Citalopram characteristics

SSRIs are widely used for treatment of depression, as well as, for example, panic disorders and obsessive—compulsive disorder. These dmgs are well recognized as clinically effective antidepressants having an improved side-effect profile as compared to the TCAs and irreversible MAO inhibitors. Indeed, these dmgs lack the anticholinergic, cardiovascular, and sedative effects characteristic of TCAs. Their main adverse effects include nervousness /anxiety, nausea, diarrhea or constipation, insomnia, tremor, dizziness, headache, and sexual dysfunction. The most commonly prescribed SSRIs for depression are fluoxetine (31), fluvoxamine (32), sertraline (52), citalopram (53), and paroxetine (54). SSRIs together represent about one-fifth of total worldwide antidepressant unit sales. 

The major distinguishing characteristic among the SSRIs is CYP enzyme inhibition. Fluvoxamine, fluoxetine, and paroxetine produce substantial inhibition of one or more CYP enzymes, whereas citalopram and sertraline do not (Table 7-29). In fact, fluvoxamine, fluoxetine, and paroxetine have all caused fatal drug-drug interactions via such CYP enzyme inhibition (339, 496, 497). 

These symptoms, particularly dizziness, are characteristic of SSRI withdrawal, and suggest that citalopram, like other SSRIs, can cause a withdrawal syndrome in some patients, despite slow tapering of the dose. 

Cipramil (Citalopram hydrobromide). Lundbeck Ltd. UK Summary of product characteristics, January 2007,... 

Recently citalopram (84) was announced as a potent specific potentiator of 5-HT, being 5-10 times as active as chlorimipramine and active both in vivo and in vitro, probably due to inhibition of 5-HT uptake. It does not possess the NA potentiating, anticholinergic, and antihistaminic properties characteristic of the tricyclics [236-238]. The compound is in an early stage of phase I clinical studies [239]. 

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