Citalopram (Celexa)

SSRI antidepressant

Dosing

(mg/d): Depression (20), Anxiety disorders (40-60). Do not use for OCD as the high dose required could prolong QTc (FDA limits dose to 40 mg/d and – in some – 20 mg/d).

Management

Side effects: apathy, sexual dysfunction, sleep disruption, nausea, restless legs, akathisia. Warning: osteopenia in post-menopausal women. Does not alter other med levels but its own levels are raised by 2C19 inhibitors like common proton pump inhibitors (ranitidine/Zantac), and FDA limits dose to 20 mg/d in those on 2C19 inhibitors, 2C19 slow metabolizers, and the elderly. Raise dose by x1.3 if using with carbamazepine.

Escitalopram is preferable as it has fewer cardiac risks and may be a little more effective.

EMR Text