Generic Name: Citalopram Hydrobromide
Class: Selective Serotonin-reuptake Inhibitors
VA Class: CN609
Chemical Name: 1-[3-(Dimethylamino)-propyl]-1-(p-fluorophenyl)-5-phthalancarbonitrile
Molecular Formula: C20H21FN2O
CAS Number: 59729-33-8
Antidepressants increased risk of suicidal thinking and behavior (suicidality) compared with placebo in children, adolescents, and young adults (18–24 years of age) with major depressive disorder and other psychiatric disorders; balance this risk with clinical need.370 371 399 Citalopram is not approved for use in pediatric patients.399 (See Pediatric Use under Cautions.)
Appropriately monitor and closely observe all patients who are started on citalopram therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process.370 371 376 399 (See Worsening of Depression and Suicidality Risk under Cautions.)
Antidepressant; selective serotonin-reuptake inhibitor (SSRI).1
Uses for Celexa
Major Depressive Disorder
Manufacturers state efficacy in hospital settings not established.1 399 However, efficacy has been demonstrated in hospitalized patients with depression, including severe depression,124 162 in several studies.62 69 99 120 121 122 123 124 125 126 162
APA states that effectiveness of antidepressants is generally comparable between and within classes of medications, including SSRIs, SNRIs, TCAs, MAO inhibitors, and other antidepressants (e.g., bupropion, mirtazapine, trazodone).a Choose antidepressant based mainly on the following factors: patient preference; nature of prior response to medication; safety, tolerability, and anticipated adverse effects; concurrent psychiatric and medical conditions; specific properties of the medication (e.g., half-life, actions on CYP isoenzymes, other drug interactions); and cost.a For most patients, an SSRI, SNRI, mirtazapine, or bupropion is considered optimal.a Consult APA’s Practice Guidelines for the Treatment of Patients with Major Depressive Disorder for additional information.a
Premenstrual Dysphoric Disorder
May be less effective than some other SSRIs (e.g., paroxetine).273
Posttraumatic Stress Disorder
Celexa Dosage and Administration
Allow at least 2 weeks to elapse between discontinuance of an MAO inhibitor intended to treat psychiatric disorders and initiation of citalopram, and vice versa.399 (See Contraindications and Serotonin Syndrome under Cautions and also see Specific Drugs under Interactions.)
Monitor for possible worsening of depression, suicidality, or unusual changes in behavior, especially at the beginning of therapy or during periods of dosage adjustments.370 371 376 399 (See Worsening of Depression and Suicidality Risk under Cautions.)
Correct hypokalemia and hypomagnesemia, if present, prior to initiating citalopram therapy; periodically monitor electrolytes during therapy as needed.399 416 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Avoid abrupt discontinuance.13 14 17 399 Taper dosage gradually and monitor for withdrawal symptoms.13 14 17 399 407 If intolerable symptoms occur following dosage reduction or discontinuance, consider reinstituting previously prescribed dosage, then resume more gradual dosage reductions.399 (See Withdrawal of Therapy under Cautions.)
Administer orally once daily (morning or evening) without regard to meals.1
Available as citalopram hydrobromide; dosages expressed in terms of citalopram.1
Major Depressive Disorder
Recommended initial dosage is 20 mg once daily, with an increase to a maximum dosage of 40 mg once daily at an interval of not <1 week.399 424 Although prescribing information previously stated that certain patients may require 60 mg daily, dosages >40 mg once daily no longer are recommended because of risk of QT-interval prolongation and because they provide no additional therapeutic benefit.399 416 417 424 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Maintenance dosages of 40–60 mg daily have been used;21 172 173 174 183 however, dosages >40 mg once daily no longer recommended due to risk of QT-interval prolongation.399 416 417 424 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Usual initial dosage: 10 mg daily.174 Increase dosage after ≥1 week in 10- or 20-mg increments up to a dosage of 20–40 mg daily, depending on individual patient response and tolerability.28 29 174 288 289
Usual maintenance dosage: 20–30 mg daily.28 29 289 Dosages >40 mg once daily no longer recommended due to risk of QT-interval prolongation.399 416 417 424 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Major Depressive Disorder
Major Depressive Disorder
No dosage adjustment necessary in patients with mild to moderate renal impairment.1 Dosage adjustment may not be necessary in patients with severe renal impairment, but caution is recommended.88 399 (See Elimination: Special Populations, under Pharmacokinetics.)
Poor CYP2C19 Metabolizers or Patients Receiving CYP2C19 Inhibitors
Cautions for Celexa
Citalopram is contraindicated in patients who are currently receiving or have recently (i.e., within 2 weeks) received therapy with an MAO inhibitor intended to treat psychiatric disorders.399 Conversely, MAO inhibitors intended to treat psychiatric disorders are contraindicated within 2 weeks of citalopram discontinuance.399 (See Serotonin Syndrome under Cautions and also see Specific Drugs under Interactions.)
Initiation of citalopram is contraindicated in patients receiving MAO inhibitors such as linezolid or IV methylene blue.399 (See Specific Drugs under Interactions.)
Concurrent pimozide therapy.1 (See Interactions.)
Worsening of Depression and Suicidality Risk
Possible worsening of depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior in both adult and pediatric patients with major depressive disorder, whether or not they are taking antidepressants; may persist until clinically important remission occurs.370 371 376 399 However, suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide.370 371 376
Appropriately monitor and closely observe patients receiving citalopram for any reason, particularly during initiation of therapy (i.e., the first few months) and during periods of dosage adjustments.370 371 376 399 (See Boxed Warning and also see Pediatric Use under Cautions.)
Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania may be precursors to emerging suicidality.370 376 399 Consider changing or discontinuing therapy in patients whose depression is persistently worse or in those with emerging suicidality or symptoms that might be precursors to worsening depression or suicidality, particularly if severe, abrupt in onset, or not part of patient’s presenting symptoms.370 371 376 399 If decision is made to discontinue therapy, taper citalopram dosage as rapidly as is feasible but consider risks of abrupt discontinuance.370 399 (See General under Dosage and Administration.)
Possible anaphylaxis, allergic reactions, and angioedema.1
If hypersensitivity reaction occurs, discontinue immediately and institute appropriate therapy as indicated.1
Other Warnings and Precautions
QT-interval Prolongation and Torsades de Pointes
Do not use citalopram dosages >40 mg daily.399 416 417 424 Use not recommended in patients with congenital long QT syndrome, bradycardia, hypokalemia or hypomagnesemia, recent AMI, or uncompensated heart failure.399 424 Do not use in patients receiving other drugs known to prolong the QTc interval.399 424 (See Interactions.)
Maximum dosage of 20 mg daily in patients who are poor metabolizers of CYP2C19 and in patients receiving a CYP2C19 inhibitor, patients with hepatic impairment, and in patients >60 years of age since higher citalopram exposures increase risk of QT-interval prolongation and torsades de pointes.399 424
In patients at risk for clinically important electrolyte disturbances, obtain baseline and periodic serum potassium and magnesium measurements.399 424 Correct hypokalemia and/or hypomagnesemia before citalopram administration because of increased risk of QTc-interval prolongation and arrhythmias.399 416 424 ECG monitoring recommended in patients in whom citalopram is not recommended but considered essential (e.g., patients with cardiac conditions mentioned above, those receiving other drugs known to prolong the QTc interval).399 424
Discontinue citalopram in patients with persistent QTc measurements >500 msec.399 424 If patient experiences symptoms indicating cardiac arrhythmias (e.g., dizziness, palpitations, syncope), initiate further evaluation, including cardiac monitoring.399 424
Potentially life-threatening serotonin syndrome reported with SSRIs and SNRIs alone, but particularly during concurrent therapy with other serotonergic drugs (e.g., 5-HT1 receptor agonists [“triptans”], TCAs, buspirone, fentanyl, lithium, tramadol, tryptophan, St. John's wort [Hypericum perforatum]) and with drugs that impair the metabolism of serotonin (particularly MAO inhibitors, both those used to treat psychiatric disorders and others, such as linezolid and methylene blue).253 316 317 386 399 400 408 (See Interactions.)
Symptoms of serotonin syndrome may include mental status changes (e.g., agitation, hallucinations, delirium, coma), autonomic instability (e.g., tachycardia, labile BP, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, and/or GI symptoms (e.g., nausea, vomiting, diarrhea).316 317 386 399 400 408
Citalopram is contraindicated in patients who are currently receiving or have recently (i.e., within 2 weeks) received therapy with MAO inhibitors intended to treat psychiatric disorders.399 Do not initiate citalopram in patients treated with other MAO inhibitors such as linezolid or IV methylene blue.399 (See Specific Drugs under Interactions.)
If concurrent therapy with other serotonergic drugs is clinically warranted, advise patient of potentially increased risk for serotonin syndrome, particularly during initiation of therapy and dosage increases.399
Monitor patients receiving citalopram for the development of serotonin syndrome.399 If manifestations occur, immediately discontinue citalopram and any concurrently administered serotonergic agents and initiate supportive and symptomatic treatment.399
Pupillary dilation (mydriasis) occurs with many antidepressants, including citalopram, and may trigger an acute attack of angle-closure glaucoma (narrow-angle glaucoma) in patients with anatomically narrow angles who do not have a patent iridectomy.399 (See Advice to Patients.)
Withdrawal of Therapy
Withdrawal effects (e.g., dysphoric mood, irritability, agitation, dizziness, sensory disturbances [e.g., paresthesias, such as electric shock sensations], anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania) reported following discontinuance of serotonergic antidepressants, particularly when discontinuance was abrupt.17 212 218 219 220 221 223 224 225 226 227 228 229 230 231 232 233 234 235 399 Events generally self-limiting, but serious cases reported.17 205 225 229 230 232 399
Possible increased risk of bleeding with SSRIs, including citalopram, and SNRIs; events ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.54 55 205 283 284 285 287 377 378 399 Concomitant use of aspirin, NSAIAs, warfarin, or other anticoagulants may increase risk.54 55 377 399 (See Drugs Affecting Hemostasis under Interactions and also see Advice to Patients.)
Possible hyponatremia during treatment with SSRIs, including citalopram, and SNRIs; in many cases, hyponatremia appears to be due to SIADH.8 9 206 207 208 344 363 399 Increased risk in patients who are volume depleted, elderly, or taking diuretics.201 202 203 204 205 208 209 210 344 363 399 Initiate appropriate medical intervention and consider drug discontinuance in patients with symptomatic hyponatremia.399
Activation of Mania/Hypomania
Risk of seizures not systematically evaluated; use with caution in patients with a history of seizure disorder.1
Citalopram did not impair intellectual function or psychomotor performance in healthy individuals.399 However, any psychoactive drug may impair judgment, thinking, or motor skills.399 (See Advice to Patients.)
Limited experience with certain concurrent systemic diseases.399 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Prescribing and Dispensing Precautions
Ensure accuracy of prescription; similarity in spelling of Celexa (citalopram hydrobromide), Celebrex (celecoxib), and Cerebyx (fosphenytoin sodium) may result in errors.346
Electroconvulsive Therapy (ECT)
Effects of concomitant use with ECT have not been systematically evaluated.1
Possible complications, sometimes severe and requiring prolonged hospitalization, respiratory support, enteral nutrition, and other forms of supportive care, reported in neonates exposed to citalopram, other SSRIs, or SNRIs late in the third trimester; may arise immediately upon delivery.212 213 380 381 382 383 399 (See General under Dosage and Administration.)
Conflicting findings from available studies evaluating possible risk of persistent pulmonary hypertension of the newborn (PPHN) following in utero exposure to SSRIs; currently unclear whether SSRI use during pregnancy can cause PPHN.399 600 601 602 603 604 605 606 610
Effect on labor and delivery unknown.399
Safety and efficacy not established in children <18 years of age.1 Results of 2 placebo-controlled trials in children and adolescents with major depressive disorder did not support a claim of efficacy for use of citalopram in pediatric patients with this condition.1 379
FDA warns that a greater risk of suicidal thinking or behavior (suicidality) occurred during the first few months of antidepressant treatment compared with placebo in children and adolescents with major depressive disorder, obsessive-compulsive disorder (OCD), or other psychiatric disorders based on pooled analyses of 24 short-term, placebo-controlled trials of 9 antidepressant drugs (SSRIs and others).370 371 However, a more recent meta-analysis of 27 placebo-controlled trials of 9 antidepressants (SSRIs and others) in patients <19 years of age with major depressive disorder, OCD, or non-OCD anxiety disorders suggests that the benefits of antidepressant therapy in treating these conditions may outweigh the risks of suicidal behavior or suicidal ideation.398 No suicides occurred in these pediatric trials.370 398 399
Carefully consider these findings when assessing potential benefits and risks of citalopram in a child or adolescent for any clinical use.1 370 371 376 398 399 (See Suicidality in the Boxed Warning and also see Worsening of Depression and Suicidality Risk under Cautions.)
Decreased appetite and weight loss observed with use of SSRIs; monitor weight and growth regularly in children and adolescents treated with long-term citalopram therapy.399
No substantial differences in safety and efficacy relative to younger adults.399
Higher citalopram exposures may increase risk of QT-interval prolongation and torsades de pointes.83 85 399 424 (See Geriatric Patients under Dosage and Administration and also see Special Populations under Pharmacokinetics.)
