Antidepressants Selective serotonin reuptake inhibitor (SSRI)
Whats the deal with Celexa?
Celexa / Citalopram
Celexa is used in the treatment of patients who are suffering from depression. Celexa is classified as an SSRI antidepressant. As with other SSRI’s it works by selectively inhibiting the reuptake of serotonin in the CNS. The result is an increased level of serotonin in the brain.
Serotonin
Serotonin is known as a biogenic amine; it has shown to be a mood regulator. Interestingly, the relationship between depression and this hormone was linked during treatment for hypertension. Patients were being treated with a biogenic amine-depleting agent reserpine, and they became depressed. Patients who were being treated for tuberculosis with ipronazid, a biogenic enhancing agent became euphoric.
Serotonin generally serves inhibitory functions in the brain, and disturbances in its functioning may underlie the irritability, anxiety, and sleep disturbances common in depression.
Contraindications
*Use of MAO inhibitors in combination with SSRI’s can cause serotonin syndrome due to abnormally high levels of serotonin in the body. The signs and symptoms of this include: diarrhea, fever, hyperactive reflexes, increased sweating, mood changes, rapid heart rate, restlessness, and shivering or shaking
Refer to pharmacology reference for extensive list of drug interactions; including beta-blocking agents, Demerol, warfarin, antibiotics
Side Effects
Agitation, anxiety, asthenia, dizziness, fatigue, fever, tremor, anorexia, diarrhea, indigestion, nausea, vomiting, decreased libido, dysmenorrhea, impotence, myalgia, upper respiratory tract infection, diaphoresis
Route and dosage
Citalopram is taken by mouth. Normal initial adult dose is 20mg once a day. Daily doses are increased at 20mg at weekly intervals, as prescribed. Usual dose is 40mg once a day, to a max of 60 mg/day
Caution
Effective antidepressant therapy may transform depression into mania in predisposed individuals (ex. bipolar disorder). If you (your patient) develops mania expect to discontinue the drug.
Monitor patient during initial treatment for suicidal ideation
Hepatic patients should be monitored closely for adverse reactions because celexa is extensively metabolized in the liver
Notes on Celexa
Celexa is currently one of the most popular antidepressants. It is frequently prescribed due to low drug/food/EtOH interactions when comparing to other SSRIs such as Prozac. Celexa is generally the first try in a pharmacological treatment of depression because it is the least potentially harmful and can be very effective. MAO inhibitors are generally used as a last resort due to the high drug and food interactions.