Products
Citalopram is commercially available as film-coated tablets and as an infusion concentrate (Seropram, generics). It has been approved in many countries since 1990. The pure -enantiomer escitalopram is also available (Cipralex, generic).
Structure and properties
Citalopram (C20H21FN2O, Mr = 324.4 g/mol) is a racemate. It is present in the tablets as citalopram hydrobromide, a fine white powder that is sparingly soluble in water. Citalopram hydrochloride is present in the infusion concentrate.
Effects
Citalopram (ATC N06AB04) has antidepressant properties. The effects are due to inhibition of the reuptake of serotonin into presynaptic neurons.
Indications
- Depression
- Panic disorders
- Obsessive-compulsive disorders
Dosage
According to the professional information. The drug is usually taken once daily and independently of meals. The maximum dose was set at 40 mg per day in 2011 because of the risk for QT prolongation.
Contraindications
- Hypersensitivity
- Patients with prolonged QT interval
Citalpram must not be administered with pimozide, MAO inhibitors, and drugs that prolong the QT interval. Full details of precautions and interactions can be found in the Drug Information Leaflet.
Interactions
Citalopram is metabolized by CYP2C19, CYP3A4, and CYP2D6 and is a CYP inhibitor. Corresponding interactions are possible. Citalopram has a high potential for drug-drug interactions.
Adverse effects
The most common potential adverse effects include dry mouth, increased sweating, agitation, decreased appetite, insomnia, fatigue, drowsiness, yawning, nausea, impotence, libido reduction, ejaculatory dysfunction, and anorgasmia in women. Citalopram may prolong the QT interval.