Clinically important hyponatremia reported in geriatric patients, who may be at increased risk for this adverse effect.201 202 203 204 205 208 209 210 344 363 399 Some clinicians recommend periodic monitoring (especially during the first several months) of serum sodium concentrations in geriatric patients receiving SSRIs.207 208 209 344 348 349 (See Hyponatremia/SIADH under Cautions.)
In pooled data analyses, a reduced risk of suicidality was observed in adults ≥65 years of age with antidepressant therapy compared with placebo.370 371 399 (See Boxed Warning and also see Worsening of Depression and Suicidality Risk under Cautions.)
Higher citalopram exposures may increase risk of QT-interval prolongation and torsades de pointes.1 4 399 424 Use with caution.399 424 (See Hepatic Impairment under Dosage and Administration and also see Elimination: Special Populations, under Pharmacokinetics.)
Common Adverse Effects
Nausea, dry mouth, insomnia, sweating, sexual dysfunction (ejaculatory disorder, impotence, decreased libido), tremor, diarrhea, somnolence, dyspepsia, fatigue, upper respiratory tract infection, rhinitis.1
Interactions for Celexa
Extensively metabolized in liver, principally by CYP2C19 and 3A4.278 399 Does not inhibit CYP2C9, 2E1, or 3A4 in vitro and exhibits only weak inhibition against CYP1A2, CYP2D6, and CYP2C19.1 2 3 170 278
Drugs Affecting Hepatic Microsomal Enzymes
Inhibitors of 3A4: Clinically important pharmacokinetic interaction unlikely.399
Drugs Metabolized by Hepatic Microsomal Enzymes
Substrates of CYP1A2, CYP2D6, and CYP2C19: Citalopram expected to have little in vivo effect on substrate metabolism; however, clinical importance unknown.1
Drugs that Prolong the QT Interval
Citalopram use not recommended in patients concurrently receiving other drugs known to prolong the QTc interval.399 424 If such use considered essential, ECG monitoring recommended.399 424 (See QT-interval Prolongation and Torsades de Pointes under Cautions.)
Drugs Affecting Hemostasis
Drugs Associated with Serotonin Syndrome
Potentially life-threatening serotonin syndrome with other serotonergic drugs.205 291 292 293 294 295 296 297 312 314 315 316 317 386 399 If concomitant use of other serotonergic drugs with citalopram is clinically warranted, advise patients of the increased risk for serotonin syndrome, particularly during treatment initiation and dosage increases.399
If serotonin syndrome occurs, immediately discontinue citalopram and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment.399 (See Serotonin Syndrome under Cautions.)
Concomitant use not recommended1
Antiarrhythmic agents, class IA (e.g., quinidine, procainamide) and class III (e.g., amiodarone, sotalol)
Antidepressants, other SSRIs (e.g., escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) or SNRIs (e.g., desvenlafaxine, duloxetine, milnacipran, venlafaxine)
Potentially life-threatening serotonin syndrome399
If concomitant use clinically warranted, advise patients of the increased risk for serotonin syndrome, particularly during treatment initiation and dosage increases399
If serotonin syndrome occurs, immediately discontinue citalopram, the SSRI or SNRI, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Antidepressants, tricyclics (TCAs) (e.g., desipramine, imipramine)
Potentially life-threatening serotonin syndrome399
Use with caution1
If concomitant use clinically warranted, advise patients of the increased risk for serotonin syndrome, particularly during treatment initiation and dosage increases399
If serotonin syndrome occurs, immediately discontinue citalopram, the TCA, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Antipsychotic agents (e.g., chlorpromazine, clozapine, pimozide, thioridazine)
Clozapine: Substantial increases in trough plasma clozapine concentrations reported with concomitant citalopram402
Clozapine: Caution advised; monitor closely and consider reduction in clozapine dosage if used concomitantly402
Pimozide: Concomitant use contraindicated399
Potentially life-threatening serotonin syndrome399
If concomitant use clinically warranted, advise patients of the increased risk for serotonin syndrome, particularly during treatment initiation and dosage increases399
If serotonin syndrome occurs, immediately discontinue citalopram, buspirone, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Potentially additive CNS effects1
Use with caution1
Pharmacokinetic interaction unlikely326
Possible increased risk of hyponatremia399
Therapeutic duplication; escitalopram is the more active isomer of racemic citalopram403
Potentially life-threatening serotonin syndrome399
Potentially life-threatening serotonin syndrome399
If serotonin syndrome occurs, immediately discontinue citalopram, fentanyl, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
5-HT1 receptor agonists (triptans; e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
If serotonin syndrome occurs, immediately discontinue citalopram, the triptan, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Potentially life-threatening serotonin syndrome320
Routine citalopram dosage adjustment not necessary325
If emergency use of linezolid is considered necessary, immediately discontinue citalopram; monitor closely for symptoms of serotonin syndrome for 2 weeks or until 24 hours after the last linezolid dose, whichever comes first399 611
If nonemergency use of linezolid is planned, withhold citalopram for at least 2 weeks prior to initiating linezolid611
Pharmacokinetic interaction unlikely168
If concomitant use clinically warranted, exercise caution and advise patients of the increased risk for serotonin syndrome, particularly during treatment initiation and dosage increases399
If serotonin syndrome occurs, immediately discontinue citalopram, lithium, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Monitor serum lithium concentrations; adjust dosage accordingly1
Concomitant use contraindicated399
Allow at least 2 weeks to elapse between discontinuance of an MAO inhibitor intended to treat psychiatric disorders and initiation of citalopram, and vice versa399
Most cases occurred when methylene blue was used as a diagnostic (visualizing) dye† (1–8 mg/kg IV) during parathyroid surgery; unclear whether there is a risk of serotonin syndrome when methylene blue is administered by other routes or in lower IV doses in patients receiving serotonergic drugs399 613 614
Generally should not use methylene blue in patients receiving citalopram;613 consider availability of alternative interventions and weigh benefits of IV methylene blue against risk of serotonin syndrome399 613
If emergency use of IV methylene blue is considered necessary, immediately discontinue citalopram and monitor for symptoms of serotonin syndrome for 2 weeks or until 24 hours after last methylene blue dose, whichever comes first399 613
If nonemergency use of methylene blue is planned, withhold citalopram for at least 2 weeks prior to initiating methylene blue613
Increased plasma metoprolol concentrations possibly resulting in decreased cardioselectivity1
NSAIAs (e.g., aspirin)
Pharmacokinetic interactions unlikely403
St. John's wort (Hypericum perforatum)
Potentially life-threatening serotonin syndrome399
If serotonin syndrome occurs, immediately discontinue citalopram, St. John's wort, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Potentially life-threatening serotonin syndrome399
If serotonin syndrome occurs, immediately discontinue citalopram, tramadol, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
If serotonin syndrome occurs, immediately discontinue citalopram, tryptophan, and any concurrently administered serotonergic agents; initiate supportive and symptomatic treatment399
Carefully monitor patients receiving warfarin during initiation and discontinuance of citalopram therapy399
Commercially available tablets and oral solution reportedly are bioequivalent.615
Food does not affect absorption.1
Poor metabolizers of CYP2C19: peak steady-state concentrations and AUCs increased by 68 and 107%, respectively.399
Plasma Protein Binding
Excreted principally in urine (75%) and feces (10%).100
20–25°C (may be exposed to 15–30°C).615
Highly selective SSRI with minimal effects on norepinephrine (NE) and dopamine (DA) neuronal reuptake and no or very low affinity for 5-HT1A, 5-HT2A, dopamine D1 and D2, α1-, α2-, and β-adrenergic, histamine (H1), GABA, muscarinic cholinergic, and benzodiazepine receptors.1 18 20 26 52
Advice to Patients
Importance of providing copy of written patient information (medication guide) each time citalopram is dispensed.370 371 376 399 Importance of advising patients to read the patient information before taking citalopram and each time the prescription is filled.399
Risk of suicidality; importance of patients, caregivers, and families being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment.370 371 376 399 (See Worsening of Depression and Suicidality Risk under Cautions.)
Potential risk of serotonin syndrome, particularly with concurrent use of citalopram and 5-HT1 receptor agonists (also called triptans), tramadol, tryptophan, other serotonergic agents, or antipsychotic agents.386 399 Importance of immediately contacting clinician if manifestations of serotonin syndrome develop (e.g., restlessness, hallucinations, delirium, loss of coordination, fast heart beat, increased body temperature, sweating, muscle stiffness, labile BP, diarrhea, coma, nausea, vomiting, confusion).386 399
Importance of instructing patients not to take citalopram with an MAO inhibitor or within 14 days of stopping the drug, and vice versa.399
Risk of QT prolongation and torsades de pointes.399 424 Importance of immediately contacting clinician if signs and symptoms of QT prolongation develop (e.g., chest pain, palpitations, bradycardia or tachycardia, shortness of breath, dizziness or fainting).399 424
Risk of cognitive and motor impairment; importance of exercising caution while operating hazardous machinery, including automobile driving, until patients gain experience with the drug’s effects.399
Importance of patients being aware that withdrawal effects may occur when stopping citalopram, especially with abrupt discontinuance of the drug.399
Importance of informing patients that if they receive diuretics, are otherwise volume depleted, or are elderly, that they may be at greater risk of developing hyponatremia during citalopram therapy.399
Importance of avoiding alcohol during citalopram therapy.399
Importance of advising patients that citalopram can cause mild pupillary dilation, which can lead to an episode of angle-closure glaucoma in susceptible individuals.399 Possible symptoms include eye pain, vision changes, and swelling or redness in or around the eye.399 Preexisting glaucoma is almost always open-angle glaucoma since angle-closure glaucoma can be treated definitively with iridectomy when diagnosed; open-angle glaucoma is not a risk factor for angle-closure glaucoma.399 Patients may wish to be examined to determine whether they are susceptible to angle-closure glaucoma and have a prophylactic procedure (e.g., iridectomy) if they are susceptible.399
Importance of continuing citalopram therapy even if a response is not evident within 1–4 weeks, unless directed otherwise.1
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription (e.g., pimozide, MAO inhibitors) and OTC drugs or herbal supplements, as well as any concomitant illnesses (e.g., cardiovascular disease [especially congenital long QT syndrome], liver disease, kidney disease, seizure disorder) or personal or family history of suicidality or bipolar disorder.399 Importance of advising patients about the risk of bleeding associated with concomitant use of citalopram with aspirin or other NSAIAs, warfarin, or other drugs that affect coagulation.399
Importance of informing patients of other important precautionary information.1 (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
10 mg (of citalopram)*
Citalopram Hydrobromide Tablets
20 mg (of citalopram)*
Citalopram Hydrobromide Tablets
40 mg (of citalopram)*
Citalopram Hydrobromide Tablets
10 mg (of citalopram) per 5 mL*
Citalopram Hydrobromide Oral Solution
AHFS DI Essentials. © Copyright 2017, Selected Revisions September 25, 2015. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
1. Forest Pharmaceuticals, Inc. Celexa (citalopram hydrobromide) tablets and oral solution prescribing information. St. Louis, MO; 2006 Sep.
2. Lane RM. Pharmacokinetic drug interaction potential of selective serotonin reuptake inhibitors [published erratum appears in Intl Clin Psychopharmacol. 1997; 12:126]. Intl Clin Psychopharmacol. 1996; 11(Suppl 5):31-61.
3. Caccia S. Metabolism of the newer antidepressants: an overview of the pharmacological and pharmacokinetic implications. Clin Pharmacokinet. 1998; 34:281-302. [PubMed 9571301]
4. Joffe P, Larsen FS, Pedersen V et al. Single-dose pharmacokinetics of citalopram in patients with moderate renal insufficiency or hepatic cirrhosis compared with healthy subjects. Eur J Clin Pharmacol. 1998; 54:237-42. [PubMed 9681666]
5. Jensen PN, Olesen OV, Bertelsen A et al. Citalopram and desmethylcitalopram concentrations in breast milk and in serum of mother and infant. Ther Drug Monit. 1997; 19:236-9. [PubMed 9108657]
6. Spigset O, Carleborg L, Öhman R et al. Excretion of citalopram in breast milk. Br J Clin Pharmacol. 1997; 44:295-8. [PubMed 9296327]
7. Priskorn M, Larsen F, Segonzac A et al. Pharmacokinetic interaction study of citalopram and cimetidine in healthy subjects. Eur J Clin Pharmacol. 1997; 52:241-2. [PubMed 9218934]
8. Voegeli J, Baumann P. Inappropriate secretion of antidiuretic hormone and SSRIs. Br J Psychiatr. 1996; 169:524-5.
9. Bouman WP, Johnson H, Pinner G. Inappropriate antidiuretic hormone secretion and SSRIs. Br J Psychiatr. 1997; 170:89-91.
10. Carli M, Reader TA. Regulation of central serotonin transporters by chronic lithium: an autoradiographic study. Synapse. 1997; 27:83-9. [PubMed 9268068]
11. Carli M, Afkhami-Dastjerdian S, Reader TA. Effects of a chronic lithium treatment on cortical serotonin uptake sites and 5-HT1A receptors. Neurochem Res. 1997; 22:427-35. [PubMed 9130253]
12. Belpaire FM, Wijnant P, Temmerman A et al. The oxidative metabolism of metoprolol in human liver microsomes: inhibition by the selective serotonin reuptake inhibitors. Eur J Clin Pharmacol. 1998; 54:261-4. [PubMed 9681670]
13. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatr. 2000; 157(Suppl 4):1-45.
