Citalopram: What you need to know!

Summary

In this video, Dr. Sil, a junior psychiatrist from Australia, explains Celexa (Citalopram), a widely used SSRI antidepressant. He covers its mechanisms, uses for various mental health disorders like depression and anxiety, and potential side effects. Dr. Sil also discusses how it affects serotonin levels, dosage recommendations, and safety concerns for different populations, including pregnant women. He emphasizes the importance of doctor-patient discussions when considering medication, managing side effects, and combining treatments. The video is an educational resource for those seeking to understand Celexa and mental health treatments.

Takeaways

• 😀 Celexa, a common antidepressant, is classified as an SSRI (Selective Serotonin Reuptake Inhibitor) that increases serotonin in the brain, helping with conditions like depression and anxiety.
• 💊 SSRIs, including Celexa, may take 2-4 weeks to show effects, with full results typically seen in 4-8 weeks. If ineffective after 8 weeks, dosage or medication changes may be needed.
• 😴 Celexa has antihistaminergic effects, meaning it can make some people feel sedated, while others may feel more energized. These varying effects guide whether it should be taken in the morning or evening.
• 🧠 The medication is used for treating various disorders like depression, anxiety, OCD, panic disorders, and premenstrual dysphoric disorder. It can also be combined with other drugs based on individual needs.
• ⚕️ Before starting Celexa, it's recommended to get blood tests, ECGs, and other health checks to rule out physical conditions that might cause anxiety or depression-like symptoms.
• 🤢 Common side effects include nausea, diarrhea, and sexual dysfunction, with the potential for less frequent effects like sedation or activation. These side effects often reduce over time.
• 💡 Celexa’s potential to cause energy boosts can increase anxiety and even suicidal thoughts in some individuals, making close monitoring essential, especially during the initial stages.
• 🧬 For long-term users, Celexa is generally safe and not habit-forming. However, stopping the medication should be done gradually to avoid SSRI discontinuation syndrome.
• 👶 Celexa is a category C drug for pregnancy, meaning the risks are uncertain, and it may affect the fetus. Decisions around use during pregnancy should balance the severity of the illness with medication risks.
• 🛑 Celexa should not be combined with MAOIs (another antidepressant class) without expert supervision due to the high risk of serotonin syndrome, a potentially dangerous condition.

Q & A

What is Celexa (Citalopram) and what type of medication is it?

Celexa, or Citalopram, is a selective serotonin reuptake inhibitor (SSRI), commonly used as an antidepressant. It works by blocking the reuptake of serotonin in the brain, theoretically increasing serotonin levels and potentially improving mood.

How does Citalopram help in treating depression?

Citalopram increases serotonin levels in the synapses between neurons, which is believed to enhance neuroplasticity and form new, less depressive circuits in the brain. This mechanism contributes to its antidepressant effects.

What conditions besides depression can Citalopram be used to treat?

Citalopram is used to treat anxiety disorders, premenstrual dysphoric disorder, obsessive-compulsive disorder (OCD), panic disorder, and specific anxiety disorders like social anxiety and agoraphobia.

How long does it take for Citalopram to start working?

Citalopram typically starts showing effects within 2 to 4 weeks. Full effects can take 4 to 8 weeks. If no improvement is seen after 8 weeks, dose adjustments or medication changes may be considered.

What are common side effects associated with Citalopram?

Common side effects include gastrointestinal issues like nausea and diarrhea, sexual dysfunction, and sedation or increased energy, depending on the individual. These side effects may improve over time.

What should be done if side effects become problematic?

If side effects are tolerable, they may diminish over time. Lowering the dose can help. However, if side effects are serious or affect quality of life, it's important to consult a doctor to consider dose adjustments or switching medications.

Is weight gain a common side effect of Citalopram?

Weight gain is considered an uncommon side effect of Citalopram compared to other SSRIs, although it can occur in some individuals.

How should Citalopram be tapered off to avoid withdrawal symptoms?

Citalopram should be tapered off slowly, ideally under medical supervision, to avoid SSRI discontinuation syndrome. A typical taper might involve reducing the dose by 50% every few days, though this process can be extended based on individual needs.

What is the risk of serotonin syndrome with Citalopram?

Serotonin syndrome can occur if Citalopram is taken alongside other serotonergic medications, such as MAOIs. It results in symptoms like sweating, rapid heart rate, confusion, and autonomic instability. This combination should generally be avoided.

Is Citalopram safe to use during pregnancy or breastfeeding?

Citalopram is classified as a risk category C drug during pregnancy, meaning animal studies have shown adverse effects, but human trials are lacking. The decision to use it should weigh the risks of untreated depression against potential medication risks. Some Citalopram may be present in breast milk.