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Citalopram

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WARNING

Clinical trials including antidepressants (sometimes known as “mood lifters”) like citalopram revealed a tiny percentage of suicide thoughts in adolescents, teenagers, and young adults (up to 24 years of age) (thinking about harming or killing oneself or planning or trying to do so). Antidepressants may increase the risk of suicide thoughts among children, adolescents, and young adults compared to those who do not take them to treat depression or other mental diseases. The extent of this danger and how much it should be taken into account when determining whether or not a child or adolescent should take an antidepressant are both unknown to professionals. Citalopram is typically not recommended for use in people under the age of 18, although in some circumstances, a doctor may determine that it is the best treatment option for a child’s illness.

Even if you are an adult above the age of 24, you should be aware that taking citalopram or other antidepressants may cause your mental health to change in unforeseen ways. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. Any of the following symptoms should prompt you, your family, or your carer to call your doctor immediately away: Depression that is either new or getting worse, thoughts of self-harm or suicide, plans or attempts to do so, excessive worry, agitation, panic attacks, trouble falling or staying asleep, aggressive behaviour, irritability, acting without thinking, extreme restlessness, and frenzied abnormal excitement. In case you are unable to call for help on your own, make sure your family or caretaker is aware of any symptoms that could be serious.

While you are taking citalopram, your doctor will want to visit you frequently, especially at the start of your treatment. Be sure to maintain all appointments for office visits with your doctor.

When you start citalopram therapy, your doctor or pharmacist will provide you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) also offers the Medication Guide.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. If you or anyone in your family has ever had mania (a frenetic, unusually exuberant mood), bipolar illness (a mood that fluctuates from depressed to excited), or attempted suicide, your risk is increased. Discuss your ailment, symptoms, and personal and family medical history with your doctor. The best course of therapy for you will be decided by you and your doctor.

Why is this medication prescribed?

Depression is treated with citalopram. The antidepressant class that includes citalopram is known as selective serotonin reuptake inhibitors (SSRIs). It is believed to function by raising serotonin levels, a naturally occurring chemical in the brain that aids in maintaining mental balance.

How should this medicine be used?

The two oral dosage forms of citalopram are tablets and liquid solutions. It is typically taken once daily, with or without meals, in the morning or the evening. Take citalopram every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Citalopram should be taken as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

Your doctor might prescribe you a low dose of citalopram to start, and then gradually increase it once a week or less.

Before you experience the full benefits of citalopram, it could take 1 to 4 weeks. Even if you feel well, keep taking citalopram. Without consulting your doctor, do not discontinue taking citalopram. Your dose will likely be gradually reduced by your doctor. You might experience withdrawal symptoms if you abruptly stop taking citalopram, including mood swings, irritability, agitation, dizziness, numbness, tingling, or electric shock-like sensations in your hands or feet, anxiety, confusion, headache, fatigue, nausea, sweating, and shaking, as well as trouble falling asleep or staying asleep. If you encounter any of these signs while lowering your citalopram dosage or soon after stopping the medication, let your doctor know.

Other uses for this medicine

Additionally, citalopram is sometimes used to treat eating disorders, alcoholism, premenstrual dysphoric disorder, panic disorder (a condition that causes sudden attacks of extreme fear with no apparent cause), and obsessive-compulsive disorder (bothersome thoughts that won’t go away and the need to perform certain actions over and over) (a group of physical and emotional symptoms that occur before the menstrual period each month), posttraumatic stress disorder, tingling in the hands and feet brought on by diabetes, social anxiety disorder (severe fear of interacting with others or performing in front of others that interferes with normal life), and specific male sexual issues. Discuss the potential dangers of using this medicine for your illness with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking citalopram,