14. The European Agency for the Evaluation of Medicinal Products (EMEA). Committee for proprietary medicinal products (CPMP) position paper on selective serotonin uptake inhibitors (SSRIs) and dependency/withdrawal reactions. London, UK; 2000 Apr 12. From EMEA web site.
15. American Psychiatric Association. Practice guideline for the treatment of patients with eating disorders (revision). Am J Psychiatr. 2000; 157(Suppl 1):1-39.
16. Calandra C, Gulino V, Inserra L et al. The use of citalopram in an integrated approach to the treatment of eating disorders: an open study. Eat Weight Disord. 1999; 4:207-10. [PubMed 10728184]
17. Lazowick AL, Levin GM. Potential withdrawal syndrome associated with SSRI discontinuation. Ann Pharmacother. 1995; 29:1284-5. [PubMed 8672834]
18. Willetts J, Lippa A, Beer B. Clinical development of citalopram. J Clin Psychopharmacol. 1999; 19(Suppl 1):36-46S.
19. Food and Drug Administration. Letter to Forest Laboratories Inc concerning NDA submission for Celexa (citalopram hydrobromide) (NDA 21-046). From FDA web site.
20. Popik P. Preclinical pharmacology of citalopram. J Clin Psychopharmacol. 1999; 19(5 Suppl 1):36-46S.
21. Tan JY, Levin GM. Citalopram in the treatment of depression and other potential uses in psychiatry. Pharmacotherapy. 1999; 19:675-89. [PubMed 10391413]
22. Hjorth S. Serotonin 5-HT1A autoreceptor blockade potentiates the ability of the 5-HT reuptake inhibitor citalopram to increase nerve terminal output of 5-HT in vivo: a microdialysis study. J Neurochem. 1993; 60:776-9. [PubMed 8419553]
23. Auerbach SB, Lundberg JF, Hjorth S. Differential inhibition of serotonin release by 5-HT and NA reuptake blockers after systemic administration. Neuropharmacology. 1995; 34:89-96. [PubMed 7623967]
24. Grimsley SR, Jann MW. Paroxetine, sertraline, and fluvoxamine: new selective serotonin reuptake inhibitors. Clin Pharm. 1992; 11:930-57. [PubMed 1464219]
25. Sapena R, Morin D, Zini R et al. Evaluation of central adrenergic receptor signal transmissions after an antidepressant administration in the rat. Biochem Pharmacol. 1992; 44:1067-72. [PubMed 1329757]
26. Hyttel J, Arnt J, Sánchez C. The pharmacology of citalopram. Rev Contemp Pharmacother. 1995; 6:271-85.
27. Sanders-Bush E, Breeding M, Knoth K et al. Sertraline-induced desensitization of the serotonin 5HT-2 receptor transmembrane signaling system. Psychopharmacol (Berlin). 1989; 99:1:64-9.
28. Leinonen E, Lepola U, Kopenen H et al. Citalopram controls phobic symptoms in patients with panic disorder: randomized controlled trial. J Psychiatry Neurosci. 2000; 25:24-32. [PubMed 10721681]
29. Wade AG, Lepola U, Kaponen HJ et al. The effect of citalopram in panic disorder. Br J Psychiatr. 1997; 170:549-53.
30. Bell CJ, Nutt DJ. Serotonin and panic. Br J Psychiatr. 1998; 172:465-71.
31. Pigott TA. OCD: where the serotonin selectivity story begins. J Clin Psychiatr. 1996; 57(Suppl 6):11-20.
32. Baumgarten HG, Grozdanovic Z. Role of serotonin in obsessive-compulsive disorder. Br J Psychiatr. 1998; 173(Suppl 35):13-20.
33. Saxena S, Brody AL, Schwartz JM et al. Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatr. 1998; 173(Suppl 35):26-37.
34. Naranjo CA, Sellers EM, Sullivan JT et al. The serotonin uptake inhibitor citalopram attenuates alcohol intake. Clin Pharmacol Ther. 1987; 41:266-74. [PubMed 3469057]
35. Meert TF. Effects of various serotonergic agents on alcohol intake and alcohol preference in Wistar rats selected at two different levels of alcohol preference. Alcohol Alcohol. 1993; 28:157-70. [PubMed 8517886]
36. Naranjo CA, Bremner KE. Clinical pharmacology of serotonin-altering medications for decreasing alcohol consumption. Alcohol Alcohol. 1993; 2(Suppl):221-9.
37. Maurel S, De Vry J, Schreiber R. Comparison of the effects of the selective serotonin-reuptake inhibitors fluoxetine, paroxetine, citalopram and fluvoxamine in alcohol-preferring cAA rats. Alcohol. 1999; 17:195-201. [PubMed 10231167]
38. Thrybom T, Rooth P, Lindstrom P. Effect of serotonin reuptake inhibitor on syndrome development in obese hyperglycemic mice (Umea ob/ob). Metabolism. 2001; 50:144-50. [PubMed 11229420]
39. Alvarado R, Contreras S, Segovia-Riquelme N et al. Effects of serotonin uptake blockers and of 5-hydroxytryptophan on the voluntary consumption of ethanol, water and solid food by UChA and UChB rats. Alcohol. 1990; 7:315-9. [PubMed 2143905]
40. Peter H, Bandelow B, Krausz M. The impact of the central serotonin system on alcoholism and therapeutic consequences. Fortschr Neurol Psychiatr. 1998; 66:459-65. [PubMed 9825251]
41. Hedlund L, Wahlstrom G. Citalopram as an inhibitor of voluntary ethanol intake in the male rat. Alcohol.1998 Nov;16:295-303.
42. Miller NS. Pharmacotherapy in alcoholism. J Addict Dis. 1995; 14:23-46. [PubMed 7632745]
43. Naranjo CA, Poulos CX, Bremner KE et al. Citalopram decreases desirability, liking, and consumption of alcohol in alcohol-dependent drinkers. Clin Pharmacol Ther. 1992; 6:729-39.
44. Pettinati HM, Volpicelli JR, Luck G et al. Double-blind clinical trial of sertraline treatment for alcohol dependence. J Clin Psychopharmacol. 2001; 21:143-53. [PubMed 11270910]
45. Naranjo C, Sellers E. Sullivan J et al. The serotonin uptake inhibitor citalopram attenuates ethanol intake. Clin Pharmacol Ther. 1987; 41:266-74. [PubMed 3469057]
46. Naranjo CA, Knoke DM. The role of selective serotonin reuptake inhibitors in reducing alcohol consumption. J Clin Psychiatr. 2001;62(Suppl 20):18-25. (IDIS 470549)
47. Naranjo CA, Knoke DM, Bremner KE. Variations in response to citalopram in men and women with alcohol dependence. J Psychiatr Neurosci. 2000; 25:269-75.
48. Thrybom T, Rooth P, Lindstrom P. Effect of serotonin reuptake inhibitor on syndrome development in obese hyperglycemic mice (Umea ob/ob). Metabolism. 2001; 50:144-50. [PubMed 11229420]
49. Garattini S. An update on the pharmacology of serotoninergic appetite-suppressive drugs. Int J Obes Relat Metab Disord. 1992; 16(Suppl 4):S41-8.
50. Harvey BH, Bouwer CD. Neuropharmacology of paradoxic weight gain with selective serotonin reuptake inhibitors. Clin Neuropharmacol. 2000; 23:90-7. [PubMed 10803799]
51. Szkudlarek J, Elsborg L. Treatment of severe obesity with a highly selective serotonin re-uptake inhibitor as a supplement to a low calorie diet. Int J Obes Relat Metab Disord. 1993; 17:681-3. [PubMed 8118471]
52. Hyttel J. Citalopram—pharmacological profile of a specific serotonin uptake inhibitor with antidepressant activity. Prog Neuro-Psychopharmacol Biol Psychiatr. 1982; 6:277-95.
53. Bjerkenstedt L, Flyckt L, Overo KF et al. Relationship between clinical effects, serum drug concentration and serotonin uptake inhibition in depressed patients treated with citalopram: a double-blind comparison of three dose levels. Eur J Clin Pharmacol. 1985;28:553-7.
54. de Abajo FJ, García Rodríguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case control study. BMJ. 1999; 319:1106-9. [PubMed 10531103]
55. Shuster J. SSRIs and upper gastrointestinal bleeding? Cutaneous reactions to psychotropic drugs; atrial fibrillation and anabolic steroids; accidental olanzapine overdose in a child. Hosp Pharm. 2000; 35:29-30,32.
56. Mukherjee J, Yang ZY. Monoamine oxidase A inhibition by fluoxetine: an in vitro and in vivo study. Synapse. 1999; 31:285-9. [PubMed 10051109]
57. Hyttel J. Neurochemical characterization of a new potent and selective serotonin uptake inhibitor: Lu 10-171. Psychopharmacology (Berl). 1977; 51:225-33. [PubMed 403537]
58. Gnerre C, Kosel M, Baumann P et al. Interaction of psychotropic drugs with monoamine oxidase in rat brain. J Pharm Pharmacol. 2001; 53:1125-30. [PubMed 11518022]
59. Neckelmann D, Bjorvatn B, Bjorkum AA et al. Citalopram: differential sleep/wake and EEG power spectrum effects after single dose and chronic administration. Behav Brain Res. 1996; 79:183-92. [PubMed 8883829]
60. van Bemmel AL, van den Hoofdakker RH, Beersma DG et al. Changes in sleep polygraphic variables and clinical state in depressed patients during treatment with citalopram. Psychopharmacology (Berl). 1993;113:225-30.
61. Hilakivi I, Kovala T, Leppävuori A et al. Effects of serotonin and noradrenaline uptake blockers on wakefulness and sleep in cats. Pharmacol Toxicol. 1987; 60:161-6. [PubMed 3473457]
62. Milne RJ, Goa KL. Citalopram: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness. Drugs. 1991; 41:450-77. [PubMed 1711447]
63. Bo P, Patrucco M, Maurelli M et al. Neurophysiological changes induced by 5-HT reuptake inhibitors in rabbits. Farmaco [Sci]. 1987; 42:505-12. [PubMed 3666124]
64. Itil TM, Menon GN, Bozak MM et al. CNS effects of citalopram, a new serotonin inhibitor antidepressant (a quantitative pharmaco-electroencephalography study). Prog Neuropsychopharmacol Biol Psychiatr. 1984; 8:397-409.
65. Muldoon C. The safety and tolerability of citalopram. Int Clin Psychopharmacol. 1996;11(Suppl 1):35-40.
66. Lader M, Melhuish A, Frcka G et al. The effects of citalopram in single and repeated doses and with alcohol on physiological and psychological measures in healthy subjects. Eur J Clin Pharmacol. 1986; 31:183-90. [PubMed 3467975]
67. Nathan PJ, Sitaram G, Stough C et al. Serotonin, noradrenaline and cognitive function: a preliminary investigation of the acute pharmacodynamic effects of a serotonin versus a serotonin and noradrenaline reuptake inhibitor. Behav Pharmacol.2000;11:639-42.
68. Christensen P, Thomsen HY, Pedersen OL et al. Orthostatic side effects of clomipramine and citalopram during treatment for depression. Psychopharmacology (Berl). 1985; 86:383-5. [PubMed 3929308]
69. Pedersen OL, Kragh-Sorensen P, Bjerre M et al. Citalopram, a selective serotonin reuptake inhibitor: clinical antidepressive and long-term effect—a phase II study. Psychopharmacology (Berl). 1982; 77:199-204. [PubMed 6812140]
70. Catalano G, Catalano MC, Epstein MA et al. QTc interval prolongation associated with citalopram overdose: a case report and literature review. Clin Neuropharmacol. 2001; 24:158-62. [PubMed 11391127]
71. Penttilä J, Syvalähti E, Hinkka S et al. The effects of amitriptyline, citalopram and reboxetine on autonomic nervous system: a randomised placebo-controlled study on healthy volunteers. Psychopharmacology (Berl). 2001; 154:343-9. [PubMed 11349386]
72. Rasmussen SL, Overo KF, Tanghoj P. Cardiac safety of citalopram: prospective trials and retrospective analyses. J Clin Psychopharmacol. 1999; 19:407-15. [PubMed 10505582]
73. Liu B, Anderson G, Mittmann N et al. Use of selective serotonin-reuptake inhibitors or tricyclic antidepressants and risk of hip fractures in elderly people. Lancet. 1998; 351:1303-7. [PubMed 9643791]
74. Thapa PB, Gideon P, Cost TW et al. Antidepressants and the risk of falls among nursing home residents. N Engl J Med. 1998; 339:875-82. [PubMed 9744971]
75. Attenburrow MJ, Mitter PR, Whale R et al. Low-dose citalopram as a 5-HT neuroendocrine probe. Psychopharmacology (Berl). 2001; 155:323-6.
