Class: SSRI Antidepressant
Dosage Forms. Tablet: 10 mg, 20 mg, 40 mg; Solution: 10 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
1. Depression: 20 mg po daily; may titrate to 40 mg po daily
1. OCD: 20-60 mg po daily
2. Panic disorder: 20-30 mg po daily, may titrate to 60 mg po daily
MOA. Citalopram is a bicyclic antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI). It does not affect reuptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine, α1- and α2-adrenergic, and serotonin receptors.
Drug Characteristics: Citalopram
Medication Safety Issues: Citalopram
Drug Interactions: Citalopram
Adverse Reactions: Citalopram
Efficacy Monitoring Parameters. Improvement in symptoms of depression, panic disorder, OCD.
Toxicity Monitoring Parameters. Worsening of mental health symptoms, suicidality, or unusual changes in behavior, especially at the initiation of therapy or with dosage increases or decreases; signs/symptoms of abnormal bleeding.
Key Patient Counseling Points. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.
Clinical Pearls. If intolerable withdrawal symptoms occur following a decrease in dose or therapy discontinuation, may need to resume the previous dose and taper at a more gradual rate. Medication guide required when dispensing.