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Citalopram Hydrobromide is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication, chemically unrelated to other SSRIs or to tricyclic, tetracyclic, or other available antidepressant agents. It is used for the treatment of depression and is known by various brand names, including Celexa and Cipramil.
Mechanism of Action: Citalopram's primary action is as an SSRI, which works by inhibiting the reuptake of serotonin in the brain, thereby increasing the levels of serotonin available to the brain's neurons. This leads to an enhancement of serotonin activity in the central nervous system (CNS), which is thought to be associated with improvements in mood.
Pharmacokinetics: Citalopram is well absorbed from the gastrointestinal tract, with peak blood levels occurring approximately 4 hours after oral administration. It is metabolized in the liver primarily by the CYP3A4 and CYP2C19 isoenzymes, and its metabolites are excreted mainly in the urine. The mean terminal half-life of citalopram is about 35 hours, and it reaches steady-state plasma concentrations within approximately one week of once-daily dosing.
Dosage and Administration: The typical starting dose for adults is 20 mg per day, which can be increased based on clinical response and tolerance. The maximum recommended dose is usually 40 mg per day. For elderly patients or those with hepatic impairment, a lower dose may be appropriate. Citalopram is available in tablet form and can be taken with or without food.
Safety and Side Effects: Common side effects include nausea, dry mouth, dizziness, sleep disturbances, and fatigue. As with other SSRIs, citalopram may cause a range of other side effects, including sexual dysfunction, weight changes, and, rarely, serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin activity.
Precautions: Citalopram should not be used in patients with a hypersensitivity to the drug or those taking monoamine oxidase inhibitors (MAOIs), as there is an increased risk of serotonin syndrome. It is also not recommended for use in children, adolescents, or young adults under 24 due to the potential risk of suicidal thoughts and behaviors.
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