76. Seifritz E, Baumann P, Müller MJ et al. Neuroendocrine effects of a 20-mg citalopram infusion in healthy males: a placebo-controlled evaluation of citalopram as 5-HT function probe. Neuropsychopharmacology. 1996; 14:253-63. [PubMed 8924193]
77. von Moltke LL, Greenblatt DJ, Giancarlo GM et al. Escitalopram (S-citalopram) and its metabolites in vitro: cytochromes mediating biotransformation, inhibitory effects, and comparison to R-citalopram. Drug Metab Dispos. 2001; 29:1102-9. [PubMed 11454728]
78. Navarro V, Gasto C, Torres X et al. Citalopram versus nortriptyline in late-life depression: a 12-week randomized single-blind study. Acta Psychiatrica Scand. 2001; 103:435-40.
79. Lüllmann-Rauch R, Nüssberger L. Citalopram-induced generalized lipidosis in rats. Acta Pharmacologica Toxicol. 1983; 52:161-7.
80. Kragh-Sorensen P, Overo KF, Petersen OL et al. The kinetics of citalopram: single and multiple dose studies in man. Acta Pharmacol Toxicol (Copenh). 1981; 48:53-60. [PubMed 6939299]
81. Overo KF. Preliminary studies of the kinetics of citalopram in man. Eur J Clin Pharmacol. 1978; 14:69-73. [PubMed 729609]
82. Fredricson Overo K. Kinetics of citalopram in man: plasma levels in patients. Prog Neuropsychopharmacol Biol Psychiatr. 1982; 6:311-8.
83. Gutierrez M, Abramowitz W. Steady-state pharmacokinetics of citalopram in young and elderly subjects. Pharmacotherapy. 2000; 20:1441-7. [PubMed 11130216]
84. Foglia JP, Pollock BG, Kirshner MA et al. Plasma levels of citalopram enantiomers and metabolites in elderly patients. Psychopharmacol Bull. 1997; 33:109-12. [PubMed 9133760]
85. Fredericson Overo K, Toft B, Christophersen L et al. Kinetics of citalopram in elderly patients. Psychopharmacology (Berl). 1985; 86:253-7. [PubMed 3929295]
86. Melzacka M, Rurak A, Adamus A et al. Distribution of citalopram in the blood serum and in the central nervous system of rats after single and multiple dosage. Pol J Clin Pharmacol Pharm. 1984; 36:675-82.
87. Rochat B, Baumann P, Audus KL. Transport mechanisms for the antidepressant citalopram in brain microvessel endothelium. Brain Res. 1999; 831:229-36. [PubMed 10412001]
88. Spigset O, Hägg S, Stegmayr B et al. Citalopram pharmacokinetics in patients with chronic renal failure and the effect of haemodialysis. Eur J Clin Pharmacol. 2000; 56:699-703. [PubMed 11214779]
89. Karlsson I, Godderis J, Augusto De Mendonca Lima C et al. A randomised, double-blind comparison of the efficacy and safety of citalopram compared to mianserin in elderly, depressed patients with or without mild to moderate dementia. Int J Geriatr Psychiatr. 2000; 15:295-305.
90. Nordeng H, Bergsholm YK, Bohler E et al. Excretion of selective serotonin reuptake inhibitors in breast milk. Tidsskr Nor Laegeforen. 2001; 121:199-203. [PubMed 11475200]
91. Rampono J, Kristensen JH, Hackett LP et al. Citalopram and demethylcitalopram in human milk; distribution, excretion and effects in breast fed infants. Br J Clin Pharmacol. 2000; 50:263-8. [PubMed 10971311]
92. Schmidt K, Olesen OV, Jensen PN. Citalopram and breast-feeding: serum concentration and side effects in the infant. Biol Psychiatr. 2000; 47:164-5
93. Amsterdam JD, Garcia Espana F, Goodman D et al. Breast enlargement during chronic antidepressant therapy. J Affect Disord. 1997; 46:151-6. [PubMed 9479619]
94. Lapatto-Reiniluoto O, Kivisto KT, Neuvonen PJ. Effect of activated charcoal alone or given after gastric lavage in reducing the absorption of diazepam, ibuprofen and citalopram. Br J Clin Pharmacol. 1999; 48:148-53. [PubMed 10417490]
95. Heikkinen T, Ekblad U, Kero P et al. Citalopram in pregnancy and lactation. Clin Pharmacol Ther. 2002; 72:184-91. [PubMed 12189365]
96. Miller LJ. Postpartum depression. JAMA. 2002; 287:762-5. [PubMed 11851544]
97. Rasmussen BB, Brosen K. Is therapeutic drug monitoring a case for optimizing clinical outcome and avoiding interactions of the selective serotonin reuptake inhibitors? Ther Drug Monitor.2000; 22:143-4.
98. Rochat B, Amey M, Baumann P. Analysis of enantiomers of citalopram and its demethylated metabolites in plasma of depressive patients using chiral reverse-phase liquid chromatography. Ther Drug Monitor. 1995; 17:273-9.
99. Dufour H, Bouchacourt M, Thermoz P et al. Citalopram—a highly selective 5-HT inhibitor–in the treatment of depressed patients. Int Clin Psychopharmacol. 1987; 225-37.
100. Dalgaard L, Larsen C. Metabolism and excretion of citalopram in man: identification of O-acyl- and N-glucuronides. Xenobiotica. 1999; 29:1033-41. [PubMed 10574684]
101. van Harten J. Clinical pharmacokinetics of selective serotonin reuptake inhibitors. Clin Pharmacokinet. 1993; 24:203-20. [PubMed 8384945]
102. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed. Washington, DC: American Psychiatric Association; 1994:393-444.
103. Lebowitz BD, Pearson JL, Schneider LS et al. Diagnosis and treatment of depression in late life. Consensus statement update. JAMA. 1997; 278:1186-90. [PubMed 9326481]
104. National Institutes of Health Office of Medical Applications of Research. NIH consensus statement: diagnosis and treatment of depression in late life. 1991; 9:1-27.
105. Fava M. New approaches to treatment of refractory depression. J Clin Psychiatr. 2000; 61(Suppl 1):26-32.
106. Nelson JC. Augmentation strategies in depression 2000. J Clin Psychiatr. 2000; 61(Suppl 2):13-9.
107. Tucker GJ. Psychiatric disorders in medical practice. In: Wyngaarden JB, Smith LH Jr, Bennett JC. Cecil textbook of medicine. 19th ed. Philadelphia; 1992:2079-90.
108. Montgomery SA. Efficacy in long-term treatment of depression. J Clin Psychiatr. 1996; 57(Suppl 2):24-30.
109. Claghorn JL, Feighner JP. A double-blind comparison of paroxetine with imipramine in the long-term treatment of depression. J Clin Psychopharmacol. 1993; 13(6 Suppl 2):23-7S.
110. Duboff EA. Long-term treatment of major depressive disorder with paroxetine. J Clin Psychopharmacol. 1993; 13(6 Suppl 2):28-33S.
111. Franchini L, Gasperini M, Perez J et al. A double-blind study of long-term treatment with sertraline or fluvoxamine for prevention of highly recurrent unipolar depression. J Clin Psychiatr. 1997; 58:104-7.
112. Montgomery SA, Doogan DP, Burnside R. The influence of different relapse criteria on the assessment of long-term efficacy of sertraline. Int Clin Psychopharmacol. 1991; 6(Suppl 2):37-46. [PubMed 1806629]
113. Montgomery SA, Dunbar G. Paroxetine is better than placebo in relapse prevention and the prophylaxis of recurrent depression. Int Clin Psychopharmacol. 1993; 8:189-95. [PubMed 8263317]
114. Franchini L, Gasperini M, Perez J et al. Dose-response of paroxetine in preventing depressive recurrences: a randomized, double-blind study. J Clin Psychiatr. 1998; 59:229-32.
115. Leonard BE. The comparative pharmacology of new antidepressants. J Clin Psychiatr. 1993; 54(Suppl):3-15.
116. Franchini L, Spagnolo C, Rampoldi R et al. Long-term treatment with citalopram in patients with highly recurrent forms of unipolar depression. Psychiatr Res. 2001; 105:129-33.
117. Verhoeven WM, Veendrik-Meekes MJ, Jacobs GA et al. Citalopram in mentally retarded patients with depression: a long-term clinical investigation. Eur Psychiatr. 2001; 16:104-8.
118. Keller MB. Citalopram therapy for depression: a review of 10 years of European experience and data from U.S. clinical trials. J Clin Psychiatr. 2000; 61:896-908.
119. Ragneskog H, Eriksson S, Karlsson I et al. Long-term treatment of elderly individuals with emotional disturbances: an open study with citalopram. Int Psychogeriatr. 1996; 8:659-68. [PubMed 9147178]
120. Charbonnier JF, Reboul P, Rougier M et al. Citalopram: an open trial of a highly selective 5-HT uptake inhibitor, administered intravenously to depressed patients. Encephale. 1987; 13:249-54.
121. Fredericson Overo K, Toft B, Christophersen L et al. Kinetics of citalopram in elderly patients. Psychopharmacology. 1985; 86:253-7. [PubMed 3929295]
122. Gastpar M, Gastpar G. Preliminary studies with citalopram (Lu 10-171), a specific 5-HT-reuptake inhibitor, as antidepressant. Prog Neuropsychopharmacol Biol Psychiatr. 1982; 6:319-25.
123. Gottlieb P, Wandall T, Overo KF. Initial, clinical trial of a new, specific 5-HT reuptake inhibitor, citalopram (Lu 10-171). Acta Psychiatrica Scand. 1980; 62:236-44.
124. Ofsti E. Citalopram- a specific 5-HT-reuptake inhibitor- as an antidepressant drug: a phase II multicenter trial. Prog Neuropsychopharmacol Biol Psychiatr. 1982; 6:327-35.
125. Ropert R, Loo H, Gay C. Preliminary open trial with a new antidepressant compound: citalopram. Encephale. 1984; 10:131-4. [PubMed 6594229]
126. Schmauss M. Dieterle D, Albus M. Citalopram, a specific 5HT reuptake inhibitor, in severely depressed inpatients: an early clinical trial. Curr Ther Res. 1985; 37:1104-12.
127. Mendels J, Fabre L, Kiev A. A double-blind placebo controlled study of citalopram in major depressive disorder. Poster presented at the 30th Annual Meeting of New Clinical Drug Evaluation Unit. Florida; 1990 May 29-Jun 1.
128. Shaw DM, Thomas DR, Briscoe MH et al. A comparison of the antidepressant action of citalopram and amitriptyline. Br J Psychiatr. 1986; 149:515-7.
129. Gravem A, Amthor KF, Astrup C et al. A double-blind comparison of citalopram (Lu 10-171) and amitriptyline in depressed patients. Acta Psychiatrica Scand. 1987; 75:478-86.
130. Kyle CJ, Petersen HE, Overo KF. Comparison of the tolerability and efficacy of citalopram and amitriptyline in elderly depressed patients treated in general practice. Depress Anxiety. 1998; 8:147-53. [PubMed 9871816]
131. Fuglum E, Rosenberg C, Damsbo N et al. Screening and treating depressed patients. A comparison of two controlled citalopram trials across treatment settings: hospitalized patients vs. patients treated by their family doctors. Danish University Antidepressant Group. Acta Psychiatrica Scand. 1996; 94:18-25.
132. Danish University Antidepressant Group. Citalopram: clinical effect profile in comparison with clomipramine: a controlled multicenter study. Psychopharmacology (Berl). 1986; 90:131-8. [PubMed 2876451]
133. Rosenberg C, Damsbo N, Fuglum E et al. Citalopram and imipramine in the treatment of depressive patients in general practice: a Nordic multicentre clinical study. Int Clin Psychopharmacol. 1994; 9(Suppl 1):41-8. [PubMed 8021437]
134. Patris M, Bouchard JM, Bougerol T et al. Citalopram versus fluoxetine: a double-blind, controlled, multicentre, phase III trial in patients with unipolar major depression treated in general practice. Int Clin Psychopharmacol. 1996; 11:129-36. [PubMed 8803650]
135. Arias F, Padin JJ, Gilaberte I et al. Comparative naturalistic study of the efficacy and tolerability of new antidepressants. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1998; 26:351-7. [PubMed 9972586]
136. Haffmans PM, Timmerman L, Hoogduin CA. Efficacy and tolerability of citalopram in comparison with fluvoxamine in depressed outpatients: a double-blind, multicentre study. The LUCIFER Group. Int Clin Psychopharmacol.1996;11:157-64.
137. Stahl SM. Placebo-controlled comparison of the selective serotonin reuptake inhibitors citalopram and sertraline. Biol Psychiatr. 2000; 48:894-901.
138. Ekselius L, von Knorring L, Eberhard G. A double-blind multicenter trial comparing sertraline and citalopram in patients with major depression treated in general practice. Int Clin Psychopharmacol. 1997; 12:323-31. [PubMed 9547134]
139. Edwards JG. Long term pharmacotherapy of depression: can reduce relapses and recurrences in major depression. BMJ. 1998; 316:1180-1. [PubMed 9552990]
140. Leinonen E, Skarstein J, Behnke K et al. Efficacy and tolerability of mirtazapine versus citalopram: a double-blind, randomized study in patients with major depressive disorder. Nordic Antidepressant Study Group. Int Clin Psychopharmacol. 1999; 14:329-37. [PubMed 10565799]
141. Stahl SM, Nierenberg AA, Gorman JM. Evidence of early onset of antidepressant effect in randomized controlled trials. J Clin Psychiatr. 2001; 62(Suppl 4):17-23; discussion: 37-40.