  • If you have any allergies, including to citalopram, escitalopram (Lexapro), other medicines, or any of the substances in the citalopram product you are taking, let your doctor and pharmacist know right once. For a list of the ingredients, consult your pharmacist or the Medication Guide.
  • Inform your doctor if you’re using pimozide (Orap), an MAO inhibitor such isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), or tranylcypromine (Parnate), or if you’ve just discontinued taking an MAO inhibitor. Most likely, your doctor will advise against using citalopram. You should wait at least 14 days after stopping citalopram before starting an MAO inhibitor.
  • You should be aware that citalopram and the SSRI escitalopram are highly similar medications (Lexapro). These two drugs shouldn’t be taken together.
  • Inform your doctor and pharmacist about any additional prescription drugs, over-the-counter remedies, and vitamins you are now taking or intend to use. Incorporate any of the following: Amphetamines such amphetamine (in Adderall, Mydayis), dextroamphetamine (in Adderall), and methamphetamine (in Desoxyn); anticoagulants (‘blood thinners’) like warfarin (Coumadin, Jantoven); and amiodarone (Nexterone, Pacerone); ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, and other nonsteroidal anti-inflammatory medicines (NSAIDs); carbamazepine (Carbatrol, Equetro, Tegretol, and other brands); chlorpromazine; medication for anxiety, chronic pain, mental illness, and seizures; cimetidine (Tagamet); diuretics (‘water pills’); disopyramide (Norpace); dofetilide (Tikosyn); erythromycin (E.E.S. Ery-Tab, Erythrocin); fentanyl (Actiq, Duragesic, Fentora, Subsys); lithium (Lithobid); almotriptan, eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Tosymra, in Treximet), and zolmitriptan (Zomig) are drugs for migraine headaches; other SSRIs include fluoxetine (Prozac, in Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); methadone (Methadose); metoprolol (Lopressor, Toprol XL); moxifloxacin; omeprazole (Prilosec, Zegerid); pentamidine (Nebupent, Pentam); s Sedatives, sleeping pills, sotalol (Betapace, Sorine, Sotylize), thioridazine (Mellaril), tramadol (Conzip, Qdolo, Ultram, in Ultracet), and procainamide are examples of serotonin-norepinephrine reuptake inhibitors (SNRIs); tranquillizers, as well as tricyclic antidepressants including amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline, and trimipramine. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all the medications you are taking, even any not on this list, as many other drugs may also interact with citalopram.
  • Inform your doctor about any dietary supplements and herbal remedies you are using, especially if they contain tryptophan or St. John’s wort.
  • Inform your physician if you currently or have previously used excessive amounts of alcohol, street drugs, or prescription medications. A recent heart attack, a slow or irregular heartbeat, heart failure (a condition in which the heart cannot pump enough blood to other parts of the body), or any other heart conditions should also be mentioned to your doctor. You should also mention any high blood pressure, bleeding issues, strokes, low magnesium levels, or long QT syndrome (a rare heart condition that can cause irregular heartbeat, fainting, or sudden death) to your doctor.
  • If you are pregnant, particularly if you are in the last few months of your pregnancy, if you plan to get pregnant, or if you are breast-feeding, let your doctor know. Call your doctor if you become pregnant while taking citalopram. If citalopram is taken throughout the final months of pregnancy, it may have negative effects on babies after birth.
  • You should be aware that citalopram may cause you to feel sleepy and may impair your thinking, judgement, and movement. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • If you plan to consume alcohol while taking citalopram, discuss the topic with your doctor. The negative effects of citalopram can be exacerbated by alcohol.
  • You must to be aware that citalopram might result in angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Citalopram could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Diarrhoea
  • Constipation
  • Vomiting
  • Abdominal pain
  • Heartburn
  • Reduction in appetite
  • Slim down
  • Increased perspiration
  • Heightened thirst
  • Excessive urination
  • Having trouble falling or staying asleep
  • Drowsiness
  • Extreme fatigue
  • Yawning
  • Weakness
  • Body part shaking that is uncontrollable
  • Joint or muscle ache
  • Mouth ache
  • Male sexual dysfunction includes reduced sex desire, difficulty getting or maintaining an erection, and delayed or nonexistent ejaculation
  • Sexual issues in women, including diminished sex desire, delayed orgasm, orgasm incapacity
  • Intense menstrual cycles
  • Clogged nose

Some adverse effects may be severe. Call your physician right away or seek emergency medical attention if you develop any of the symptoms below, including those in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

  • Chest ache
  • Breathing difficulty
  • Dizziness
  • Fainting
  • Fever, sweating, confusion, anxiety, hallucinations, lack of coordination, severe muscle stiffness or twitching, nausea, vomiting, or diarrhoea
  • Coma (loss of consciousness)
  • Blisters or hives
  • Rash
  • Itching
  • Breathing or swallowing challenges
  • Edoema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes
  • Hoarseness
  • Uncommon bruising or bleeding
  • Nosebleed
  • Headache
  • Unsteadiness
  • Issues with memory, focus, or thought
  • Seizures

Children who use citalopram may experience decreased appetite and weight loss. The physician for your child will keep a close eye on their development. If you are worried about your child’s weight gain or growth while taking this medicine, talk to your child’s doctor. Consult your child’s doctor about the dangers of giving them citalopram.

Further negative effects of citalopram are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Symptoms of overdose may include the following:

  • Dizziness
  • Sweating
  • Nausea
  • Vomiting
  • Body part shaking that is uncontrollable
  • Drowsiness
  • Hammering, rapid, or erratic heartbeat
  • Loss of memory
  • Confusion
  • Seizures
  • Coma (loss of consciousness)
  • Rapid respiration
  • Around the mouth, fingers, or fingernails: bluish colour
  • Muscular ache
  • Urine with a dark colour

What other information should I know?

Keep all of your appointments with your physician and the lab. Before you begin taking citalopram and while you are receiving treatment with this medicine, your doctor may request a number of laboratory assessments and electrocardiograms (EKGs), a test to keep track of your heartbeat and rhythm.

Do not let anyone else take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Celexa®
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