Talk:Citalopram

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[edit] Side-effects

This article seems to overemphasize side-effects greatly. I suggest decreasing the length of the side-effects lists. Condensing them into a summary would increase readability. --Muugokszhiion 04:12, 9 May 2006 (UTC)

Yeah but how? To be complete, we should include all side effects. I completely agree this looks out-of-place and like an academic piece. Do you have a suggestion? Or, if you want, go ahead and make the changes you suggest. If someone does not like it, they can always revert...Regards, musti 06:35, 9 May 2006 (UTC)
Have you seen the list of possible side-effects in the leafelet with a box of citalopram? I don't think there's a condition under the sun they missed off... hypotension, hypertension, oedema, weight gain, weight loss, euphoria, depression, suicidal tendancies, hyposensitivity, hypersensitivity... (those aren't actual quotes, but its all kinds of things and their exact oposites)--KX36 19:56, 3 February 2007 (UTC)

Where are the references for the incidence of side-effects in clinical trials? The figure of 10% is thrown around casually in the paragraph yet no link is provided. Having read extensively about the efficacy and side-effects of citalopram these figures seem false and consideration needs to be made about the similar levels of side-effects reported by those on placebo in clinical trials.58.172.248.145 (talk) 00:10, 31 March 2008 (UTC)

Well, all I know is that this had better be an exageration on the side effects cuz I'd rather not be in the 10% of the "side-affected" as my doctor prescribed it earlier today as a substitute for Lexapro. --John R. Sellers 04:15, 10 May 2006 (UTC)

Completely Off-topic, but I wonder why would your doctor do that...in any case, don't worry, Celexa and Lexapro are generally very well received by the body (SSRIs are generally well tolerated compared to MAOI or other class of ADs). You have to give it some time (like 2 weeks) though. And I am sure you got the usual talk fm your doctor, re: come back if you have side effects, etc etc. All the best, John :-) musti 04:39, 10 May 2006 (UTC)
Thanks Musti. The reason he switch was cuz for some reason Medicaid stopped paying for my Lexapro.
It is worth noting that there is little clinical difference between Celexa (citalopram) and Lexapro (escitalopram) but that the patent has expired on Celexa and hence it is available generically much cheaper. Lexapro is heavily promoted as a superior (and much more expensive) product by the manufacturer. Just go to the official Celexa website; it's hard to find anything on Celexa because it keeps trying to direct you to Lexapro. 149.68.73.19 23:09, 11 February 2007 (UTC)

Anyway, I know these "Discuss" pages are really meant for discusasing the associated articles themselves, so I'll shutup now. --John R. Sellers 04:54, 10 May 2006 (UTC)

I'd like it if a long term side effect were added to this article; namely the reduction of serotonin naturally produced by the body after a few months of treatment. This is due to the drug's effect of increasing serotonin levels and can be attributed to habituation. It's something i'm concerned about and I was a little dissapointed there was no mention of it in this article. I recieved this information from my pharmacology professor and it's in my textbook... i'm having difficulty providing a reliable source to link you guys on the internet.

here's something- http://en.wikipedia.org/wiki/PSSD

At the cerebral molecular level there are profound and permanent reductions in both the

rate-limiting serotonin synthetic enzyme, tryptophan hydroxylase, in dorsal raphe and in serotonin transporter (SERT) expression in cortex. It is not known whether PSSD in rodents exactly recapitulates the human condition, but the long term neurobehavioral consequences are very similar.[9][10]. Long-term alterations in gene expression may result from disturbances in 5-HT neurotransmission in the brain of the animals[11].

For example, chronic treatment with fluoxetine (Prozac) has been shown to cause persistent desensitization of 5HT1A receptors even after removal of the SSRI[12].