142. Mendels J, Kiev A, Fabre LF. Double-blind comparison of citalopram and placebo in depressed outpatients with melancholia. Depress Anxiety. 1999; 9:54-60. [PubMed 10207659]
143. Burrows GD, McIntyre IM, Judd FK et al. Clinical effects of serotonin reuptake inhibitors in the treatment of depressive illness. J Clin Psychiatr. 1988; 49(Suppl):18- 22.
144. Brown WA, Harrison W. Are patients who are intolerant to one SSRI intolerant to another? Psychopharmacol Bull.1992; 28:253-6.
145. Joffe RT, Levitt AJ, Sokolov ST et al. Response to an open trial of a second SSRI in major depression. J Clin Psychiatr. 1997; 58:326-7.
146. American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatr. 1998; 37(Suppl 10):63S-83S.
147. Ambrosini PJ. A review of pharmacotherapy of major depression in children and adolescents. Psychiatr Ser. 2000; 51:627-33.
148. Hughes CW, Emslie GJ, Crismon ML et al. The Texas children’s medication algorithm project: report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder. J Am Acad Child Adolesc Psychiatr. 1999; 38:1442-54.
149. Emslie GJ, Rush J, Weinberg WA et al. A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatr. 1997; 54:1031-7. [PubMed 9366660]
150. Lebowitz BD, Pearson JL, Schneider LS et al. Diagnosis and treatment of depression in late life. Consensus statement update. JAMA. 1997; 278:1186-90.National Institutes of Health Office of Medical Applications of Research. NIH consensus statement: diagnosis and treatment of depression in late life. 1991; 9;1-27.
151. Kerr JS, Fairweather DB, Mahendran R et al. The effects of paroxetine, alone and in combination with alcohol on psychomotor performance and cognitive function in the elderly. Int Clin Psychopharmacol. 1992; 7:101-8. [PubMed 1487621]
152. American Psychiatric Association. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. Am J Psychiatr. 1997; 154(Suppl):1-39.
153. Small GW, Rabins PV, Barry PB et al. Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer’s Association, and the American Geriatrics Society. JAMA. 1997; 278:1363-1371. [PubMed 9343469]
154. Raskind MA, Peskind ER. Alzheimer’s disease and related disorders. Med Clin North Am. 2001; 85:803-17. [PubMed 11349485]
155. Flint AJ, van Reekum R. The pharmacologic treatment of Alzheimer’s disease: a guide for the general psychiatrist. Can J Psychiatr. 1998; 43:689-97.
156. Pollock BG, Mulsant BH, Sweet R et al. An open pilot study of citalopram for behavioral disturbances of dementia: plasma levels and real-time observations. Am J Geriatr Psychiatr. 1997; 5:70-8.
157. Nyth AL, Gottfries CG, Lyby K et al. A controlled multicenter clinical study of citalopram and placebo in elderly depressed patients with and without concomitant dementia. Acta Psychiatrica Scand. 1992; 86:138-45.
158. Molcho A, Stanley M. Antidepressants and suicide risk: issues of chemical and behavioral toxicity. J Clin Psychopharmacol. 1992; 12(2 Suppl):13S-8S. [PubMed 1577985]
159. Gleason OC, Yates WR, Isbell MD et al. An open-label trial of citalopram for major depression in patients with hepatitis C. J Clin Psychiatr. 2002; 63:194-8.
160. Andersen G, Vestergaard K, Lauritzen L. Effective treatment of poststroke depression with the selective serotonin reuptake inhibitor citalopram. Stroke. 1994; 25:1099-104. [PubMed 8202964]
161. Andersen G, Vestergaard K, Riis JO. Citalopram for post-stroke pathological crying. Lancet. 1993; 342:816-7. [PubMed 8104265]
162. Guelfi JD, Strub N, Loft H. Efficacy of intravenous citalopram compared with oral citalopram for severe depression. Safety and efficacy data from a double-blind, double-dummy trial. J Affect Disord. 2000; 58:201-9. [PubMed 10802128]
163. Feighner JP, Overo K. Multicenter, placebo-controlled, fixed-dose study of citalopram in moderate-to-severe depression. J Clin Psychiatr. 1999; 60:824-30.
164. Montgomery SA, Rasmussen JG, Lyby K et al. Dose response relationship of citalopram 20 mg, citalopram 40 mg and placebo in the treatment of moderate and severe depression. Int Clin Psychopharmacol.1992;6(Suppl 5):65-70.
165. Appelberg BG, Syvalahti EK, Koskinen TE et al. Patients with severe depression may benefit from buspirone augmentation of selective serotonin reuptake inhibitors: results from a placebo-controlled, randomized, double-blind, placebo wash-in study. J Clin Psychiatr. 2001; 62:448-52.
166. Landon M, Bjorling G, Agren H et al. A randomized, double-blind, placebo-controlled trial of buspirone in combination with an SSRI in patients with treatment-refractory depression. J Clin Psychiatr. 1998; 59:664-8.
167. O’Reardon JP, Brunswick DJ, Amsterdam JD. Treatment-resistant depression in the age of serotonin: evolving strategies. Curr Opin Psychiatr. 2000; 13:93-8.
168. Baumann P, Nil R, Souche A et al. A double-blind, placebo-controlled study of citalopram with and without lithium in the treatment of therapy-resistant depressive patients: a clinical, pharmacokinetic, and pharmacogenetic investigation. J Clin Psychopharmacol1996; 16:307-14.
169. Muraki I, Inoue T, Hashimoto S et al. Effect of subchronic lithium treatment on citalopram-induced increases in extracellular concentrations of serotonin in the medial prefrontal cortex. J Neurochem. 2001; 76:490-7. [PubMed 11208912]
170. Gram LF, Hansen MGJ, Sindrup SH et al. Citalopram: interaction studies with levopromazine, imipramine, and lithium. Ther Drug Monit. 1993; 15:18-24. [PubMed 8451775]
171. Papakostas YG, Markianos M, Zervas IM et al. Administration of citalopram before ECT: seizure duration and hormone responses. J ECT. 2000; 16:356-60. [PubMed 11314873]
172. Montgomery SA, Kasper S, Stein DJ et al. Citalopram 20 mg, 40 mg and 60 mg are all effective and well tolerated compared with placebo in obsessive-compulsive disorder. Int Clin Psychopharmacol. 2001; 16:75-86. [PubMed 11236072]
173. Kopenen H, Lepola U, Leinonen E et al. Citalopram in the treatment of obsessive-compulsive disorder: an open pilot study. Acta Psychiatrica Scand. 1997; 96:343-6.
174. Cipram tablets abbreviated prescribing information. Middle East Medical Index. 23rd ed. CCM Middle East s.a.r.l. Athens, Greece. 2001:5.584-5.585.
175. Thomsen PH, Ebbesen C, Persson C. Long-term experience with citalopram in the treatment of adolescent OCD. J Am Acad Child Adolesc Psychiatr. 2001; 40:895-902.
176. Thomsen PH. Child and adolescent obsessive-compulsive disorder treated with citalopram: findings from an open-trial of 23 cases. J Child Adolesc Psychopharmacol. 1997; 7:157-66. [PubMed 9466233]
177. Micallef J, Blin O. Neurobiology and clinical pharmacology of obsessive-compulsive disorder. Clin Neuropharmacol. 2001; 24:191-207. [PubMed 11479390]
178. Bajo S, Battaglia M, Pegna C et al. Citalopram and fluvoxamine in Tourette’s disorder. J Am Acad Child Adolesc Psychiatr. 1999: 38:230-1.
179. Flicker C. Citalopram treatment of poststroke patients: improvement of uncontrolled crying. J Am Geriatrics Soc. 1998; 46:S67.
180. Ekselius L, von Knorring L. Changes in personality traits during treatment with sertraline or citalopram. Br J Psychiatr. 1999; 174:444-8.
181. Wikander I, Sundblad C, Andersch B et al. Citalopram in premenstrual dysphoria: is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle? J Clin Psychopharmacol. 1998; 18:390-8.
182. Eriksson E. Serotonin reuptake inhibitors for the treatment of premenstrual dysphoria. Int Clin Psychopharmacol. 1999; 14(Suppl 2):S27-33. [PubMed 10471170]
183. Marazziti D, Dell’Orso L, Gemignani A et al. Citalopram in refractory obsessive-compulsive disorder: an open study. Int Clin Psychopharmacol. 2001; 16:215-9. [PubMed 11459335]
184. Stein DJ, Montgomery SA, Kasper S et al. Predictors of response to pharmacotherapy with citalopram in obsessive-compulsive disorder. Int Clin Psychopharmacol. 2001; 16:357-61. [PubMed 11712625]
185. Seedat S, Lockhat R, Kaminer D et al. An open trial of citalopram in adolescents with post-traumatic stress disorder. Int Clin Psychopharmacol. 2001; 16:21-5. [PubMed 11195256]
186. Wehr AM, Namerow LB. Citalopram for OCD and Tourette’s syndrome. J Am Acad Child Adolesc Psychiatr. 2001; 40:740-1.
187. Hochstrasser B, Isaksen PM, Kopenen H et al. Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy. Br J Psychiatr. 2001; 178:304-10.
188. Larsen F, Priskorn M, Overo KF. Lack of citalopram effect on oral digoxin pharmacokinetics. J Clin Pharmacol. 2001; 41:340-6. [PubMed 11269575]
189. Minutentag NW, Bernik MA. Comparative study of citalopram and imipramine in the treatment of panic disorder. Revista de Psiquiatria Clinica. 2001; 28:44-51.
190. Priskorn M, Sidhu JS, Larsen F et al. Investigation of multiple dose citalopram on the pharmacokinetics and pharmacodynamics of racemic warfarin. Br J Clin Pharmacol. 1997; 44:199-202. [PubMed 9278211]
191. Kabuto H, Yokoi I, Endo A et al. Chronic administration of citalopram inhibited El mouse convulsions and decreased monoamine oxidase-A activity. Acta Med Okayama. 1994; 48:311-6. [PubMed 7535969]
192. Anon. Selective serotonin reuptake inhibitors and SIADH: Adverse Drug Reactions Advisory Committee. Med J Austr. 1996; 164:562.
193. Bluff DD, Oji N. SIADH in a patient receiving sertraline. Ann Intern Med. 1995; 123:811. [PubMed 7574211]
194. Bouman WP, Johnson H, Trescoli-Serrano C et al. Recurrent hyponatremia associated with sertraline and lofepramine. Am J Psychiatr. 1997; 154:580. [PubMed 9090354]
195. Bradley ME, Foote EF, Lee EN et al. Sertraline-associated syndrome of inappropriate antidiuretic hormone: case report and review of the literature. Pharmacotherapy. 1996; 16:680-3. [PubMed 8840376]
196. Goldstein L, Barker M, Segall F et al. Seizure and transient SIADH associated with sertraline. Am J Psychiatr. 1996; 153:732. [PubMed 8615425]
197. Jackson C, Carson W, Markowitz J et al. SIADH associated with fluoxetine and sertraline therapy. Am J Psychiatr. 1995; 123:811.
198. Kessler J, Samuels SC. Sertraline and hyponatremia. N Engl J Med. 1996; 335:524. [PubMed 8676965]
199. Liu BA, Mittmann N, Knowles SR et al. Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. CMAJ. 1996; 155:519-27. [PubMed 8804257]
200. Thornton SL, Resch DS. SIADH associated with sertraline therapy. Am J Psychiatr. 1995; 152:809. [PubMed 7726325]
201. Chua TP, Vong SK. Hyponatraemia associated with paroxetine. Br Med J. 1993; 306:143.
202. Chua TP, Vong SK. Paroxetine and hyponatraemia. Br J Clin Pract. 1994; 48:49. [PubMed 8179984]
203. Goddard C, Paton C. Hyponatremia associated with paroxetine. Br Med J. 1992; 305:1332.
204. Johnsen CR, Hoejlyng N. Hyponatremia following acute overdose with paroxetine. Int J Clin Pharmacol Ther. 1998; 36:333-5. [PubMed 9660041]
205. SmithKlineBeecham Pharmaceuticals. Paxil (paroxetine hydrochloride) tablets and oral suspension prescribing information. 2001 Apr.
