Sign: nausea, dizziness, drowsiness, dysarthria, heart rhythm and conduction disorders (QT interval lengthening, sinus tachycardia, nodal rhythm), increased sweating, cyanosis, tremor, amnesia, confusion, rhabdomyolysis, convulsions, coma.
Treatment: gastric lavage, symptomatic and supportive treatment, there is no specific antidote.
Sign: nausea, dizziness, drowsiness, dysarthria, sinus tachycardia, nodular rhythm, increased sweating, cyanosis, tremor, amnesia, confusion, heart rhythm and conduction disorders (QT interval prolongation), rhabdomyolysis, convulsions, coma.
Treatment: gastric lavage, symptomatic and supportive treatment, there is no specific antidote.
hypersensitivity to Citalopram or any component included in the drug,
simultaneous use with MAO inhibitors, as well as within 14 days after discontinuation of their administration, treatment with MAO inhibitors can be started no earlier than 7 days after discontinuation of Citalopram,
age of children (the effectiveness and safety of the application is not established).
With caution:
hepatic and / or renal impairment,
the presence of convulsive seizures in the history,
patients over 65 years of age,
the presence of drug dependence (incl. in history),
mania, hypomania.
hypersensitivity to citalsipam (Citalopram)MU or to any component that is part of the drug,
age of children (under 18 years),
the drug should not be used in combination with MAO inhibitors, as well as within 14 days after stopping their reception. Treatment with MAO inhibitors can be started no earlier than 7 days after discontinuation of citalsipam (Citalopram)ma.
With caution:
hepatic and / or renal impairment,
seizures in history,
advanced age.
Enhances the effect of sumatriptan and other serotonergic drugs. Does not affect the action of ethanol, lithium preparations, benzodiazepines, antipsychotics (neuroleptics), narcotic analgesics, beta-blockers, phenothiazines, tricyclic antidepressants, antihistamines and antihypertensive drugs.
To a slight extent, it inhibits cytochrome P4502D6, and therefore weakly interacts with drugs, which are metabolized with its participation.
With the simultaneous administration of MAO inhibitors, it is possible to develop a hypertensive crisis (serotonin syndrome).
Cimetidine increases the concentration in the blood and enhances the effect of Citalopram.
With simultaneous administration of warfarin, PV increases by 5%.
Enhances the effect of sumatriptan and other serotonergic drugs. Does not affect the action of ethanol, lithium preparations, benzodiazepines, antipsychotics( neuroleptics), narcotic analgesics, beta-blockers, phenothiazines, tricyclic antidepressants, antihistamines and antihypertensive drugs. To a slight extent inhibits cytochrome CYP2D6, therefore, it weakly interacts with drugs, which are metabolized with its participation. With the simultaneous administration of MAO inhibitors, it is possible to develop a hypertensive crisis (serotonin syndrome). Cimetidine increases the concentration in the blood and enhances the effect of citalsipam (Citalopram)ma. With simultaneous administration of warfarin, prothrombin time increases by 5%
From the nervous system: rarely-asthenia, drowsiness or insomnia, anxiety, tremor, restlessness, amnesia, apathy, extrapyramidal effects, mood change, aggressive behavior, depersonalisation, emotional lability, euphoria, manic and/or psychotic (including hallucinations) disorders, panic reactions, serotonin syndrome (agitation, confusion, diarrhea, hyperthermia, hyperreflexia, ataxia).
From the digestive tract: rarely - dry mouth, nausea, vomiting, hypersalivation, flatulence, diarrhea, abdominal pain, anorexia.
From the cardiovascular system: rarely-bradycardia, decreased blood pressure, orthostatic hypotension, arrhythmia.
On the part of hematopoietic organs: rarely-thrombocytopenia, bleeding.
On the side of the senses: rarely-mydriasis, Accommodation paresis, impaired taste.
Reproductive system: violation of sexual function (violation of ejaculation, decreased libido, impotence, menstrual disorders).
Allergic reactions: rash, rarely-epidermal necrolysis, rhinitis, sinusitis.
And others: rarely-hyperthermia, polyuria, mastodynia, galactorrhea, hyponatremia, violation of urination, arthralgia, myalgia, yawning, grinding of teeth, increase or decrease in body weight, dyspnea.
From the nervous system: rarely — asthenia, fatigue, drowsiness or insomnia, anxiety, tremor, restlessness, amnesia, apathy, extrapyramidal effects, mood change, aggressiveness, hallucinations, depersonalization, emotional lability, euphoria, mania, hypomania, panic behavior, paranoid reaction, psychosis, серотониновый syndrome (agitation, confusion, diarrhea, hyperthermia, hyperreflexia, ataxia, fatigue, tremor, sweating, restlessness, uncontrollable behavior).
