Citalopram: What you need to know!
Summary
TLDRIn 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.
Outlines
💊 Introduction to Celexa and Mental Health
Dr. Sil introduces Celexa (Citalopram), one of the most common SSRIs, widely used in treating depression. He explains his background as a junior doctor training to become a psychiatrist and his work in treating mental health disorders like schizophrenia, bipolar disorder, and depression. He emphasizes the importance of understanding medications in psychiatry and his goal of educating people about mental health, inviting viewers to join his community.
🧠 How SSRIs Work and Citalopram's Role
Dr. Sil discusses the mechanism behind SSRIs like Celexa, explaining how they block serotonin reuptake between neurons, increasing serotonin levels, which is believed to improve mood. He delves into the theory of how increased serotonin helps with neuroplasticity, thus reducing depressive symptoms. Citalopram is commonly prescribed for depression, anxiety disorders, and conditions like OCD and PMDD. Its effects vary, with some individuals feeling sedated, while others experience increased energy.
⏳ Timeframe for Celexa's Effects
Dr. Sil explains that Celexa typically starts showing effects after 2–4 weeks, with a full impact seen by 8 weeks. If no improvement occurs after that, dosage adjustments or changes in medication may be needed. He also highlights that Celexa can be combined with other medications for treating various symptoms, such as insomnia, depressive symptoms, or bipolar disorder, under a doctor's supervision.
🩺 Health Tests and Considerations Before Taking Celexa
Before starting Celexa, Dr. Sil recommends getting general health tests like heart rate, blood pressure, blood work, and an ECG to rule out other conditions that may contribute to anxiety or depression. He emphasizes the importance of addressing potential physical causes of mental health symptoms, such as thyroid issues, electrolyte imbalances, or nutritional deficiencies, which could present as anxiety or depression.
💊 Celexa's Common Side Effects
The side effects of Celexa are similar to those of other SSRIs, with common issues including gastrointestinal discomfort like nausea and diarrhea due to serotonin activity in the gut, and sexual side effects affecting both men and women. Celexa may also cause sedation or increased energy in different individuals, influencing when the medication should be taken. Dr. Sil advises patience, as most side effects diminish over time as the body adjusts.
⚠️ Managing Serious Side Effects and Dose Adjustments
Dr. Sil outlines serious side effects of Celexa, such as increased anxiety or suicidal ideation, and stresses the importance of consulting with a doctor if these arise. He suggests that side effects can often be managed with other medications or dosage adjustments. He recommends starting at a low dose and gradually increasing it to minimize side effects, and also discusses the possibility of using medications like benzodiazepines for anxiety in the short term.
💰 Celexa Dosing Tips and Saving Money
Celexa is typically taken in doses between 20–60 mg per day. Dr. Sil provides a cost-saving tip: since the price difference between 20 mg, 40 mg, and 60 mg tablets is minimal, patients can opt for higher-dose tablets and split them to save on medication costs. He also discusses tapering off Celexa to avoid SSRI discontinuation syndrome, which can cause rebound anxiety.
🔄 Drug Interactions with Celexa
Dr. Sil emphasizes the importance of avoiding certain drug interactions when taking Celexa, particularly with Monoamine Oxidase Inhibitors (MAOIs), which can lead to serotonin syndrome—a serious and potentially life-threatening condition. He describes symptoms of serotonin syndrome, such as sweating, confusion, and autonomic instability, and stresses the need for proper medical supervision when switching antidepressants.
👶 Celexa in Special Populations
Dr. Sil discusses how Celexa dosing varies for different populations. In patients with renal or liver impairment, lower doses are recommended. Elderly patients also require careful dosing due to slowed metabolic rates. He highlights the lack of definitive safety data for Celexa in pregnancy and breastfeeding, advising patients to weigh the risks with their doctor. He emphasizes the importance of monitoring mental health during pregnancy and the postpartum period due to the high risk of developing or worsening mental illness.
📺 Conclusion and Call to Action
Dr. Sil concludes by encouraging viewers to leave comments about their experiences with Celexa, both positive and negative, to help others. He expresses his commitment to answering questions and invites viewers to subscribe to his channel if they find the content helpful, thanking them for watching and wishing them a good day.
Mindmap
Keywords
💡SSRI
💡Serotonin
💡Neuroplasticity
💡Side effects
💡Depression
💡Anxiety disorders
💡Suicidal ideation
💡Tapering
💡Drug interactions
💡Pregnancy and breastfeeding
Highlights
Introduction of Celexa as a commonly used antidepressant and explanation of the speaker's role as a junior doctor specializing in psychiatry.
Explanation that Celexa is not just an antidepressant but an SSRI (Selective Serotonin Reuptake Inhibitor), focusing on its action on serotonin reuptake and neuroplasticity.