Anyone have any idea why a doctor would want to switch me from Paxil (paroxetine) to citalopram? Her initial desire was to switch me to some other new SSRI, but that wouldn't have been covered by my insurance. When she saw that, she looked up alternatives, and paroxetine was in the list, but she seemed to pick something semi-randomly, just to get me off the paroxetine. I'm wondering whether citalopram is significantly better in some way that isn't obvious from the online research I've done so far... Is there something in the side effects of each? Rhyssan 18:54, 4 January 2007 (UTC)Rhyssan

Citalopram has a far lower reported rate of side effects and withdrawal effects, compared to paroxetine. It's possible that your doctor is concerned about the increasing negative reports re. paroxetine, and is trying to spare you potential problems in that area (and spare themselves the possibility of a lawsuit, etc). Citalopram, like all psychotropic medication, has its own issues, but paroxetine is generally considered to be more problematic in terms of side effects and withdrawal. Perhaps your doctor has seen a lot of problems with paroxetine in their own practice? MrBronson 17:22, 19 April 2007 (UTC)

I have a question about side effects- I recently took celexa for about a month and then stopped taking it because it made work too difficult ( I was exhausted and the yawning was embarrasing). Since I stopped taking it I have been irrational and moody. I have been feeling very depressed and i can't seem to control my anxiety or crying. Is this normal?

- Not sure how old this entry is, but what you describe is certainly not unheard of, if not "normal". While acute withdrawal from SSRIs rarely lasts longer than a month, various adverse neurological effects can persist for some time in some patients. These reduce with time - extreme cases can persist for several years, but most problems of this type resolve within a year. N.B. There is little reliable research explaining this phenomenon, so it is to a large degree anecdotal evidence. There is, however, a mountain of anecdotal evidence, much of it originating with people whose issues pre-SSRI were fairly minor, and it is a very real concern. MrBronson 17:22, 19 April 2007 (UTC)

[edit] Elimination half-life?

Someone might want to change "Elimination half-life -- 85% hepatic clearance, and 15% renally" (in the top-right table), as I'm not sure that "85% hepatic clearance, and 15% renally" has anything to do with the half-life of a compound. I.e., it is describing the means with which the compound is metabolised, but not the duration. In any case, compare with the descriptions for other SSRIs et al., if you're not sure what I mean. --24.141.174.2 05:17, 13 May 2006 (UTC)

Thanks for the heads-up. Done. Regards, musti 06:06, 13 May 2006 (UTC)

[edit] Correct dosages?

"Citalopram is safe and well tolerated in the therapeutic dose range of 20 to 60 mg/day."

I take Cipramil daily in a dosage of 900mg/day, and I know of patients who take far more. The above sentence can't be right, can it? Jamyskis Whisper, Contribs Germany 20:33, 22 November 2006 (UTC)

Sorry, I must have been half-asleep when I wrote this. It's Orfaril that I take 900mg/day. I do take 60mg of Cipramil a day. Jamyskis Whisper, Contribs Germany 20:36, 28 November 2006 (UTC)

[edit] Sweating

I read that sweating is a side effect but my sweating was rediculous. I had to change shirts twice before meetings during week two. It seems to be better but is a barometer for how nervous I am before meetings. Really nervous more sweating. My doc left me on it, but i'm wondering if I should be trying a different drug?

Tom


I too experience extreme sweating while on Celexa, although it started when I was on Wellbutrin and continued long after I detoxed from that. It doesn't matter what anti-persperants I use; i still have giant saucer-sized sweat stains in my armpits almost constantly, even if I'm not hot or nervous.

--Robin


I experienced the sweating as well. I had to change my shirt maybe 3 times a day! I noticed the sweating increased when I had a cigarette. The sweating did cease after a few weeks. I've been on the citalopram for about 6 months now. I started off with 10mg and have gradually increased it to 40mg. Its been a GOD SEND to be honest. The 40mg seems to have done the trick for me. Hopefully, this is as high a dosage as I need and won't have to be on it forever.

-- Jane

[edit] Withdrawal Side Effects

I have noticed several of the symptoms that others have discussed--sweating and depression--as I have tried to stop taking Celexa. However, the biggest symptom I have noticed coming off of Celexa is my equilibrium being off and excessive saliva in my mouth. I am wondering if anyone else has had experience with these symptoms? After a few days of being miserable I always end up starting my Celexa again and the symptoms slowly go away again. Bdnchixs 14:14, 17 April 2007 (UTC)Bdnchixs 14:14, 17 April 2007 (UTC)

Again, this is not really the purpose of this talk page, but...

