Citalopram is indicated for:

• Major depressive disorder
• Panic disorder

Citalopram is a bicyclic phthalane derivative and acts as a selective serotonin reuptake inhibitor (SSRI). It has little or no effect on the reuptake of noradrenaline, dopamine, and GABA. Its antidepressant effect is due to the inhibition of serotonin reuptake. It shows minimal or no affinity for 5-HT₁A, 5-HT₂A, D₁ and D₂ receptors, α₁, α₂ β-adrenergic, histamine H₁, muscarinic, cholinergic, benzodiazepine, and opioid receptors.

Depressive illness:

• Adult: 20 mg daily as a single dose in the morning or evening increased if necessary to max. 60 mg daily
• Elderly: Max 40 mg daily.
• Child: Not recommended.

Panic disorder:

• Adult: Initially 10 mg daily increased to 20 mg after 7 days, usual dose 20–30 mg daily; max. 60 mg daily
• Elderly: Max 40 mg daily
• Child: Not recommended.

Citalopram should not be used concurrently with MAO inhibitors, serotonin agonists, neuroleptics, cimetidine, alcohol, ketoconazole, itraconazole, and macrolide antibiotics.

Citalopram should not be used in patients experiencing a manic episode.

Palpitations, postural hypotension, cough, yawning, confusion, impaired concentration, amnesia, migraine, taste disturbance, increased salivation, rhinitis, tinnitus, and urinary disorders may occur.

Pregnancy: Adequate and well-controlled studies in pregnant women are limited. Therefore, Citalopram should be used during pregnancy only if the expected benefit outweighs the potential risk to the fetus.

Lactation: Citalopram is excreted into breast milk. The decision to continue breastfeeding or discontinue the drug should consider the potential risk to the infant and the benefit to the mother.

Citalopram should be used with caution in patients with epilepsy, those undergoing electroconvulsive therapy, history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, bleeding disorders, hepatic or renal impairment, pregnancy, and breastfeeding.

Doses up to 2000 mg have been taken without significant alteration in cardiovascular parameters. However, respiratory depression and convulsions may occur.

SSRIs & related anti-depressant drugs

Store below 30°C, away from light and moisture. Keep out of reach of children.