Discussion of how Celexa works: increasing serotonin in the synapse between neurons, potentially boosting neuroplasticity to reduce depressive brain circuits.
Celexa is used for a range of conditions including depression, anxiety disorders, obsessive-compulsive disorder, and premenstrual dysphoric disorder.
Variability in patient responses: some may feel sedated due to antihistaminergic effects, while others may feel more energetic.
Initial effects typically start within 2 to 4 weeks, with full effects expected by 8 weeks. If there is no effect, the dosage may need to be adjusted or the medication changed.
Combination therapy: Celexa can be combined with other medications like trazodone or bupropion, depending on the condition being treated.
Before starting Celexa, tests such as blood work and ECGs are recommended to exclude physical causes of depression or anxiety, such as thyroid issues or heart malformations.
Common side effects include gastrointestinal issues like nausea or diarrhea, as serotonin is also active in the gut.
Sexual side effects like problems with erection, ejaculation, and orgasm can occur, affecting both men and women.
Celexa is less likely to cause weight gain compared to other SSRIs, though weight gain can still happen.
The importance of starting at a low dose to mitigate side effects, which usually lessen over time as the body adjusts to the medication.
Rare but serious side effects like serotonin syndrome may occur, especially when combined with other serotonergic drugs like MAOIs.
Advice on dosing: Celexa is usually taken in one dose per day and can be broken in half to save money without affecting the medication’s effectiveness.
Considerations for special populations, such as those with renal or liver impairments, the elderly, children, and pregnant or breastfeeding women.
Recommendation to taper off Celexa slowly to avoid SSRI discontinuation syndrome, which can cause rebound anxiety.
Transcripts
satal pram brand named Celexa probably
one of the most common anti-depressants
in the world and if you want to know all
about it then you've come to the right
place hello and welcome my name is Dr
Sil I'm a junior doctor from Australia
and I'm training to become a
psychiatrist I work on Mental Health
Awards psychiatric Awards and I treat
things like schizophrenia major mood
disorders like depression bipolar
illness I also am involved in the
treatment of personality disorders I do
Psychotherapy uh so I have a very um
varied role uh which is really good um
but knowing about medications is
absolutely critical to being a good
psychiatrist and so that's why I also
make these videos cuz I'm interested in
mental health education and if that
sounds like your cup of tea you can
consider subscribing and joining the
community all right let's talk about
satala
[Music]
pram so I think we're only a minute or
two into the video and I've already made
uh a mistake I think we call satell
pramin anti-depressant and we call a lot
of things anti-depressant but really the
more accurate term for it is an SSRI
selective serotonin reuptake inhibitor
and that's because when we run studies
to see how these medications work it
looks like they block the reuptake pump
of Serotonin at those spaces between
neurons theoretically increasing the
amount of serotonin in that syapse
between neurons and thereby having an
effect that is anti-depressive and the
theory here is that it increases a
chemical called BNF brain derived
neurotrophic factor and that makes um
neuroplasticity more available to
forming less depressive circuits in the
brain we don't have to get into the all
the nitty-gritty of all the
neurochemistry and the biology of how
these things work because it's
incompletely understood but there's
still plenty that we do understand about
this medication and so that's what I
want to talk about so yeah let's talk
about why it's used the indications for
calram include depression anxiety
disorders premenstrual dysphoric
disorder obsessive compulsive disorder
panic disorder and more specific anxiety
disorders would include things like
panic disorder or agoraphobia or social
anxiety disorder as well now we spoke
about already how it works on that re
serotonin reuptake uh protein on the
neuronal membrane but it's also probably
got some antihistaminergic effects as
well which put simply means it can make
some people sedated but strangely other
people don't get sleepy at all they
actually get kind of energetic off of it
and it's hard to predict who's going to
have which response but it's important
to remember that people can have both
responses cuz it'll inform when you
should take the medication and we'll
talk about that later now how long until
it works well generally with ssris you
want to try them for at least 2 weeks
and you start at a low dose and then you
can try increasing the dose uh generally
between 2 and 4 weeks you'll start
seeing the start of its effect and
between 4 and 8 weeks you'll have its
effect if there is no effect after 8
weeks you need to consider a dose change
or a change of medications and these
decisions should be made in discussion
with your doctor now ESAT alpram can be
used in combination with other
medications depending on what the
illness is being treated some people
with insomnia might consider a Trazodone
and um and calop pram combination
sometimes it's used with metazine or
bupropion in terms of treating for
depressive symptoms sometimes it's used
in combination with mood stabilizers if
treating is suspected bipolar illness
all these things need to be decided uh
between you and your doctor and
considering the pros and cons for your
individual circumstances now tests
