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Side effects and drug interactions



Citalopram is generally considered safe and well-tolerated in the therapeutic dose range of 20 to 60 mg/day. A doctor must always monitor a patient taking an SSRI like citalopram. Distinct from some other agents in its class, citalopram exhibits linear pharmacokinetics and minimal drug interaction potential, making it a better choice for the elderly or comorbid patients. [6] Citalopram should be taken with caution when using St John' s wort. [7]



Citalopram can have a number of adverse effects. In clinical trials, over 10% of patients reported one or more of the following side effects: fatigue, drowsiness, dry mouth, increased sweating (hyperhidrosis), trembling, headache, dizziness, sleep disturbances, insomnia, cardiac arrhythmia, blood pressure changes, nausea and/or vomiting, diarrhea, heightened anorgasmia in females, impotence and ejaculatory problems in males.

Lainaus:

[b]In rare cases [/b](around over 1% of cases), some allergic reactions, convulsions, mood changes, anxiety and [b]confusion[/b] have been reported.

Also sedation may be present during treatment of citalopram. If this occurs it is advisable to take the dose at bedtime instead of in the morning.



Another uncommon side effect is bruxism (teeth grinding). [8] When patients start using citalopram they may experience a feeling similar to electricity or minor shocks in their upper body and in their hands. This is caused by the chemical changes occurring in the brain and they pass with time. Occasionally, panic attacks, thoughts of suicide or self-injury may occur or increase in the first few weeks, before the antidepressant effect starts. [9]



Citalopram and other SSRIs have been shown to cause sexual side effects in some patients, both males and females. [10] Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction.



Citalopram is contraindicated in individuals taking MAOIs. It is considered relatively safe in overdose, although fatal cases of dosages 840 mg to 1960 mg have been reported. [11]



SSRI discontinuation syndrome has been reported when treatment is stopped. Tapering off citalopram therapy, as opposed to abrupt discontinuation, is recommended in order to diminish the occurrence of discontinuation symptoms.



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