benefit of people who do research on how pharmaceutical companies craft their marketing, etc. 173.52.6.148 (talk) 22:12, 21 June 2009 (UTC)

It's the brand name created by Lundbeck so unless they've said something, I doubt you'll find a reliable source. Pharma brand names are usually invented by marketing departments or agencies and are a topic unto themselves. Simishag (talk) 18:49, 22 June 2009 (UTC)

I don't know, but the generic name "citalopram" makes me think they're telling the users to "sit on the pram", like they're babies that need coddling. 71.32.253.184 (talk) 04:17, 1 June 2012 (UTC)

taking citalopram

Off-topic discussion

i want to know if it is safe to start taking citalopram after being on cocaine a few days before?? —Preceding unsigned comment added by 86.28.225.13 (talk) 17:29, 28 July 2009 (UTC) Yes, it should be, as the two drugs have different pharmacologies and don't appear to interact.--Metalhead94 (talk) 00:57, 31 July 2009 (UTC) I started taking Citalopram HBR 20 mg Tablettor at bedtime on Friday Nov 6...two days ago. The only way I can express my physical side effect is ...My stomach has a burning sensation, almost like "full"....uncomfortable. Have no appetite and experiencing some dizziness. Are these side effects normal ? As my body adapts to the medication with they go away ? Can i reduce the dosage to 1/2 a pill to reduce the side effect? —Preceding unsigned comment added by 76.124.248.159 (talk) 16:43, 8 November 2009 (UTC) Note about the cocaine question - as cocaine directly does not have an interaction, it is sometimes cut with various drugs (hydrocodone is a popular one in my area) and hydrocodone does seem to have an interaction with citalopram. As for the loss of appetite and stomach pains, i've been experiencing the same side effects. Cutting down on the amount of sugar i was consuming helped some. If you smoke marijuana it will help a lot honestly (especially in the appetite department.) — Preceding unsigned comment added by 72.226.120.167 (talk) 11:46, 26 August 2012 (UTC)