required prior to starting if you are a
healthy individual otherwise you don't
need to have other blood test before
trying calam I suggest everyone with the
firstep s of depression should get a
series of tests anxiety as well because
there are organic or physical health
contributions or causes for these things
so getting a set of observations with
your your your GP looking for things
like heart rate and blood pressure at
Baseline getting things like blood tests
done and an ECG these are all really
helpful things to exclude other things
that could be generating anxiety if you
have a congenital heart malformation
that causes palpitation
and you know that could theoretically
present as anxiety first time if you
have high levels of thyroid hormone
because of a uh you know hyperactive GOA
that you don't know about in your
thyroid glands well that can present as
anxiety as a first presentation so there
are physical health things that present
as anxiety electrolyte abnormalities um
you know nutritional deficits iron
folate probably vitamin B12 and vitamin
D all sorts of things can at least
contribute to anxiety and it's and and
you want to optimize your General Health
especially if there's any kind of mental
um health problem in terms of side
effects it's similar with calop pram as
it is to the other ssris selective
serotonin reuptake Inhibitors so there's
the gastrointestinal or the gut side
effects things like nausea diarrhea and
this is because serotonin the chemical
is very active in the bowel and in the
gut there are serotonin receptors
throughout and so you can get a nauseous
um response some people may even vomit
uh so that's one domain of side effects
there's also sexual side effects so
problems with erection ejaculation
orgasm uh in both men and women uh can
be seen with SSR eyes and as we said
before there's there's probably an
anti-histamine effect um and so
depending on where your antihistamine
receptors are some people might get a
sedative response to satal pram and that
will guide if you should take it in the
morning or at night so some people get
sedated uh other people people don't get
sedated at all and they'll feel super
activated and get more energy than
they've had in a long time and want to
go and do things if that's the case you
shouldn't take this medication at night
there are some more rare side effects um
that may be more common in people who
are have abnormal metabolism or you know
renal failure liver failure elderly
people um there's something called uh
well anyway we don't have to go into
syndrome of inappropriate antidiuretic
hormone but it's it's essentially a side
effect where your sodium levels can get
affected by the medication
and that can be diagnosed in a blood
test and a urine test in terms of weight
gain this is actually considered a
relatively unom common side effect from
satal pram uh ssris can have Associated
weight gain as a side effect it can be
seen uh but satal pram is considered one
of the less associated with weight gain
now if you're getting side effects what
to do well first you know start at a low
dose lower the starting dose if needed
but try to if it's not a serious side
effect and it's not causing significant
functional or quality of life issues try
to tolerate it wait they they usually
aate most side effects will get less
intense and even sometimes disappear as
your body gets used to the medication I
guess it can be considered a side effect
but uh as I was saying it can be kind of
activating and people can get energetic
and um uh kind of more Restless that can
manifest as anxiety and actually uh if
there's suicidal thinking it can worsen
suicidal ideation as there's an increase
in energy and so if that's the case um
that can be well first of all you need
to talk to your doctor about all the
side effects you're experiencing these
different side effects can be managed
with different strategies there are some
medication options for some side effects
so if there's um uh you know anxiety
associated with starting the the SSRI
you can consider a short-term use of
benzo Pines that needs to be discussed
with your doctor to see if you're an
appropriate candidate uh then there's
also things like sexual side effects can
be um treated with sanl or Viagra that's
uh done sometimes if there's insomnia
sometimes a low dose of metazine can
help which is another uh anti-depressant
but it works differently to an SSRI and
can have an additive uh anti-depressant
effect as well but it's important to
remember that side effects are generally
dose dependent so starting at a lower
dose and slowly increasing the dose can
often help with the side effects all
right right now talking about dosing so
uh the range is usually between 20 and
60 mg a day it's usually taken in one
dose and it can be either in the morning
or at night depending on if it has a
sedating effect on you or no effect on
you or an activating effect on you but
here's the hot tip uh to save money
usually the tablets come with a scored
uh tablet so you can break them in half
and the the cost difference between uh a
20 mg tablet or 40 Mig tablet and a 60
mg tablet is generally not much at all
they're usually roughly priced the exact
same so if you are on 10 mg I suggest
getting a script for 20 milligrams and
breaking them in half and you get twice
the medication for the same price and go
the same goes for um 60 Mig tablet if
you want to break it in half and have 30
Mig uh so just think about that with
your doctor and it can hopefully save
you a bit of cash now in terms of
long-term use it's considered safe in
terms of uh like habit forming or
dependency or tolerance uh it's
