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Citalopram: General information
Citalopram is an antidepressant that selectively and reversibly inhibits MAO-A slows down serotonin metabolism, norepinephrine and dopamine, increases their content in the CNS. With its antidepressant action, improves mood and concentration, eliminates fatigue, dysphoria, nervous exhaustion, psychomotor retardation, and improves sleep. Optimal antidepressant effect develops with MAO inhibition by 60-80%. Effect is manifested by the end of 1 week of treatment. Citalopram has no adverse effect on the reaction rate.
Citalopram is used to treat depression of various etiologies (in manic-depressive psychosis, various forms of schizophrenia, alcoholism, senile and involutional, reactive and neurotic), and social phobia.
Citalopram is not recommended for use in cases of hypersensitivity, acute conditions accompanied by “confusion” of consciousness, excitement, agitation, pheochromocytoma, pregnancy, lactation, and infancy.
Please consider the recommended dosage before use citalopram. The drug must be consumed internally, immediately after a meal. The patient must take citalopram 20mg in one tablet a day. In severe depressive states and treatment failure after 7 days the patient might take citalopram 40mg. If the effect is achieved, the dose can be reduced, and one can take citalopram 10mg. In case of liver disease or taking drugs that are inhibitors of microsomal enzymes, the dose should be reduced by 30-50% from the average therapeutic dose. In case of social phobia: 10 mg / day in 2 divided doses, the initial dose – 20 mg / day, from the 4th day the dosage is increased to 40 mg / day. Taking Citalopram in doses of 40 mg / day for more than 3 days is not recommended.
In patients with schizophrenia Citalopram 40mg can cause a worsening of the disorder (the prescription is only possible under the guise of anti-psychotic drugs). On the background of hyperthyroidism or pheochromocytoma, but also in patients with initially elevated blood pressure (especially those who take food that contains large amounts of tyramine) may significantly increase blood pressure.
Before use Citalopram it is necessary to monitor the blood pressure (in patients with low or labile blood pressure, it may be reduced to a greater extent) in the period of treatment – monitoring of peripheral blood (with the use of tricyclic antidepressants in some cases there might develop agranulocytosis, and therefore it is recommended to monitor the blood pressure, especially when the temperature of the body in increased, and in case of the development of influenza-like symptoms and sore throat), long-term therapy to control the functions of the SSA and the liver. In elderly and patients with diseases of the SSA one should monitor blood pressure, and ECG. At the ECG there might appear clinically insignificant changes (flattening of the T wave, segment depression, ST, expansion of the complex QRS).
Parenteral administration is possible only in a hospital, under the supervision of a physician. Caution is needed with a sharp transition to the vertical position from the “lying” or “sitting” position. During the period of treatment one should avoid the use of ethanol. In case of stopping taking Citalopram 10mg after prolonged treatment there may develop the withdrawal syndrome. The drug is prescribed no earlier than 14 days after discontinuation of MAO inhibitors, beginning with small doses. The drug reduces the seizure threshold (is used with extreme caution in patients with epilepsy, as well as in case of presence of other predisposing factors of seizure occurance, such as traumatic brain injury of any etiology, the simultaneous use of antipsychotic drugs (neuroleptics), during the period of refusal or withdrawal of ethanol drugs with anticonvulsant properties, such as benzodiazepines).
If you want to use Citalopram, please read the information about its interaction with other drugs. The medicine strengthens and lengthens the effect of opiates and ibuprofen. Citalopram 20mg tends to enhance the vasoconstrictive effect of tyramine in foods that (if possible) requires its exclusion from the diet. Do not combine with clomipramine (increases the likelihood of severe reactions from the CNS). Treatment with tricyclic antidepressants and others can be started immediately after the end of therapy. The drug does not change the pharmacokinetics and pharmacodynamics of anticoagulants, digoxin, and ethanol. Taking dextromethorphan during therapy increases the risk of serious side effects from the central nervous system.
Citalopram: Side effects
Before you decide to use citalopram, you should be aware of its side effects. The side effects from nervous system include: dizziness, headache, anxiety, excitement, agitation, insomnia, anxiety, blurred vision, paresthesia, rarely – confusion. From the digestive system: dry mouth, nausea, heartburn, constipation or diarrhea, feeling of heaviness in the stomach.