Medication

Citalopram

Structure

One tablet of Citalopram includes 10 mg, 20 mg or 40 mg of the same active substance.

Excipients: lactose monohydrate, corn starch, copovidone, croscarmellose sodium, magnesium stearate, microcrystalline cellulose.

Shell composition: white opadray (hypromellose, titanium dioxide, macrogol).

Release form

White biconvex tablets of a round or capsular shape (depending on the manufacturer).

  • 10 tablets of any dosage in contour packaging - one, two, three, four or five packages in a cardboard box.
  • 14 tablets in any dosage of 20 mg or 40 mg in a blister - 2 blisters in a cardboard box.

Pharmachologic effect

Antidepressant effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The mechanism of action of the drug Citalopram is associated with selective suppression of reuptake of the mediator serotonin in synapses of nerve cells and with minimal effect on the reuptake of mediators norepinephrine and dopamine. Does not show ability to react with a number of receptors (some serotonin, dopamine, H1-histamine, adrenergic receptors, m-cholinergic receptors, GABA receptors and benzodiazepine receptors).

Helps improve mood, suppresses anxiety, eliminates dysphoria, weakens the feeling of tension and fear, relieves obsessive states, almost does not cause sleeping pills.

Confident clinical effect is recorded after 7-10 days of constant use.

Pharmacokinetics

The highest concentration of citalopram in blood after admission occurs in 3-4 hours. Changes in the level of active substance are linear. Bioavailability is approaching 80%. Plasma protein binding reaches 80%.

It is present in the blood mainly in its original form. Transformed by deamination, demethylationand oxidation. The elimination half-life reaches 1.5 days. It is evacuated with urine and through the intestines.

Indications for use

  • affective (bipolar, depressive, dysthymic) disorders;
  • depression diverse genesis;
  • anxiety-phobic disorders (panic, phobic, generalized anxiety, obsessive-compulsive, stressful post-traumatic);
  • mixed anxiety and depressive disorders;
  • somatic disorder;
  • dementia of vascular originwith depressive symptoms;
  • psychosomatic diseases from autonomic dysfunction;
  • depressionin elderly people;
  • depressive disorders in women (pregnant depression, premenstrual dysphoria, premenopausal depression, postpartum depression);
  • depression at alcoholism;
  • eating disorders (bulimia, anorexia).

Contraindications

Sensitization to the components of the drug.

Side effects

  • Changes by nervous activity: headache, dizziness, tremor, insomnia, drowsinessexcitement migrainesleep disturbance nervousness paresthesia, amnesiaviolation of concentration, decreased libido, anxiety, anorexiaincrease appetite, apathyconfusion of thoughts suicidal attempts, asthenia, aggressive behavior, mood changes, agitationemotional lability maniapanic behavior hypomania, paranoid reactionexcessive fatigue, psychosis, anxiety, cramps, extrapyramidal disorders, euphoria, hallucinations, serotonin syndrome, depersonalization, convulsive seizures(in exceptional cases).
  • Changes by blood circulation: tachycardia, atrial flutter, orthostatic hypotension, bradycardia,change in blood pressure ventricular and supraventricular arrhythmias.
  • Changes by digestion: increased salivation, dry mouth, nausea, constipation, dyspepsia, diarrhea,vomiting flatulence, abdominal pain, anorexiaincrease in content enzymes the liver.
  • Changes by excretory system: polyuriafrequent urination.
  • Changes metabolism: hyponatremiachange in body weight hyperthermia.
  • Changes by breathing: rhinitiscough sinusitis, dyspnea.
  • Changes by reproductive system: libido change, ejaculation disorders, dysmenorrhea, female anorgasmia, menstrual cycle changes impotence, galactorrhea.
  • Changes by skin: epidermal necrolysisphotosensitivity, rash, excessive sweating, itching, angioedema.
  • Changes by sensory organs: impaired vision, impaired accommodation, impaired taste, mydriasis, noise in ears.
  • Changes by musculoskeletal system: pain in muscles and joints.
  • Changes by blood coagulation systems: development of bleeding of different localization, thrombocytopenia.
  • Other changes: fatigue, asthenia, allergic reactionsmalaise, fainting, mammalgiateeth grinding, yawning, anaphylactoid reaction.

Instructions for use Citalopram (Method and dosage)

Instructions for use Citalopram recommends taking the drug inside once a day regardless of the meal at any time, but it must be washed down with water. After the start of therapy, the antidepressant effect can be expected no earlier than two weeks later. Therapy should be continued until the symptoms disappear within six months. It is recommended to cancel the drug slowly, gradually reducing the dose over 2-3 weeks.