considered safe uh if you do want to
stop I always suggest a taper and a slow
taper at that uh just to avoid SSRI
discontinuation syndrome which is this
rebound anxiety that can happen with
people who stop um serotonergic
medications and uh you know this
textbook that I'm using to reference
this talk suggests 3 days at 50% of the
original dose and then another 3 days at
50% of that dose I would slow that even
down further talk to your doctor about
what works for you uh but but I wouldn't
I wouldn't rush it now in terms of drug
interactions there are significant and
important drug interactions to know
about um the main one is with uh
monoamine oxidase Inhibitors which is a
class of medication also used in
depression management uh things like
mide mobom and
phenoline uh the these medications are
pretty strong anti-depressants so you
and you will probably have been told
about the side effects and the risks of
changing anti-depressants if you've
started on these drugs uh but the
important thing is to make sure there's
3 weeks Gap after stopping a monoamine
oxidase inhibitor and MAOI before
starting an
SSRI uh so taking an M MAOI and an SSRI
at the same time is essentially never
well very very rarely only done by
people with significant expertise in the
area with very close monitoring uh so if
that's happening you know I'm sure
you're talking to your doctor about it
very frequently but otherwise I would I
wouldn't risk it and the reason is
because the MAOI blocks the the protein
enzyme that breaks down serotonin so if
you block the breakdown of Serotonin
plus you block the reuptake of Serotonin
using the SSRI and the MAOI then MAOI
then you've just got this huge surplus
of serotonia bathed in it and what can
happen is something called a serotonin
syndrome which makes people look I've
seen serotonin syndrome and it's very
scary you know people look sweaty they
um they have autonomic instability so
the their heart rate's through the roof
and the blood pressure going up and down
and they're sweating and the pupils are
dilated you get confusion uh and it's a
really horrible people feel extremely
nauseous uh so it's all the side effects
of Serotonin put on a thousand times uh
worse so you know it needs to be avoided
and talk to your doctor if there's
multiple serotonin acting medications
now in terms of special populations so
for people who have renal impairment or
poor kidney function uh it's usually
doesn't require a significant dose
change if it's mild or moderate if it's
severe renal impairment then you might
have to try a lower dose uh with a liver
impairment the dose will usually be
around 20 Mig and sometimes up to 40 but
rarely would it ever go up to 60 so it's
usually a lower dose range in the
elderly as well it's used at a lower
dose range just because the metabolic
rate is slowed and with children um I
won't even comment on dose ranges it has
to be done with a specialist uh
especially under the age of 12 ssris
need to be done with a with a consultant
um specialist yeah and in pregnancy it's
a risk category C which means there are
some uh animal studies that show adverse
effects but no human trials which you
know this is so frustrating but part of
the complexity of healthcare that we
just don't have the data to suggest
whether it's safe or not in pregnancy
which is really important but it's just
there's no ethical way to collect that
data so uh you have to basically weigh
up the risks uh of the medication versus
the risks of not taking any medication
and so the severity of the illness needs
to be taken into account so someone who
stops eating when they're depressed um
and becomes bedridden and suicidal
that's obviously extremely high risk and
and needs treatment um and so you have
to weigh the risks of a depressive
relapse or whatever the indication
you're taking it for the the risks of a
relapse of mental illness um versus uh
the side effects of the medication but
there have been some studies that are
not very strong studies you know that
they these are suggested that ssris can
cause some um heart defects in in
fetuses that it can affect the
circulation around the lungs and um also
in breastfeeding so some of the drug is
found in the mother's breast milk it's
really important to remember that um
pregnancy and the postpartum period
after pregnancy is a super high risk for
um mothers for developing mental illness
so the treatment you know is is really
important so I just really encourage you
guys to talk to your doctors and have
strong monitoring if if you're in that
population group all right so T pram
that's it we've done it there's nothing
else I really wanted to talk about um if
you have any questions leave them in the
comments below and I'll try and answer
as many as I can uh and if you've had an
experience on satal pram comment down
below what your experience was like
positive and negative uh it's all useful
reading for people and uh and yeah I'll
see you all in the next video but if you
find this stuff helpful and you want to
support my my Channel please consider
subscribing and liking the video other
than that sorry about that other than
that I wish you all a beautiful day and
I'll see you all in the next video bye
for now
تصفح المزيد من مقاطع الفيديو ذات الصلة
Understanding Aripiprazole: Uses, Side Effects, and More with Dr. Syl
MK 677 Only Cycle? | Everything You Need To Know About MK 677 | Ibutamoren | Nutrobal
Everything You Need to Know About Trintellix (Vortioxetine)
TAMSULOSIN (FLOMAX) - Doctor's Guide to Taking!
रोज़ Vitamin E का सिर्फ एक कैप्सूल लें, शरीर में 9 ऐसे बड़े बदलाव आएंगे की हैरान रह जाओगे
How to avoid side effects from finasteride.
5.0 / 5 (0 votes)