From the digestive tract: rarely - dry mouth, nausea, vomiting, hypersalivation, flatulence, diarrhea, abdominal pain, anorexia.
From the cardiovascular system: rarely-bradycardia, decreased blood pressure, orthostatic hypotension, arrhythmia.
On the part of hematopoietic organs: rarely-thrombocytopenia, bleeding.
On the side of the senses: rarely-mydriasis, Accommodation paresis, impaired taste.
Reproductive system: violation of sexual function (violation of ejaculation, decreased libido, impotence), menstrual disorders.
Allergic reactions: rash, rarely-epidermal necrolysis, rhinitis, sinusitis.
depression of different etiology (treatment and prevention),
panic disorders (including agoraphobia),
obsessive-compulsive disorders (obsessive neurosis).
treatment of depressive diseases and prevention of relapses,
treatment of panic disorder with / or without fear of open space,
treatment of obsessive-compulsive disorder (obsessive neurosis).
Citalopram is an antidepressant belonging to the group of selective serotonin reuptake inhibitors. Having a pronounced ability to suppress serotonin reuptake, it does not have or has a very weak ability to bind to a number of receptors, including histamine, muscarin and adrenergic receptors. Citalopram inhibits cytochrome P4502D6 very little and therefore does not interact with drugs metabolized by this enzyme (the risk of side effects and toxic effects is lower).
The antidepressant effect usually develops after 2-4 weeks of treatment. Citalopram has practically no effect on the conducting system of the heart and BLOOD pressure, on hematological indicators, liver and kidney function, does not cause an increase in body weight.
Citalopram does not disrupt human cognitive functions, does not cause a sedative effect, in experimental studies, the drug did not find a teratogenic effect, effect on reproductive function and perinatal development of offspring.
Citalsipam (Citalopram)m, having a pronounced ability to suppress serotonin reuptake, does not or has a negligible ability to bind to a number of receptors, including histamine, muscarinic and adrenergic receptors. Inhibits cytochrome P4502D6 only to a small extent and therefore does not interact with drugs metabolized by this enzyme. Thus, side effects and toxic effects are manifested to a lesser extent. The antidepressant effect usually develops after 2-4 weeks of treatment. Citalsirgam (Citalopram)m practically does not affect the conducting system of the heart and BLOOD pressure, on hematological indicators, liver and kidney function, does not cause an increase in body weight. Citalsirgam (Citalopram)m does not disrupt human cognitive functions, does not cause a sedative effect. In experimental studies, the drug did not find a teratogenic effect, effect on reproductive function and perinatal development of offspring
The bioavailability of Citalopram is about 80% and is practically independent of food intake. Cmax plasma is reached by 2-4 h after administration. Binding to plasma proteins-less than 80%. In plasma is present in unchanged form. At doses of 10-60 mg / day, pharmacokinetic parameters have a linear dependence. The volume of distribution is 12 l / kg. the equilibrium concentration with a single daily dose is established by 7-14 days. Penetrates into breast milk.
Metabolized by demethylation, deamination and oxidation involving cytochrome P450 (isoenzymes CYP3A4 and CYP2C19) to form less pharmacologically active metabolites.
Tonne1/2 - 1.5 days. Excretion is carried out by the kidneys and with feces.
Patients over 65 years of age
A longer biological T is observed1/2 (1.5-3.75 days) and lower Cl values (0.08-0.3 l/min). Steady-state concentrations in elderly patients were almost twice as high as those in younger patients receiving the same dose.
Liver failure
In patients with reduced liver function, Citalopram is excreted more slowly. The biological half-life of Citalopram is almost 2-fold increased and the equilibrium plasma concentrations of Citalopram are almost 2-fold higher than in patients with normal liver function after administration of the same dose.
Renal failure
Excretion of Citalopram is slower in patients with a low to medium degree of decreased renal function with no significant effect on pharmacokinetics.
The bioavailability of citalsipam (Citalopram)ma when ingested is about 80% and practically does not depend on food intake. Cmax plasma is reached by 2-4 h after administration. Binding to plasma proteins-less than 80%. In plasma is present in unchanged form. At doses of 10-60 mg / day, pharmacokinetic parameters have a linear dependence. The volume of distribution is 12 l / kg. the equilibrium concentration with a single daily dose is established by 7-14 days. Penetrates into breast milk. Metabolized by demethylation, deamination and oxidation involving cytochrome P450 (isoenzymes CYP3A4 and CYP2C19) to form less pharmacologically active metabolites. You1/2 the drug is 1.5 days. Excretion is carried out by the kidneys and with feces.