206. Bourgeois JA, Babine SE, Bahadur N. A case of SIADH and hyponatremia associated with citalopram. Psychosomatics. 2002; 43:241-2. [PubMed 12075041]
207. Hull M, Kottlors M, Braune S. Prolonged coma caused by low sodium and hypo-osmolarity during treatment with citalopram. J Clin Psychopharmacol. 2002; 22:337-8. [PubMed 12006908]
208. Odeh M, Beny A, Oliven A. Severe symptomatic hyponatremia during citalopram therapy. Am J Med Sci. 2001; 321:159-60. [PubMed 11217819]
209. Wilkinson TJ, Begg EJ, Winter AC et al. Incidence and risk factors for hyponatremia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol. 1999; 47:211-7. [PubMed 10190657]
210. ten Holt WL, van Iperen CE, Schrijver G et al. Severe hyponatremia during therapy with fluoxetine. Arch Intern Med. 1996; 156:681-2. [PubMed 8629882]
211. Snider RD. Case report: left bundle branch block–a rare complication of citalopram overdose. J S C Med Assoc. 2001; 97:380-2. [PubMed 11584496]
212. Nordeng H, Lindemann R, Perminov KV et al. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001; 90:288-91. [PubMed 11332169]
213. Dahl ML, Olhager E, Ahlner J. Paroxetine withdrawal syndrome in a neonate. Br J Psychiatr. 1997; 171:391-2.
214. Ericson A, Kallen B, Wiholm BE. Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol. 1999; 55:503-8. [PubMed 10501819]
215. Kulin NA, Pastuszak A, Sage SR et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA. 1998; 279:609-10. [PubMed 9486756]
216. Stork CM. Serotonin reuptake inhibitors and atypical antidepressants. In: Goldfrank LR, Howland MA, Flomenbaum NE et al, eds. Goldfrank’s toxicologic emergencies. 7th ed. New York: McGraw-Hill; 2002:865-74.
217. Anon. Escitalopram (Lexapro) for depression. Med Lett Drugs Ther. 2002; 44:83-4. [PubMed 12360121]
218. Blayac JP, Hillaire Buys D, Peyriere H et al. La pharmacovigilance des nouveaux antidepresseurs: evaluation des troubles neuro-psychocomportementaux. Therapie. 1997; 52:117-22. [PubMed 9231505]
219. Bryois C, Rubin C, Zbinden JD et al. Syndrome de sevrage aux inhibiteurs selectifs de la recapture de la serotonine: a propos d’un cas. Schweiz Rundsch Med Prax. 1998; 97:345-8.
220. Coupland NJ, Bell CJ, Potokar JP. Serotonin reuptake inhibitor withdrawal. J Clin Psychopharmacol. 1996; 16:356-62. [PubMed 8889907]
221. Frost L, Lal S. Shock-like sensations after discontinuance of SSRIs. Am J Psychiatr. 1995; 152:810. [PubMed 7726327]
222. Landry P, Roy L. Withdrawal hypomania associated with paroxetine. J Clin Psychopharmacol. 1997; 17:60-1. [PubMed 9004064]
223. Markowitz JS, DeVane CL, Liston HL et al. An assessment of selective serotonin reuptake inhibitor discontinuation symptoms with citalopram. Int Clin Psychopharmacol. 2000; 15:329-33. [PubMed 11110008]
224. Lejoyeux M, Ades J. Antidepressant discontinuation: a review of the literature. J Clin Psychiatr. 1997; 58(Suppl 7):11-5, discussion 16.
225. Price JS, Waller PC, Wood SM. A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms upon withdrawal. Br J Clin Pharmacol. 1996; 42:757-63. [PubMed 8971432]
226. Rosenbaum JF, Fava M, Hoog SL et al. Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biol Psychiatr. 1998; 44:77-87.
227. Rosenbaum JF, Zajecka J. Clinical management of antidepressant discontinuation. J Clin Psychiatr. 1997; 58(Suppl 7):37-40.
228. Schatzberg AF, Haddad P, Kaplan EM et al. Possible biological mechanisms of the serotonin reuptake inhibitor discontinuation syndrome: Discontinuation Consensus Panel. J Clin Psychiatr. 1997; 58(Suppl 7):23-7.
229. Zajecka J, Tracy KA, Mitchell S. Discontinuation symptoms after treatment with serotonin reuptake inhibitors: a literature review. J Clin Psychiatr. 1997; 58:291-7.
230. Louie AK, Lannon RA, Ajari LT. Withdrawal reaction after sertraline discontinuation. Am J Psychiatr.1994;151:450-1. Letter.
231. Hindmarch I, Kimber S, Cockle SM. Abrupt and brief discontinuation of antidepressant treatment: effects on cognitive function and psychomotor performance. Int Clin Psychopharmacol. 2000; 15:305-18. [PubMed 11110006]
232. Fernando AT 3rd, Schwader P. A case of citalopram withdrawal. J Clin Psychopharmacol. 2000; 20:581-2. [PubMed 11001246]
233. Voirol P, Rubin C, Bryois C et al. Pharmacokinetic consequences of a citalopram treatment discontinuation. Ther Drug Monit. 1999; 21:263-6. [PubMed 10365634]
234. Benazzi F. Citalopram withdrawal symptoms. Eur Psychiatr. 1998; 13:219-20.
235. Stahl MM, Lindquist M, Pettersson M et al. Withdrawal reactions with selective serotonin re-uptake inhibitors as reported to the WHO system. Eur J Clin Pharmacol. 1997; 53:163-9. [PubMed 9476026]
236. Barak Y, Kimhi R, Weizman R. Is selectivity for serotonin uptake associated with a reduced emergence of manic episodes in depressed patients? Int Clin Psychopharmacol. 2000; 15:53-6.
237. Bryois C, Ferrero F. Mania induced by citalopram. Arch Gen Psychiatr. 1994; 51:664-5. [PubMed 8042916]
238. Bunney WE Jr, Goodwin FK, Murphy DL et al. The “switch process” in manic-depressive illness. II. Relationship to catecholamines, REM sleep, and drugs. Arch Gen Psychiatr. 1974; 27:304-9.
239. Lebegue B. Mania precipitated by fluoxetine. Am J Psychiatr. 1987; 144:1620. [PubMed 3500651]
240. Peet M. Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Br J Psychiatr. 1994; 164:549-50.
241. Settle EC Jr, Puzzuoli Settle G. A case of mania associated with fluoxetine. Am J Psychiatr. 1984; 141:280-1. [PubMed 6362443]
242. Wernicke JF. The side effect profile and safety of fluoxetine. J Clin Psychiatr. 1985; 46:59-67.
243. Turner SM, Jacob RG, Beidel DC et al. A second case of mania associated with fluoxetine. Am J Psychiatr. 1985; 142:274-5. [PubMed 3871593]
244. Eli Lilly and Company. Prozac (fluoxetine hydrochloride) prescribing information. Indianapolis, IN: 2001 Feb.
245. Anon. Drugs for psychiatric disorders. Med Lett Drugs Ther. 1994; 36:89-96. [PubMed 7935156]
246. Baldwin D, Fineberg N, Montgomery S. Fluoxetine, fluvoxamine, and extrapyramidal tract disorders. Int Clin Psychopharmacol. 1991; 6:51-8. [PubMed 1906498]
247. Choo V. Paroxetine and extrapyramidal reactions. Lancet. 1993; 341:624. [PubMed 8094844]
248. Committee on Safety of Drugs. Curr Prob Pharmacovigilance. 1993; 19:1.
249. Holliday SM, Plosker GL. Paroxetine. A review of its pharmacology, therapeutic use in depression and therapeutic potential in diabetic neuropathy. Drugs Aging. 1993; 3:278-99. [PubMed 8324301]
250. Ayd FJ. Paroxetine, a new selective serotonin reuptake inhibitor. Int Drug Ther Newsl. 1993; 28:5-12.
251. Boyer WF, Feighner JP. An overview of paroxetine. J Clin Psychiatr. 1992; 53(Suppl 2):3-6.
252. Pfizer Roerig. Zoloft (sertraline hydrochloride) tablets prescribing information. New York; 2000 Jan.
253. Aydin N, Anac E, Caykoylu A et al. Neuroleptic malignant syndrome due to citalopram overdose. Can J Psychiatr. 2000; 45:941-2.
254. Isbister GK, Dawson A, Whyte IM. Citalopram overdose, serotonin toxicity, or neuroleptic malignant syndrome? Can J Psychiatr.2001; 46:657-9.
255. Fu K, Konrad RJ, Hardy RW et al. An unusual multiple drug intoxication case involving citalopram. J Anal Toxicol. 2000; 24:648-50. [PubMed 11043674]
256. Rothenhausler HB, Hoberl C, Ehrentrout S et al. Suicide attempt by pure citalopram overdose causing long-lasting severe sinus bradycardia, hypotension and syncopes: successful therapy with a temporary pacemaker. Pharmacopsychiatry. 2000l; 33:150-2.
257. Musshoff F, Schmidt P, Madea B. Fatality caused by a combined trimipramine-citalopram intoxication. Forensic Sci Int. 1999; 106:125-31. [PubMed 10664899]
258. Sanders-Bush E, Mayer SE. 5-Hydroxytryptamine (serotonin) receptor agonists and antagonists. In: Hardman JG, Limbird LE, Molinoff PB et al, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill; 1996:249-63.
259. Reviewers’ comments (personal observations) on fluoxetine hydrochloride 28:16.04.
260. Wise MEJ. Citalopram-induced bruxism. Br J Psychiatr. 2001; 178:182.
261. Possidente E, Egidio Nardi A, Figueira I et al. SSRI-induced bruxism: case report of four patients. Jornal Brasileiro de Psiquiatria. 1997; 46:285-8.
262. Jimenez-Jimenez FJ, Molina JA. Extrapyramidal symptoms associated with selective serotonin reuptake inhibitors: epidemiology, mechanisms and management. CNS Drugs. 2000; 14:367-9.
263. Richard MA, Fiszenson F, Jreissati M et al. Cutaneous adverse effects during selective serotonin reuptake inhibitors therapy: 2 cases. Ann Dermatol Venereol. 2001; 128:759-61. [PubMed 11460042]
264. Meuleman C, Jourdain P, Bellorini M et al. Citalopram and torsades de pointes: a case report. Arch Mal Coeur Vaiss. 2001; 94:1021-4. [PubMed 11603066]
265. Kennedy SH, Eisfeld BS, Dickens SE et al. Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatr. 2000; 61:276-81.
266. Kiev A, Feiger A. A double-blind comparison of fluvoxamine and paroxetine in the treatment of depressed outpatients. J Clin Psychiatr. 1997; 58:146-52.
267. Modell JG, Katholi CR, Modell JD et al. Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther. 1997; 61:476-87. [PubMed 9129565]
268. Montejo AI, Llorca G, Izquierdo JA et al. Sexual dysfunction secondary to SSRIs: a comparative analysis in 308 patients. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1996; 24:311-21. [PubMed 9054202]
269. Montejo Gonzales AL, Llorca G, Izquierdo JA et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine. J Sex Marital Ther. 1997; 23:176-94. [PubMed 9292833]
270. Rosen RC, Lane RM, and Menza M. Effects of SSRIs on sexual function: a critical review. J Clin Psychopharmacol. 1999; 19:67-85. [PubMed 9934946]
271. Dent LA, Brown WC, Murney JD. Citalopram-induced priapism. Pharmacotherapy. 2002; 22:538-41. [PubMed 11939691]
272. Berk M, Acton M. Citalopram-associated clitoral priapism: a case series. Int Clin Psychopharmacol. 1997; 12:121-2. [PubMed 9219048]
273. Waldinger MD, Zwinderman AH, Olivier B. SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram. J Clin Psychopharmacol. 2001; 21:556-60. [PubMed 11763001]
274. Montejo AL, Llorca G, Izquierdo JA et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatr.2001;62(Suppl 3):10-21.
275. Michael A, Herrod JJ. Citalopram-induced decreased libido. Br J Psychiatr. 1997; 171:90.
276. Landen M, Eriksson E, Agren H et al. Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors. J Clin Psychopharmacol. 1999; 19:268-71. [PubMed 10350034]
277. Ekselius L, von Knorring L. Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care. J Clin Psychopharmacol. 2001; 21:154-60. [PubMed 11270911]
278. Sproule BA, Naranjo CA, Bremner KE et al. Selective serotonin reuptake inhibitors and CNS drug interactions: a critical review of the evidence. Clin Pharmacokinet. 1997; 33:454-71. [PubMed 9435993]
279. Goodnick PJ. Use of antidepressants in treatment of comorbid diabetes mellitus and depression as well as in diabetic neuropathy. Ann Clin Psychiatr. 2001; 13:31-41.
280. Sindrup SH, Bjerre U, Dejgaard A et al. The selective serotonin reuptake inhibitor citalopram relieves the symptoms of diabetic neuropathy. Clin Pharmacol Ther. 1992; 52:547-52. [PubMed 1424428]
281. Seedat S, Stein DJ, Emsley RA. Open trial of citalopram in adults with post-traumatic stress disorder. Int J Neuropsychopharmacol. 2000; 3:135-40. [PubMed 11343590]
282. Khouzam HR, El-Gabalawi F, Donnelly NJ. The clinical experience of citalopram in the treatment of post-traumatic stress disorder: a report of two Persian Gulf War veterans. Mil Med. 2001; 166:921-3. [PubMed 11603249]
283. Skop BP, Brown TM. Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors. Psychosomatics. 1996; 37:12-6. [PubMed 8600488]
284. Boettcher M, Peoples J, Proujansky R et al. Rectal bleeding with use of selective serotonin reuptake inhibitors. J Pediatr Gastroenterol. 1999; 29:522.