It's completely unrealistic to expect withdrawal issues to dissipate in "a few days". Some people experience no withdrawal whatsoever, for some it is minor, for some it is extremely severe. If you DO experience withdrawal, it will last at least two weeks. In extreme cases, some problems can persist for months or even years, but in the vast majority of cases withdrawal is over within a month to six weeks. Loss of equilibrium, especially, is a *very* common withdrawal effect. If the problems are so severe they stop you coming off the medication altogether, the best approach is to cut down by very small increments - for example, 2mg every month. MrBronson 17:28, 19 April 2007 (UTC)

[edit] Urination and ejaculation difficulty

I seem to have more difficulty urinating and ejaculating. FWIW, I'm male. The ejaculating issues I can deal with, but having to spend 10 minutes in the bathroom just to urinate is driving me nuts. Citalopram is the only new drug (I take others, but they have are for my ankylosingspondyltus; Humira and methotrexate) I'm on and I'm taking daily dosages of 20mg. This is also my first week. I just thought I would document this. -- 75.8.119.38 13:49, 6 May 2007 (UTC)

- I've been taking daily doses of 10mg for five weeks, and I've had similar problems with ejaculation. Bear in mind that one of the indications for this drug is premature ejaculation, so I guess this shouldn't surprise us. I should also add that the drug is definitely having a therapeutic effect on me even at this low dosage. Kinbotic 13:15, 17 May 2007 (UTC)

[edit] Use of the word "safe" & Other issues

I object to the use of the phrase, "Citalopram is safe and well-tolerated" - even if the change is initially to "Citalopram is generally considered safe and well-tolerated by ..."

Saying outright that any drug is safe is ridiculous. Different patients react differently to this drug, as with all others. The FDA warning that SSRIs may cause an increased likelihood of suicide attempts applies to Citalopram also, therefore the broad use of the word "safe" is misleading.

The phrase also leads to thoughts of bias regarding the article.

Moreover, the side effects of Citalopram can be and often are widespread and serious. I disagree that the side effect portion should be de-emphasized. The same is true for withdrawal symptoms, and are not to be taken lightly. Although some people have minor to nil side effects and withdrawal symptoms, that does not negate that some patients have serious side effects and withdrawal symptoms.

This page should provide accurate information that reflects the broad spectrum of experience users have with Citalopram. There is no question that an unbiased pharmacist and psychiatrist should review it.

Shizgirl 14:08, 28 July 2007 (UTC)

I partially reverted your edits. The article mentions negative side effects, and links to lenghty discussions of the issues you mention at SSRI and SSRI discontinuation syndrome. Drugs that have passed FDA trials are designated as "generally considered safe" - if you can find a reliable source that states otherwise for citalopram we can talk about including it. Medical professionals often edit these articles. Cheers, Skinwalker 15:11, 28 July 2007 (UTC)

[edit] teeth grinding

Does anybody else experiance teeth grinding or an aching jaw? I am on twenty milograms a day. worked up form ten. I notice that I am still irritable but not depressed. I can actually get up and function. I am kind of wondering if I am having too much or too little! What I have found is that my thinking is clearer. That is great. love to hear if anyone else has experianced the teeth grinding or any sort of irritability. Maree. —Preceding unsigned comment added by 219.88.61.212 (talk) 05:56, 24 October 2007 (UTC)

hi i was wanting a bit if advice im seeing a girl how is on citalopram 20mg she does suffer from bad teeh grinding during the night and she is always tired. i know its really none of my business but i want to suport her. she openly told me she was depressed. any advice would be great thanx. mark —Preceding unsigned comment added by 78.148.58.46 (talk) 21:39, 17 December 2007 (UTC)

You should really sign this call for advice. Any medical professional (like myself) watching this site will refer you to her primary care provider. This leaves you to seek advise from other sources (that is a person who is not a medical professional), which may be fine for your needs. If you wanted some discussion I would be happy to talk with you offline. --Remark knights (talk) 16:05, 18 December 2007 (UTC)

[edit] Alcohol

Hello, I have been on Citalopram for 2 weeks now, and am starting to feel a bit more positive about things. I have not had a drop of alcohol whilst on the drugs, as the box says NO alcohol. I would quite like a drink at christmas, and wondered what problems if any that might cause. Grateful for any thoughts on that.