Patients over 65 years of age. A longer biological half-life (1.5–3.75 days) and a lower clearance (0.08-0.3 l/min) are observed. Steady-state concentrations in elderly patients were almost twice as high as those in younger patients receiving the same dose.
Impaired liver function. In patients with reduced liver function, citalsipam (Citalopram)m is excreted more slowly. The biological half-life of citalsipam (Citalopram)ma is almost 2-fold increased and plasma equilibrium concentrations of citalsipam (Citalopram)ma are almost 2-fold higher than in patients with normal liver function after administration of the same dose.
Impaired renal function. Excretion of citalsipam (Citalopram)ma is slower in patients with a low to medium degree of decreased renal function with no significant effect on pharmacokinetics. Currently, the experience in the treatment of patients with severe renal insufficiency (creatinine cl <20 ml/min) is insufficient.
Cipram (Citalopram)
Citalopram
Inside. at any time of the day, regardless of the meal, once.
Depression: the recommended daily dose of Cipram (Citalopram) a is 20 mg. Depending on the individual patient's response to treatment and the severity of the disease, the dose can be increased, the maximum daily dose is 60 mg. Usually, the antidepressant effect of the drug is observed after 2-4 weeks of treatment. Antidepressant treatment should be carried out for a long time. Usually, to prevent relapse, treatment should be carried out for 6 months or even a longer period. Patients with periodic (recurrent) depression should be treated for several years to prevent the onset of later phases of the disease. In case of completion of treatment, Cipram (Citalopram) should be gradually canceled within a few weeks
Panic disorders: the recommended daily dose is 10 mg during the first week of treatment, after which the dose is increased to 20 mg/day, the maximum daily dose is 60 mg.in the treatment of panic disorder, the maximum effect of Citalopram is observed after 3 months of treatment. This effect persists throughout the maintenance treatment period.
Obsessive compulsive disorder: the recommended daily dose-20 mg Depending on the individual patient's response to treatment and the severity of the disease, the dose can be increased, the maximum daily dose-60 mg in the treatment of obsessive-compulsive disorder drug effect is manifested after 2-4 weeks of treatment, during the continuation of treatment can be observed further improvement.
In patients aged 65 years and older, the maximum daily dose does not exceed 40 mg.
Impaired renal function: Patients with slightly or moderately impaired renal function can use the drug in the usual doses. Currently, the experience in the treatment of patients with severe renal insufficiency (creatinine cl less than 20 ml/mol) is negligible.
Impaired liver function: Patients with impaired liver function should not receive more than 30 mg / day.
Inside, 1 ounce a day at any time, either while eating or on an empty stomach.
Depression. The recommended daily dose is 20 mg of citalsipam (Citalopram)ma. Depending on the individual patient's response to treatment and the severity of the disease, the dose can be increased to a maximum of 60 mg/day.
Panic disorders. It is recommended to use 10 mg citalsipam (Citalopram)ma 1 ounce a day for the first week of treatment, after which the dose is increased to 20 mg/day. Depending on the individual patient's response to treatment and the severity of the disease, the dose can be increased to a maximum of 60 mg/day.
Obsessive compulsive disorder. The recommended daily dose is 20 mg 1 ounce a day. Depending on the individual patient's response to treatment, the dose can be increased from 20 mg to a maximum of 60 mg/day.
Patients aged 65 years and older. The recommended starting dose can be increased to 40 mg/day.
Impaired renal function. Patients with slightly or moderately impaired renal function can use the drug in usual doses. Information on the treatment of citalsipam (Citalopram)in patients with severe renal impairment (creatinine cl up to 20 ml/min) is not available.
Impaired liver function. Patients with impaired liver function should be prescribed no more than 30 mg/day.
The duration of treatment. Usually, the antidepressant effect of the drug is observed after 2-4 weeks of treatment. Antidepressant treatment is symptomatic and should be carried out for a long time. Usually, to prevent relapse, treatment should be carried out for 6 months or even a longer period. In the case of patients with periodic (recurrent) depression, maintenance therapy should be carried out for several years to prevent the occurrence of later phases of the disease. In case of completion of treatment, the drug should be canceled gradually for several weeks. In the treatment of panic disorder, the maximum effect of citalsipam (Citalopram)ma is observed after 3 months of treatment and persists throughout the period of maintenance therapy. In the treatment of obsessive-compulsive disorder, the effect of the drug is manifested after 2-4 weeks of treatment, with further treatment, further improvement can be observed