In the treatment depressionThe recommended starting dosage is 20 mg per day. If necessary, it can be increased to 40 mg per day. The maximum daily dose is 60 mg.

At panic disordersinitial dose is 10 mg per day. After a week of treatment, it should be increased to 20 mg per day. If the effect of treatment is unsatisfactory, the dosage can be increased to a maximum of 60 mg per day. The therapeutic effect is usually achieved after about 3 months of therapy.

In elderly patients, the daily recommended dose is 20 mg. Depending on the severity of the condition and individual sensitivity, it can be increased to the maximum in this category of patients - 40 mg per day.

Do not suddenly stop therapy. The dose should be consistently reduced over several weeks, in order to reduce the risk of withdrawal syndrome.

Overdose

Signs of an overdose: coma, drowsiness, stuporincrease QT interval, epileptic seizures, ventricular arrhythmia, cyanosisvomiting nausea Perspirationcramps hyperventilation. The appearance of signs is not excluded. serotonin syndrome.

Overdose therapy: should be supportive and symptomatic, include administration laxatives and enterosorbentsgastric lavage. For disorders of consciousness of the patient, it is recommended intubate. ECG and vital functions should be monitored. Convulsive syndrome treated Diazepam. Increase QRS complexon ECG normalize by the introduction gipertonic sodium chloride solution.

Interaction

When combined with MAO blockersappearance is possible hypertensive crisis (malignant serotonin syndrome). Use of the drug Citalopram with MAO blockers and within 2 weeks after their cancellation is prohibited.

Act Sumatriptan and other drugs serotonergic groupstimulated by citalopram when used together.

Terms of sale

Prescription only.

Storage conditions

Store at temperatures up to 25 ° C in a dark place. Keep out of the reach of children.

Shelf life

3 years.

Special instructions

In patients with liver failure, citalopram should be used in the lowest effective doses.

With compensated renal failure correction of the medication regimen is not required; information on use in severe renal failure is not available.

During treatment with the drug, a slight decrease in heartbeat is possible, which is not very important, however, in individuals with an initially reduced number of heart contractions, Citalopram can cause a stronger bradycardia.

Caution is advised to use the drug in large doses against the background of the use of cimetidine in maximum doses.

In patients with depression often there is a decrease in concentration, which is exacerbated by the use of psychotropic drugs.

Analogs of citalopram

Matches for ATX Level 4 code:ActaparoxetineLickedFluxenParoxinSurfliftAsentraEliceaFluoxetineLenuxinEscitalopramAdepressSelectraStimulusCypramilZoloftParoxetineProzacPaxilRexetinFevarin

The following are the most famous analogues of Citalopram: Pram, Oprah, Sedopram, Umorap, Citalorin, Siozam, Tsipramil, Citalift, Citalek, Citalon, Citol.

For children

The medicine is not used in patients under 18 years of age.

During pregnancy and lactation

The drug is allowed to be used in these periods with extreme caution and only as directed by a doctor.

Reviews about Citalopram

Reviews about Citalopram tell about the excellent results of treatment with the drug in those cases when it did not cause side effects. These effects when they appear are quite pronounced and usually do not allow further administration of the drug. In any case, the evaluation of the effect of the drug and the selection of doses can only be done by an experienced specialist.

Citalopram price, where to buy

The price of Citalopram 20 mg No. 30 in Russia starts from 390 rubles.

  • Online Pharmacies in Russia
  • Online pharmacies in UkraineUkraine

Pharmacy Dialog

  • Citalopram tablets 10mg No. 30201 rub.order
  • Citalopram tablets 20mg No. 30353 rub.order
  • Escitalopram (tab. Pp.pl / rev.10mg No. 28) 262 rub.order
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Pharmacy24

  • Escitalopram Teva 20 mg N28 tablets TOV Teva Operations Poland, Poland275 грн.order
  • Escitalopram Teva 10 mg No. 28 tablets TOV Teva Operations Poland, Poland170 UAH to order

Pani Pharmacy

  • ECCITALOPRAM tablets Escitalopram tablets 20mg No. 28 Poland, Teva Operations Poland 289 UAH order
  • ESCITALOPRAM tablets ESCITALOPRAM tablets 10mg No. 28 Poland, Teva Operations Poland 183 UAH order
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Watch the video: Depression Symptoms & Help : Side Effects of Celexa: Anti-Depressants (December 2019).

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