API: Citalopram hydrobromide

What Is Citalopram hydrobromide and How Does It Work?

Citalopram hydrobromide is an antidepressant that belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). The drug is highly against serotonin reuptake but has minimal effects on the reuptake of norepinephrine and dopamine.1 Although the exact mechanisms of action of SSRIs is not well understood, this class of drugs is thought to work by inhibiting the reabsorption of serotonin into the presynaptic cell. This increases the amount of serotonin left in the synaptic cleft that is then available to bind to postsynaptic receptors. Citalopram is intended to be used as treatment for depression but off-label has been used to treat other mental conditions, as well as menopausal hot flashes.2

Approved Indications

  • Depression: Citalopram hydrochloride is used to treat depression by restoring serotonin balance in the brain, and may also improve energy levels and overall feelings of well-being.
  • Off-label Uses: The drug is can also be used to treat other conditions, such as obsessive-compulsive disorder, panic disorder, and hot flashes due to menopause.

Side Effects and Drug Interactions

Common side effects in patients taking citalopram hydrobromide include3:

  • Drowsiness and fatigue
  • Insomnia
  • Nausea or upset stomach
  • Diarrhea
  • Stuffy nose, sneezing, sore throat, cough, or other cold-like symptoms
  • Dry mouth
  • Increased sweating
  • Increased urination
  • Changes in weight
  • Decreased sex drive, impotence, or difficulties achieving orgasm

Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience an allergic reaction (hives, trouble breathing, swelling of the face, lips, tongue, or throat), headache, rigid muscles, confusion, irregular heartbeats or increased heart rate, tremors, lightheadedness, hallucinations, agitation, loss of coordination, headache with chest pain and severe dizziness, fainting, slurred speech, severe weakness or unsteadiness, muscle cramps, seizures (convulsions), shallow breathing, or prolonged erection should contact their physician immediately. Patients who see a severe worsening of depression or who have suicidal thoughts should seek help as soon as possible.

Patients who are allergic to citalopram hydrobromide should not take this drug. This drug is contraindicated in patients who are currently on certain monoamine oxidase inhibitors (MAOIs) such as linezolid or intravenous methylene blue, and in patients taking pimozide. Patients who previously took MAOIs should have a two-week washout period before starting this drug. Patients who are pregnant, breastfeeding, or planning to become pregnant should notify their physicians before starting this drug.   

Latest News and Research

Citalopram was first synthesized in 1972 and released in 1989 as a method of treating anxiety-based depression. The drug is a common treatment for depression, but researchers are also studying other conditions that may benefit from citalopram treatment. A study published in 2010 reported on the anti-arthritis properties of the drug in two model systems: a mouse model of collagen-induced arthritis and an ex vivo human model of rheumatoid arthritis.4 The results showed that citalopram (as well as fluoxetine) halted the progression of arthritis in the mouse model and suppressed inflammatory cytokine production in the human arthritic tissue. Citalopram, as well as other similar drugs, may be provide much relief in patients suffering from arthritis.

Other studies focus on how to optimize the efficiency of citalopram. For example, one group found that combination therapy of citalopram with omega-3 fatty acids was more effective than citalopram alone in alleviating symptoms of major depressive disorder.5 Other studies have shown citalopram to be effective at treating panic disorders, obsessive-compulsive disorders, eating orders such as anorexia, bulimia, and binge-eating.6

Because of its widespread use, citalopram is also under study in terms of its safety profile. Recent studies have shown that high dosages of citalopram can cause electrocardiographic abnormalities. There is a distinct dose-effect relationship with QT prolongation across a broad range of citalopram doses. Pharmacists and physicians should use caution when prescribing high doses of citalopram or if the patient has other risk factors for QT effects.7 Escitalopram also appears to be seems to be less toxic than citalopram after an acute overdose, with side effects of citalopram including seizures and tremors, in addition to cardiac toxicity.8

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Show 8 footnotes

  1. “Celexa (citalopram hydrobromide) Tablets/Oral Solution,” October 2008, http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=9121
  2. “Celexa,” 2016, http://www.rxlist.com/celexa-drug/consumer-uses.htm
  3. “Celexa,” Aril 2, 2015, http://www.rxlist.com/celexa-side-effects-drug-center.htm
  4. “Fluoxetine and citalopram exhibit potent anti-inflammatory activity in human and murine models of rheumatoid arthritis and inhibit toll-like receptors,” January 7, 2010, http://onlinelibrary.wiley.com/doi/10.1002/art.27304/full
  5. “Omega-3 Fatty Acid Augmentation of Citalopram Treatment for Patients with Major Depressive Disorder,” February 2012, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375825/
  6. “Citalopram,” http://www.chm.bris.ac.uk/motm/citalopram/citalopramh.htm
  7. “Citalopram and cardiac toxicity,” April 2013, http://link.springer.com/article/10.1007/s00228-012-1408-1
  8. “Comparison of Toxicity of Acute Overdoses with Citalopram and Escitalopram,” July 2010, http://www.sciencedirect.com/science/article/pii/S0736467908006677