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CitalopramAka: Celexa, Escitalopram, Lexapro

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  1. Mechanism
    1. Selective Serotonin Reuptake Inhibitor (SSRI)
    2. Minimal effects on other neurotransmitters
  2. Pharmacokinetics
    1. Half-life: 20 hours
  3. Indications
    1. Major Depression
  4. Preparations
    1. Citalopram (Celexa)
      1. Tablets: 10, 20 (scored), 40 (scored)
      2. Oral Solution: 10 mg/5 ml
    2. Escitalopram (Lexapro)
      1. Active isomer of racemic citalopram
      2. Tablets: 5, 10 (scored), 20 mg (scored)
  5. Dosing
    1. Citalopram (Celexa)
      1. Starting dose: 20 mg PO qd
      2. Most effective dose: 40 mg PO qd
      3. Maximum Dose: 60 mg (FDA approved max dose is 40 mg)
    2. Escitalopram (Lexapro)
      1. Starting Dose: 10 mg qd (equivalent to 40 mg Celexa)
      2. Higher dose at 20 mg is not more effective than 10 mg
  6. Adverse Effects
    1. No increased weight gain
    2. Midway on spectrum between Anxiolytic and anxiogenic
      1. Similar to Zoloft on this spectrum
      2. Well tolerated
    3. Nausea
      1. May occur initially but is transient
      2. Consider decreasing dose to 10 mg initially
    4. Less Sexual Dysfunction than Prozac, Zoloft, Paxil
      1. Sexual dysfunction in 10-15% of cases
      2. Similar to Luvox and Effexor in terms of this effect
      3. See Antidepressant Induced Sexual Dysfunction
  7. Drug Interactions
    1. Minimal Cytochrome P450 inhibition
    2. No Clinically Significant drug interactions
      1. May be best SSRI for patients on multiple medications
  8. Resources
    1. Celexa Website (Forest Pharmaceuticals)
      1. http://www.celexa.com

Citalopram (C0008845)

Definition (MSH)A furancarbonitrile that is one of the SEROTONIN UPTAKE INHIBITORS used as an antidepressant. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia in preference to tricyclic antidepressants, which aggravate this condition.
Definition (CSP)selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects; effective in reducing ethanol uptake in alcoholics.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD015283
EnglishCitalopram, CITALOPRAM PREPARATION, Cytalopram
Spanishcitalopram
Parent ConceptsPropylamines (C0033504), Amines (C0002508), Antidepressive Agents (C0003289), Serotonin Uptake Inhibitors (C0162758), Benzofurans (C0005068), Nitriles (C0028131), [CN609] ANTIDEPRESSANTS, OTHER (C0973506), Selective serotonin re-uptake inhibitor (C0360105), Drug allergen (C1320237)
SourcesAOD, CSP, LNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Celexa (C0719199)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishCelexa
SourcesCSP, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Escitalopram (C1099456)

Definition (NCI)The active S-stereoisomer of the selective serotonin reuptake inhibitor (SSRI) citalopram with antidepressant, anti-obsessive-compulsive and antibulimic properties. Escitalopram inhibits the reuptake of the neurotransmitter serotonin (5-HT) at the serotonin reuptake pump of the neuronal membrane of the presynaptic cell, thereby increasing levels of 5-HT within the synaptic cleft and enhancing the actions of serotonin on 5HT1A autoreceptors. Unlike other SSRIs, escitalopram appears to not only bind to a primary high-affinity site on the serotonin transporter protein but also to a secondary lower-affinity allosteric site that is considered to stabilize and prolong drug binding.
Definition (MSH)S-enantiomer of citalopram.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD015283
EnglishEscitalopram, ESCITALOPRAM PREPARATION
Spanishescitalopram
Parent ConceptsAntidepressive Agents (C0003289), [CN609] ANTIDEPRESSANTS, OTHER (C0973506), Unclassified Ingredients (C1372954), Selective serotonin re-uptake inhibitor (C0360105), Anti-Anxiety Agents (C0040616)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Lexapro (C1170371)

Definition (MSH)Trade name of escitalopram, the active S-enantiomer of the racemic citalopram.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD015283
EnglishLexapro
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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