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CITALOPRAM

CITALOPRAM

Manufacturer: Golden State Medical Supply, Inc.

Score: 144.0

Quick Summary

Citalopram is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) in adults. It works by increasing the levels of serotonin in the brain. The recommended initial dosage is 20 mg once daily, with a maximum dosage of 40 mg once daily. Citalopram has several important safety considerations, including a boxed warning for suicidal thoughts and behaviors in pediatric and young adult patients, and contraindications for use with monoamine oxidase inhibitors (MAOIs) and pimozide. The drug has also been associated with adverse reactions such as nausea, diarrhea, and ejaculation disorder.

Key Clinical Findings and Indications

  • Treatment of major depressive disorder (MDD) in adults
  • Selective serotonin reuptake inhibitor (SSRI)
  • Increases serotonin levels in the brain

Important Safety Information

Warning

Suicidal thoughts and behaviors in pediatric and young adult patients

Contraindications

  • Monoamine oxidase inhibitors (MAOIs)
  • Pimozide
  • Hypersensitivity to citalopram or any of the inactive ingredients

Adverse Reactions

  • Nausea
  • Diarrhea
  • Ejaculation disorder
  • Somnolence
  • Insomnia

Dosing Recommendations

General Guidance

Reduce dosage gradually when discontinuing treatment

Major depressive disorder (MDD)

Adult Dose

20 mg once daily, with a maximum dosage of 40 mg once daily

Pediatric Dose

Not established

Special Population Considerations

Pregnancy

  • Pregnancy exposure registry available
  • No established increased risk of major birth defects or miscarriage
  • Risk of persistent pulmonary hypertension of the newborn (PPHN)

Nursing Mothers

  • Citalopram is excreted in human breast milk
  • Caution advised when administering to nursing women

Pediatric Use

  • Safety and effectiveness not established in pediatric patients
  • Increased risk of suicidal thoughts and behaviors in pediatric patients

Geriatric Use

  • Maximum recommended dosage is 20 mg once daily for patients greater than 60 years of age
  • Increased risk of hyponatremia in elderly patients