Friday, July 17, 2009

Citalopram




Trade names

Citalopram.

Subgroup

Selective serotonin inhibitors reverse the seizure.

Action

Antidepressive effect usually develops within 2-4 weeks of therapy. Almost did not have, or have little ability to bind to a variety of receptors, including gistaminovye, m-and holinoretseptory adrenoceptor. Sedative effect is absent.

Mechanism of Action

Selectively inhibits the reverse neuronal capture of serotonin in the brain. In a very small extent inhibits cytochrome P450 IID6, therefore, does not interact with drugs metabolized this isoenzyme. Not affect the conductive system of the heart and blood pressure did not alter haematological indices, liver and kidney, no increase in body weight.

Pharmacokinetics

If ingestion Cmax is determined within 2-4 h. Bioavailability - 80% binding to plasma proteins - less than 80%. Changes in plasma concentration are linear. After 1-2 weeks of therapy in the plasma concentration equilibrium is established. In blood plasma Citalopram is largely unchanged. Metabolized by demethylation, deamination and oxidation. T1 / 2 was 1.5 days. Return via the kidneys and intestines. Antidepressive effect develops within 2-4 weeks. treatment.

Indications

* Depression of varying etiology and structure (in adults);
* Panic disorder with or without agoraphobia;
* Obsessive-compulsive disorder (ROC).

Contraindications

Hypersensitivity, pregnancy, lactation (the period of treatment stop breast-feeding).

Side Effects

Drowsiness, dry mouth, nausea, increased sweating, tremors, convulsive seizures, bradycardia (with initially reduced HR).

Interaction

Enhances effects sumatriptana etc. serotoninergicheskih drugs; tsimetidin increases the equilibrium concentration in the blood. If you are receiving with MAO inhibitors may hypertonic crisis (serotoninovy syndrome).

Dosing and Administration in Adults

Inside, on one occasion, at any time of day, regardless of the meal. Initial dose - 20 mg per day, maximum - 60 mg / day. Older - 20 mg daily dose, maximum - 40 mg / day. When liver failure is recommended to use the minimum dose.

Overdosage

Symptoms: drowsiness, disturbance of articulation, coma, occasionally - great convulsive seizures, increased sweating, sinus tachycardia, cyanosis, lung hyperventilation, nausea, vomiting.

Treatment: gastric lavage, maintenance of vital functions.

Cautions

Precautions: Be wary appoint persons working with potentially dangerous machinery or driving vehicles (reduced ability to focus and increased reaction time).

Do not combine with MAO inhibitors or designate within the first two weeks after their withdrawal.

With the development of manic state should stop taking.