285. Goldberg RJ. Selective serotonin reuptake inhibitors: infrequent medical adverse effects. Arch Fam Med. 1998; 7:78-84. [PubMed 9443704]
286. Alderman CP, Seshadri P, Ben Tovim DI. Effects of serotonin reuptake inhibitors on hemostasis. Ann Pharmacother. 1996; 30:1232-4. [PubMed 8913401]
287. Tielens JA. Vitamin C for paroxetine- and fluvoxamine-associated bleeding. Am J Psychiatr. 1997; 154:883-4. [PubMed 9167526]
288. Perna G, Bertani A, Caldirola D et al. A comparison of citalopram and paroxetine in the treatment of panic disorder: a randomized, single-blind study. Pharmacopsychiatry. 2001; 34:85-90. [PubMed 11434404]
289. Lepola UM, Wade AG, Leinonen EV et al. A controlled, prospective, 1-year trial of citalopram in the treatment of panic disorder. J Clin Psychiatr. 1998; 59:528-34.
290. Priskorn M, Larsen F, Segonzac A et al. Pharmacokinetic interaction study of citalopram and cimetidine in healthy subjects. Eur J Clin Pharmacol. 1997; 52:241-2. [PubMed 9218934]
291. Graber MA, Hoehns TB, Perry PJ. Sertraline-phenelzine drug interaction: a serotonin syndrome reaction. Ann Pharmacother. 1994; 28:732-5. [PubMed 7919561]
292. Lappin RI, Auchincloss EL. Treatment of the serotonin syndrome with cyproheptadine. N Engl J Med. 1994; 330:1021-2. [PubMed 8121457]
293. Mandalos GE, Szarek BL. Dose-related paranoid reaction associated with fluoxetine. J Nerv Ment Dis. 1990; 178:57-8. [PubMed 2295892]
294. Mills KC. Serotonin syndrome. Am Fam Physician. 1995; 52:11475-82.
295. Reynolds RD. Serotonin syndrome: what family physicians need to know. Am Fam Physician. 1995; 52:1263-71. [PubMed 7572545]
296. Sporer KA. The serotonin syndrome. Implicated drugs, pathophysiology and management. Drug Saf. 1995; 13:94-104. [PubMed 7576268]
297. Steinberg H. Dear doctor letter regarding use of Zoloft (sertraline hydrochloride). New York, New York: Pfizer Inc, U.S. Pharmaceuticals Group; 1995 Aug 1.
298. Brodribb TR, Downey M, Gilbar PJ. Efficacy and adverse effects of moclobemide. Lancet. 1994; 343:475. [PubMed 7905962]
299. Kline SS, Mauro LS, Scala-Barnett DM et al. Serotonin syndrome versus neuroleptic malignant syndrome as a cause of death. Clin Pharm. 1989; 8:510-4. [PubMed 2568897]
300. Nierenberg DW, Semprebon M. The central nervous system serotonin syndrome. Clin Pharmacol Ther. 1993; 53:84-8. [PubMed 8257462]
301. Sternbach H. The serotonin syndrome. Am J Psychiatr. 1991; 148:705-13. [PubMed 2035713]
302. Wyeth-Ayerst. Redux (dexfenfluramine hydrochloride) capsules prescribing information. Philadelphia, PA; 1996 April 29.
303. Somerset Pharmaceuticals. Eldepryl (selegiline) capsules prescribing information (dated 1996 May). In: Physicians’ desk reference. 51st ed. Montvale, NJ: Medical Economics Company Inc; 1997:2729-31.
304. Mathew NT, Tietjen GE, Lucker C. Serotonin syndrome complicating migraine pharmacotherapy. Cephalalgia. 1996; 16:323-7. [PubMed 8869767]
305. Beasley CM, Masica DN, Heiligenstein JH et al. Possible monoamine oxidase inhibitor–serotonin uptake inhibitor interaction: fluoxetine clinical data and preclinical findings. J Clin Psychopharmacol. 1993; 13:312-20. [PubMed 8227489]
306. Bhatara VS, Bandettini FC. Possible interaction between sertraline and tranylcypromine. Clin Pharm. 1993; 12:222-5. [PubMed 8491079]
307. Brannan SK, Talley BJ, Bowden CL. Sertraline and isocarboxazid cause a serotonin syndrome. J Clin Psychopharmacol. 1994; 14:144-5. [PubMed 8195456]
308. Coplan JD, Gorman JM. Detectable levels of fluoxetine metabolites after discontinuation: an unexpected serotonin syndrome. Am J Psychiatr. 1993; 150:837. [PubMed 8480837]
309. Feighner JP, Boyer WF, Tyler DL et al. Adverse consequences of fluoxetine-MAOI combination. J Clin Psychiatr. 1990; 51:222-5.
310. Jermaine DM. Potential fluoxetine-selegiline interaction. Ann Pharmacother. 1992; 26:1300.
311. Miller F, Friedman, R et al. Disseminated intravascular coagulation and acute myoglobinuric renal failure: A consequence of the serotonin syndrome. J Clin Psychopharmacol. 1991; 11:277-9. [PubMed 1918432]
312. Neuvonen PJ, Pohjola-Sintonen S, Tacke U et al. Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses. Lancet. 1993; 342:1419. [PubMed 7901695]
313. Sternbach H. Danger of MAOI therapy after fluoxetine withdrawal. Lancet. 1988; 2:850-1. [PubMed 2902292]
314. Spigset O, Mjorndal T, Lovhelm O. Serotonin syndrome caused by a moclobemide-clomipramine interaction. Br Med J. 1993; 306:248.
315. Hojer J, Personne M, Skagius AS et al. Serotonin syndrome. Several cases of this often overlooked diagnosis. Lakartidningen. 2002; 99:2054-5, 2058-60. [PubMed 12082784]
316. Brosen K, Naranjo CA. Review of pharmacokinetic and pharmacodynamic interaction studies with citalopram. Eur Neuropsychopharmacol. 2001; 11:275-83. [PubMed 11532381]
317. Dams R, Benijts TH, Lambert WE et al. A fatal case of serotonin syndrome after combined moclobemide-citalopram intoxication. J Anal Toxicol. 2001; 25:147-51. [PubMed 11300508]
318. Laine K, Anttila M, Heinonen E et al. Lack of adverse interactions between concomitantly administered selegiline and citalopram. Clin Neuropharmacol. 1997; 20:419-33. [PubMed 9331518]
319. Blume CD. Dear doctor letter regarding use of Eldepryl. Tampa, FL: Somerset Pharmaceuticals; 1994 Nov 14.
320. Evans ML, Kortas KJ. Potential interaction between isoniazid and selective serotonin reuptake inhibitors. Am J Health-Syst Pharm. 1995; 52:2135-6. [PubMed 8535949]
321. Blier P, Bergeron R. The safety of concomitant use of sumatriptan and antidepressant treatments. J Clin Psychopharmacol. 1995; 15:106-9. [PubMed 7782482]
322. Diamond S. The use of sumatriptan in patients on monoamine oxidase inhibitors. Neurology. 1995; 45:1039-40. [PubMed 7783861]
323. Wing YK, Clifford EM, Sheehan BD et al. Paroxetine treatment and the prolactin response to sumatriptan. Psychopharmacology. 1996; 124:377-9. [PubMed 8739554]
324. Szabo CP. Fluoxetine and sumatriptan: possibly a counterproductive combination. J Clin Psychiatr. 1995; 56:37-8.
325. Gutierrez M, Abramowitz W. Lack of effect of a single dose of ketoconazole on the pharmacokinetics of citalopram. Pharmacotherapy. 2001; 21:163-8. [PubMed 11213852]
326. Liston HL, Markowitz JS, Hunt N et al. Lack of citalopram effect on the pharmacokinetics of cyclosporine. Psychosomatics. 2001; 42:370-2. [PubMed 11496034]
327. Benazzi F. Organic hypomania secondary to sibutramine-citalopram interaction. J Clin Psychiatr. 2002; 63:165.
328. Nolting A, Abramowitz W. Lack of interaction between citalopram and the CYP3A4 substrate triazolam. Pharmacotherapy. 2000; 20:750-5. [PubMed 10907965]
329. Moller SE, Larsen F, Pitsiu M et al. Effect of citalopram on plasma levels of oral theophylline. Clin Ther. 2000; 22:1494-501. [PubMed 11192140]
330. Rosenblatt JE, Rosenblatt NC. How long a hiatus between discontinuing fluoxetine and beginning sertraline? Curr Affect Illness. 1992; 11(8):2. Abstract.
331. Schleis T. Realities of the fluoxetine-to-sertraline switch. Am J Health-Syst Pharm. 1995; 52:423. [PubMed 7757876]
332. SmithKline Beecham Pharmaceuticals, Philadelphia, PA: Personal communication.
333. Stock AJ, Kofoed L. Therapeutic interchange of fluoxetine and sertraline: experience in the clinical setting. Am J Hosp Pharm. 1994; 51:2279-81. [PubMed 7801990]
334. Reviewers’ comments (personal observations) on sertraline hydrochloride 28:16.04.
335. Moller SE, Larsen F, Khan AZ et al. Lack of effect of citalopram on the steady-state pharmacokinetics of carbamazepine in healthy male subjects. J Clin Psychopharmacol. 2001; 21:493-9. [PubMed 11593075]
336. Leinonen E, Lepola U, Koponen H. Substituting carbamazepine with oxcarbazepine increases citalopram levels. A report on two cases. Pharmacopsychiatry. 1996; 29:156-8. [PubMed 8858715]
337. Steinacher L, Vandel P, Zullino DF et al. Carbamazepine augmentation in depressive patients non-responding to citalopram: a pharmacokinetic and clinical pilot study. Eur Neuropsychopharmacol. 2002; 12:255-60. [PubMed 12007677]
338. Baumann P. Care of depression in the elderly: comparative pharmacokinetics of SSRIs. Int Clin Psychopharmacol. 1998; 13(Suppl 5):S35-43. [PubMed 9817619]
339. Catterson ML, Preskorn SH. Pharmacokinetics of selective serotonin reuptake inhibitors: clinical relevance. Pharmacol Toxicol. 1996; 78:203-8. [PubMed 8861776]
340. Forest Pharmaceuticals, Inc. Lexapro (escitalopram oxalate) prescribing information. St. Louis, MO; 2002 Aug.
341. Parker NG, Brown CS. Citalopram in the treatment of depression. Ann Pharmacother. 2000; 34:761-71. [PubMed 10860138]
342. American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002; 159(4 Suppl):1-50.
343. Kupfer DJ, Chengappa KNR, Gelenberg AJ et al. Citalopram as adjunctive therapy in bipolar depression. J Clin Psychiatry. 2001; 62:985-90. [PubMed 11780881]
344. Barclay TS, Lee AJ. Citalopram-associated SIADH. Ann Pharmacother. 2002; 36:1558-63. [PubMed 12243606]
345. Burke WJ, Gergel I, Bose A. A fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients. J Clin Psychiatry. 2002; 63:331-6. [PubMed 12000207]
346. Sharpe R. Monsanto, FDA are trying to overcome confusion over name of arthritis drug. Wall St J. 1999 Apr 15.
347. Personne M, Sjoberg G, Persson H. Citalopram overdose—review of cases treated in Swedish hospitals. Clin Toxicol. 1997; 35:237-40.
348. Reviewers’ comments (personal observations).
349. Forest Pharmaceuticals, Inc., St. Louis, MO: Personal communication.
350. Varia IM, Cloutier CA, Doraiswamy PM. Treatment of social anxiety disorder with citalopram. Prog Neuropsychopharmacol Biol Psychiatry. 2002; 26:205-8. [PubMed 11853114]
351. Schneier FR, Blanco C, Campeas R et al. Citalopram treatment of social anxiety disorder with comorbid major depression. Depress Anxiety. 2003; 17:191-6. [PubMed 12820174]
352. Atmaca M, Kuloglu M, Tezcan E et al. Efficacy of citalopram and moclobemide in patients with social phobia: some preliminary findings. Hum Psychopharmacol. 2002; 17:401-5. [PubMed 12457375]
353. Simon NM, Sharma SG, Worthington JJ et al. Citalopram for social phobia: a clinical case series. Prog Neuropsychopharmacol Biol Psychiatry. 2001; 25:1469-74. [PubMed 11513360]
354. Bouwer C, Stein DJ. Use of the selective serotonin reuptake inhibitor citalopram in the treatment of generalized social phobia. J Affect Disord. 1998; 49:79-82. [PubMed 9574863]
355. Lepola U, Koponen H, Leinonen E. Citalopram in the treatment of social phobia: a report of three cases. Pharmacopsychiatry. 1994; 27:186-8. [PubMed 7838888]
356. Waugh J, Goa KL. Escitalopram : a review of its use in the management of major depressive and anxiety disorders. CNS Drugs. 2003; 17:343-62. [PubMed 12665392]
357. Barbey JT, Roose SP. SSRI safety in overdose. J Clin Psychiatry. 1998; 59(Suppl. 5):42-8. [PubMed 9786310]
358. Reviewers’ comments (personal observations) on clomipramine hydrochloride 28:16.04.
359. Kaminski CA, Robbins MS, Weibley RE. Sertraline intoxication in a child. Ann Emerg Med. 1994; 23:1371-4. [PubMed 8198316]
360. Baumgartner JL, Emslie GJ, Crismon ML. Citalopram in children and adolescents with depression or anxiety. Ann Pharmacother. 2002; 36:1692-7. [PubMed 12398561]
361. Calabrese JR, Londborg PD, Shelton MD et al. Citalopram treatment of fluoxetine-intolerant patients. J Clin Psychiatry. 2003; 64:562-7. [PubMed 12755660]
362. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002:277-81.
