Therapeutic plasma concentrations (parent drug + active metabolite) = 200-350 ng/m L.Mild-moderate sedation; constipation; nausea; increased appetite; mild-moderate anticholinergic effects; d the TCA least likely to produce postural hypotension. SSRIs have few anticholinergic and cardiovascular adverse effects.Life-threatening and fatal reactions have occurred in patients who receive SSRIs within 2 weeks of using monoamine oxidase inhibitor antidepressants.
In vitro studies indicated that CYP3A4 and CYP2C19 are the primary enzymes involved in the metabolism of citalopram.
Citalopram is a relatively weak inhibitor of CYP2D6.
Anxiety; nervousness; insomnia; anorexia; mild bradycardia; sinoatrial node slowing; weight loss; solar photosensitivity; hyponatremia; sexual dysfunction; may alter glycemic control in diabetic patients.
EKG at baseline to evaluate for preexisting cardiac conduction abnormalities.
Therapeutic drug concentration ranges in plasma have been identified for all agents, but dosage adjustments should be based on a patient's clinical response and not solely on plasma concentrations.
Marked sedation; dizziness; headache; weight gain; anticholinergic effects; d orthostatic blood pressure (BP) changes (postural hypotension); may produce sexual dysfunction.Therapeutic plasma concentrations (parent drug + active metabolite) = 110-250 ng/m L.Moderately to very sedating; dizziness; headache; weight gain; moderate anticholinergic effects; d postural hypotension.Optimal antidepressant effect is characteristically delayed by 2-3 weeks; however, onset of antianxiety effect is comparatively rapid.Therapeutic plasma concentrations (parent drug + active metabolite) = 100-200 ng/m L.Moderately to very sedating; dizziness; headache; weight gain; moderate anticholinergic effects; d moderate-marked orthostatic BP changes; may produce sexual dysfunction (both genders).