Jacky 17.12.07 —Preceding unsigned comment added by 81.145.240.148 (talk) 14:16, 17 December 2007 (UTC)

I just found this at drugstore.com. I trust the answer, but not enough to add it to wikipedia. Here is what they said:

Celexa, (generic name citalopram), Luvox (fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine) and Zoloft (sertraline) are antidepressant drugs called SSRIs (selective serotonin reuptake inhibitors). In general, the manufacturers of most SSRIs recommend avoiding alcohol with these medicines. The combination of an SSRI and alcohol could possibly increase the chance or severity of side effects such as drowsiness, slow reflexes, or clouded judgment. This can be dangerous when driving a car or operating other machinery.

Also, alcohol may make you feel depressed. In this way, alcohol can interfere with the actions of your SSRI to treat depression. Try to avoid or limit your use of alcohol while taking an SSRI.

--Remark knights (talk) 16:11, 18 December 2007 (UTC)

Hi, Thanks for taking the trouble to answer my query. It sounds like I might be safe to have a glass of wine at Christmas then, as I do not plan to drive or operate machinery ! Jacky —Preceding unsigned comment added by 81.145.242.17 (talk) 20:00, 22 December 2007 (UTC)

[edit] citalopram

i was going to start on citalopram but after readoing all this mess i changed my =mind suicide ideas teeth grinding sweating those alone are enought symtoms to make me change my mind thanks —Preceding unsigned comment added by 68.218.249.240 (talk) 23:13, 22 February 2008 (UTC)

I have been on Citalopram HBR 20 mg for about five weeks now and I feel much better than I did before I started the medication. I have depression and anxiety as well as OCD and Citalopram seems to do the job in keeping my depression at a low to non-existent level. I don't feel as anxious, and many of my "ticks" or compulsions have seemed to disappear. I know that the side-effects of teeth grinding, suicidal thoughts and sweating don't sound very pleasant, but I personally haven't experienced the teeth griding or suicidal thoughts. I do perspire a little more than I did before being on the medication, but it is a great trade-off compared to depression. Medicine effects every individual differently. So before you write off citalopram as a bad medication, I would try it first and see how it is after a couple weeks. If you don't like it, there are always many more options. ~GarynMB —Preceding unsigned comment added by 75.138.63.83 (talk) 23:32, 26 March 2008 (UTC)

[edit] Celexa is very good for Phobias

I was almost home-bound from a weather phobia that started when I moved to an area with alot of severe/tornatic weather. I had always been afraid of storms, I had witnessed someone being struck by lightening on the beach, so that added to my stress. After a conversation with my doctor, he asked me to try Celexa, I now take the generic, I was surprised that within weeks I was able to cope like a "normal" person. It also helped me be more productive at work and not "worrying" all the time. Even at home the enviornment was much less stressful. I only wish I had had it when my children were little. They would have been in a less chaotic home. Thank Goodness for this medication.69.68.89.3 (talk) 17:14, 31 March 2008 (UTC)Betty Murphy 3/31/2008

[edit] itchy skin with citlopram

does anyone have the same trouble as me. i was put onto citlopram 40mg per day and after six months i have experiencd side affects that cause my skin to itch and sting.it is sometimes to much to bare. is it just me or is this a usual thing. i found that after starting with citlopram i felt much better, as i was coming of diazapam it stopped me from having that awful churning in the stomach, so i will be sorry if i have to stop them. has anyone experenced the same thing —Preceding unsigned comment added by 86.152.142.204 (talk) 21:18, 14 April 2008 (UTC) ohhhh... —Preceding unsigned comment added by 78.149.188.177 (talk) 14:24, 16 April 2008 (UTC)