Rhyme Of The Ancient Wanderer (Support for Dysthymia, BPD, and Depression)


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Information on the medication.

GENERIC NAME: citalopram

DRUG CLASS AND MECHANISM: Citalopram is an antidepressant medication that affects neurotransmitters, the chemical transmitters within the brain. Neurotransmitters manufactured and released by nerves attach to adjacent nerves and alter their activities. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Such uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves. The reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Citalopram was approved by the FDA in July 1998.



PREPARATIONS: Tablets (oval): 20mg, 40mg.

STORAGE: Tablets should be kept at room temperature, 15 to 30C (59 to 86F).

PRESCRIBED FOR: Citalopram is used for the management of depression. It also has been tested in persons with obsessive- compulsive disorders and panic disorders.

DOSING: Citalopram is given as a single daily dose, usually in the morning. As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often adjusted slowly upwards to find the most effective dose. Elderly patients, debilitated persons, and patients with certain kidney or liver diseases may need lower doses.

DRUG INTERACTIONS: All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants,for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. This same type of interaction also may occur with selegiline (Eldepryl), fenfluramine (Pondimin), and dexfenfluramine (Redux). Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI.

PREGNANCY: There are no adequate studies of citalopram in pregnant women.

NURSING MOTHERS: It is not known if citalopram is secreted in breast milk.

SIDE EFFECTS: The most commonly-noted side effects associated with citalopram are nausea, vomiting, excessive sweating, headache, tremor, and inability to sleep. Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Some patients may experience withdrawal reactions upon stopping some SSRIs such as paroxetine, and such symptoms also may occur with citalopram. Symptoms of withdrawal include dizziness, tingling sensations , tiredness, vivid dreams, irritability or poor mood.

Less Common Side Effects
Abdominal pain;
change in sense of taste;
increased sweating;
increased yawning;
loss of appetite;
pain in muscles or joints;
stuffy or runny nose;
burning or prickly feelings on skin;
tooth grinding;
trembling or shaking;
unusual increase or decrease in weight;
unusual tiredness or weakness;
watering of mouth;

More Common
Decrease in sexual desire or ability;


Less Common
blurred vision;
increase in frequency of urination or amount of urine produced;
lack of emotion;
loss of memory;
menstrual changes;
skin rash or itching;
trouble in breathing;


Bleeding gums;
breast tenderness or enlargement or unusual secretion of milk (in females);
dizziness or fainting;
irregular heartbeat;
low blood sodium (confusion, convulsions ,
dryness of mouth,
increased thirst, lack of energy);
mood or mental changes;
nose bleed;
painful urination;
purple or red spots on skin;
sore throat,
fever, and chills;
red or irritated eyes;
burning, or peeling of skin;
trouble in holding or releasing urine;
unusual or sudden body or facial movements or postures;
serotonin syndrome
- agitation,
- confusion,
- diarrhea,
- fever,
- overactive reflexes,
- poor coordination,
- restlessness,
- shivering,
- sweating,
- talking or acting with excitement you cannot control,
- trembling or shaking,
- twitching

Withdrawal Side Effects - Notify Doctor
trembling or shaking;


Overdose Effects - Notify Doctor

More Common:
fast heartbeat;
trembling or shaking;

Bluish colored skin or lips;
convulsions (seizures);
deep or fast breathing with dizziness;
general feeling of discomfort or illness;
loss of memory;
muscle pain;
slow or irregular heartbeat;

This information is not intended to replace "traditional" mental health therapy. If you have questions or concerns about your physical and/or mental health ... contact your family physician and/or mental health professional in your area.