363. Holland S, Townley S, Summerfield R. Citalopram – a risk factor for postoperative hyponatraemia. Anaesthesia. 2003; 58:491-2. [PubMed 12694018]
364. Hagebeuk EEO, Tans JTJ, de Regt EW. A stroke patient with a non-convulsive status epilepticus during citalopram therapy. Eur J Neurol. 2002; 9:315-22.
365. Anon. FDA statement regarding the anti-depressant Paxil for pediatric population. FDA Talk Paper. Rockville, MD: Food and Drug Administration; 2003 Jun 30. T03-43. From the FDA website.
366. Food and Drug Administration. Questions and answers on Paxil (paroxetine hydrochloride). From: Center for Drug Evaluation and Research web site. 2003 Jun 23. From the FDA website.
367. Anon. FDA issues public health advisory entitled: Reports of suicidality in pediatric patients being treated with antidepressant medications for major depressive disorder (MDD). FDA Talk Paper. Rockville, MD: Food and Drug Administration; 2003 Oct 27. From the FDA website.
368. Anon. Reports of suicidality in pediatric patients being treated with antidepressant medications for major depressive disorder (MDD). FDA Public Health Advisory. Rockville, MD: Food and Drug Administration; 2003 Oct 27. From the FDA website.
369. Anon. SSRIs safe for children? Med Lett Drugs Ther.2003; 45:53-4.
370. US Food and Drug Administration. Antidepressant use in children, adolescents, and adults: class revisions to product labeling. Rockville, MD; 2007 May 2. From the FDA web site.
371. US Food and Drug Administration. FDA news: FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. Rockville, MD; 2007 May 2. From the FDA web site.
372. Anon. FDA statement on recommendations of the psychopharmacologic drugs and pediatric advisory committees. Rockville, MD; 2004 Sep 16. From the FDA web site.
373. American Psychiatric Association (APA). APA responds to FDA’s new warning on antidepressants. Arlington, VA; 2004 Oct. 15. From the APA web site.
374. American Academy of Child and Adolescent Psychiatry (AACAP). AACAP responds to the new FDA warnings on pediatric antidepressant medications. Washington, D.C; 2004 Oct 15. From the AACAP web site.
375. American Academy of Pediatrics (AAP). Children, antidepressants and a black box warning. Washington, D.C; 2004 Oct. 15. From the AAP web site.
376. US Food and Drug Administration. Revisions to medication guide: antidepressant medicines, depression and other serious mental illnesses and suicidal thoughts or actions. Rockville, MD; 2007 May 2. From the FDA web site.
377. Dalton SO, Johansen C, Mellemkjaer L et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med. 2003; 163:59-64. [PubMed 12523917]
378. van Walraven C, Mamdani MM, Wells PS et al. Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study. BMJ. 2001; 323:655-8. [PubMed 11566827]
379. Wagner KD, Robb AS, Findling RL et al. A randomized, placebo-controlled trial of citalopram for the treatment of major depression in children and adolescents. Am J Psychiatry. 2004; 161:1079-83. [PubMed 15169696]
380. Morag I, Batash D, Keidar R et al. Paroxetine use throughout pregnancy: does it pose any risk to the neonate? J Toxicol Clin Toxicol. 2004; 42:97-100.
381. Haddad PM, Pal BR, Clarke P et al. Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome? J Psychopharmacol. 2005; 19:554-7.
382. Moses-Kolko EL, Bogen D, Perel J et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA. 2005; 293:2372-85. [PubMed 15900008]
383. Sanz EJ, De-Las-Cuevas C, Kiuru A et al. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet. 2005; 365:482-7. [PubMed 15705457]
384. Dear healthcare professional letter regarding changing the Pregnancy subsection of the Precautions section in the labels for Paxil (paroxetine HCl) and Paxil(paroxetine HCl) CR. Philadelphia, PA: GlaxoSmithKline; 2005 Sep.
385. Hendrick V, Smith LM, Suri R et al. Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol. 2003; 188:812-5. [PubMed 12634662]
386. Food and Drug Administration. Public health advisory: combined use of 5-hydroxytryptamine receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephrine reuptake inhibitors (SNRIs) may result in life-threatening serotonin syndrome. Rockville, MD; 2006 Jul 19. From the FDA website.
390. Abbott Laboratories. Meridia (sibutramine hydrochloride monohydrate) capsules prescribing information. North Chicago, IL; 2006 Aug.
391. SmithKlineBeecham Pharmaceuticals. Paxil (paroxetine hydrochloride) tablets and oral suspension prescribing information. 2005 Sep.
392. Dear healthcare professional letter regarding further revisions to the labels for Paxil (paroxetine HCl) and Paxil (paroxetine HCl) CR in the pregnancy precautions and warnings section. Philadelphia, PA: GlaxoSmithKline; 2005 Dec.
393. Food and Drug Administration. Public health advisory: paroxetine. Rockville, MD; 2005 Dec 8. From the FDA website.
394. Trivedi MH, Fava M, Wisniewski SR et al. for the STAR*D Study Team. Medication augmentation after the failure of SSRIs for depression. N Engl J Med. 2006; 354:1243-52. [PubMed 16554526]
395. Rush AJ, Trivedi MH, Wisniewski SR et al. for the STAR*D Study Team. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N Engl J Med. 2006; 354:1231-42. [PubMed 16554525]
396. Clark DB, Andrus MR, Byrd DC. Drug interactions between linezolid and selective serotonin reuptake inhibitors: case report involving sertraline and review of the literature. Pharmacotherapy. 2006; 26:269-76. [PubMed 16466332]
397. Eli Lilly and Company. Cymbalta (duloxetine hydrochloride) delayed-release capsules prescribing information. Indianapolis, IN; 2007 Jun 28.
398. Bridge JA, Iyengar S, Salary CB. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007; 297:1683-96. [PubMed 17440145]
399. Forest Pharmaceuticals, Inc. Celexa (citalopram hydrobromide) tablets prescribing information. St. Louis, MO; 2014 Jul.
400. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005; 352:1112-20. [PubMed 15784664]
401. Heikkine T, Ekblad U, Laine K. Transplacental transfer of citalopram, fluoxetine and their primary demethylated metabolites in isolated perfused human placenta. BJOG. 2002; 109:1003-8. [PubMed 12269673]
402. Novartis Pharmaceuticals. Clozaril (clozapine) prescribing information. East Hanover, NJ; 2005 May.
403. Forest Pharmaceuticals, Inc. Lexapro (escitalopram oxalate) tablets/oral solution prescribing information. St. Louis, MO; 2003 Dec.
405. Müller D, Weinmann W, Hermanns-Clausen M. Chinese slimming capsules containing sibutramine sold over the internet: a case series. Dtsch Arztebl Int. 2009; 106:218-22. [PubMed 19471631]
406. Wyeth. Pristiq (desvenlafaxine succinate) extended-release tablets prescribing information. Philadelphia, PA; 2009 Aug.
407. Rabins PV, Blacker D, Rovner BW et al. and the APA Work Group on Alzheimer’s Disease and other Dementias. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias, second edition. Am J Psychiatry. 2007; 164(Suppl 12):5-56.
408. Stevens DL. Association between selective serotonin-reuptake inhibitors, second-generation antipsychotics, and neuroleptic malignant syndrome. Ann Pharmacother. 2008; 42:1290-7. [PubMed 18628446]
409. Ames D, Wirshing WC. Ecstasy, the serotonin syndrome, and neuroleptic malignant syndrome--a possible link?. JAMA. 1993; 269:869-70. [PubMed 8426445]
410. Zin CS, Nissen LM, Smith MT et al. An update on the pharmacological management of post-herpetic neuralgia and painful diabetic neuropathy. CNS Drugs. 2008; 22:417-42. [PubMed 18399710]
411. Pfizer. Zyvox (linezolid) injection, tablets, and for oral suspension prescribing information. New York, NY: 2008 Jul.
412. Steinberg M, Morin AK. Mild serotonin syndrome associated with concurrent linezolid and fluoxetine. Am J Health-Syst Pharm. 2007; 264:59-62.
413. Taylor JJ, Wilson JW, Estes LL et al. Linezolid and serotonergic drug interactions: a retrospective survey. Clin Infect Dis. 2006; 43:180-7. [PubMed 16779744]
414. Sola CL, Bostwick JM, Hart DA et al. Anticipating linezolid-SSRI interactions in the general hospital setting: an MAOI in disguise. Mayo Clin Proc. 2006; 81:330-4. [PubMed 16529136]
415. Hachem RY, Hicks K, Huen A et al. Myelosuppression and serotonin syndrome associated with concurrent use of linezolid and selective serotonin reuptake inhibitors in bone marrow transplant recipients. Clin Infect Dis. 2003; 37:e8-11. [PubMed 12830431]
416. Food and Drug Administration. FDA drug safety communication: abnormal heart rhythms associated with high doses of celexa (citalopram hydrobromide). Rockville, MD; 2011 Aug 24. Available from FDA website.
417. Food and Drug Administration. Celexa (citalopram hydrobromide): Drug safety communication- abnormal heart rhythms associated with high doses. Rockville, MD; 2011 Aug 24. Available from FDA website.
418. de Gregorio C, Morabito G, Cerrito M et al. Citalopram-induced long QT syndrome and torsade de pointes: role for concomitant therapy and disease. Int J Cardiol. 2011; 148:226-8. [PubMed 19540606]
419. Bruggisser M, Bravo A, Bodmer M. [Medication associated long QT syndrome]. Praxis (Bern 1994). 2009; 98:1409-15; quiz 1415. [PubMed 19953465]
420. Kanjanauthai S, Kanluen T, Chareonthaitawee P. Citalopram induced torsade de pointes, a rare life threatening side effect. Int J Cardiol. 2008; 131:e33-4. [PubMed 17919753]
421. Fayssoil A, Issi J, Guerbaa M et al. Torsade de pointes induced by citalopram and amiodarone. Ann Cardiol Angeiol (Paris). 2011; 60:165-8. [PubMed 21295285]
422. Tarabar AF, Hoffman RS, Nelson L. Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest. J Med Toxicol. 2008; 4:101-5. [PubMed 18570170]
423. Isbister GK, Friberg LE, Stokes B et al. Activated charcoal decreases the risk of QT prolongation after citalopram overdose. Ann Emerg Med. 2007; 50:593-600. [PubMed 17719135]
424. Food and Drug Administration. FDA drug safety communication: revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. Rockville, MD; 2012 Mar 28. Available from FDA website.
425. Forest Pharmaceuticals, Inc. Viibryd (vilazodone hydrochloride) tablets prescribing information. St Louis, MO; 2011 Mar.
600. Food and Drug Administration. FDA drug safety communication: Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies. 2011 Dec 14. From the FDA website.
601. Roerig, Division of Pfizer Inc. Zoloft (sertraline hydrochloride) tablets and oral concentrate. 2012 Jan.
602. Chambers CD, Hernandez-Diaz S, Van Marter LJ et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. New Engl J Med. 2006; 354:579-87. [PubMed 16467545]
603. Källén B, Olausson PO. Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2008; 17:801-6. [PubMed 18314924]
604. Wichman CL, Moore KM, Lang TR et al. Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc. 2009; 84:23-7. [PubMed 19121250]
605. Andrade SE, McPhillips H, Loren D et al. Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2009; 18:246-52. [PubMed 19148882]
606. Wilson KL, Zelig CM, Harvey JP et al. Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol. 2011; 28:19-24. [PubMed 20607643]
607. US Food and Drug Administration. Public health advisory: treatment challenges of depression in pregnancy and the possibility of persistent hypertension in newborns. Rockville, MD; 2006 Jul 19. From the FDA website.
608. Yonkers KA, Wisner KL, Stewart DE et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstet Gynecol. 2009; 114:703-13. [PubMed 19701065]
609. Cohen LS, Altshuler LL, Harlow BL et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA. 2006; 295:499-507. [PubMed 16449615]
610. Kieler H, Artama M, Engeland A et al. Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. Br Med J. 2012; 344:d8012.
611. US Food and Drug Administration. Drug Safety Communication: Serious CNS reactions possible when linezolid (Zyvox) is given to patients taking certain psychiatric medications. 2011 Jul 26. From FDA website.
612. US Food and Drug Administration. Drug Safety Communication: Updated information about the drug interaction between linezolid (Zyvox) and serotonergic psychiatric medications. 2011 Oct 20. From FDA website.
613. Food and Drug Administration. Drug Safety Communication: Serious CNS reactions possible when methylene blue is given to patients taking certain psychiatric medications. 2011 Jul 26. From FDA website.
614. Food and Drug Administration. Drug Safety Communication: Updated information about the drug interaction between methylene blue (methylthioninium chloride) and serotonergic psychiatric medications. 2011 Oct 20. From FDA website.
615. Roxane Laboratories, Inc. Citalopram hydrobromide oral solution USP 10 mg/5 mL prescribing information. Columbus, OH; 2014 May.
616. Boehringer Ingelheim, Roxane Laboratories. Safety data sheet: Citalopram hydrobromide oral solution USP, 10mg/5mL. Columbus, OH; 2014 Nov 11.
a. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder, third edition. Am J Psychiatry. 2010; 167(suppl)
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