March 24, 2023

Starting alphabetically, today we’re profiling our first SSRI option: Citalopram.

Hi guys dr joy here today is going to be our first profile of vanessa sorry medication and we are talking about citalopram or celexa um citalopram is a valid option for a lot of people’s depression um it’s typically dosed anywhere between 10 to 40 milligrams once per day to get either in the morning or an evening um clinical pearl about establishment is that it

Does hit some of the histamine receptors in our body and so for some people that can mean they experience some sedation or drowsiness with it it’s got kind of an antihistamine effect similar to benadryl so if you’re one of those people who takes a teleprem and you do notice some drowsiness go ahead and dose it at that time the most common side effects with the

Telegram are going to be typically nausea or stomach upset dry mouth you can have either drowsiness or insomnia in some cases and sweating what’s worthy points about citalopram so citalopram unfortunately has an fda warning um on its labeling and that is because it is known to carry an increased risk for causing an abnormal heart rhythm or an arrhythmia which

Can be very dangerous and potentially life-threatening so the things to remember about citalopram and this admirable heart rhythm is that the risk is higher with the higher doses of citalogram so there’s a few things we need to take into consideration regarding this risk number one you should not be on more than 20 milligrams per day of citalopram if you are over

The age of 60 years old if you have liver problems if you have gotten genetic testing done which shows that you are a slow metabolizer of citalopram and finally if you are on certain medications which can boost the levels of citalopram and cause it to build up in your blood next consideration is is very important it is super super important that your doctor be

Checking your ekg before you start on citalopram and then after any dose increase of your stotelogram so in my patients across the board i’m doing this i’m checking an ekg at least annually if not more often and what i’m looking for is this little calculation called the qtc interval so the qtc number is going to give me and your doctors kind of an indication as

To whether you might be approaching what we consider the danger zone so getting closer to or being at even higher risk for having one of these dangerous abnormal heart rhythms so something to keep in mind if you’re on satellite ram and at any point you experience chest pain dizziness heart palpitations or skipped beats flutters especially if you pass out while

Taking citalopram you need to seek immediate medical attention because any of these symptoms could be a sign of that underlying abnormal heart rhythm next thing to consider is there are commonly used medications which when taken with citalopram could actually increase your risk of having a dangerous abnormal heart rhythm and these medications are typically called

Qtc prolonging medications um unfortunately they can be rather common for example you’ve got a popular over-the-counter anti-gerd medication called prilosec or omeprazole it’s qtc prolonging medicine uh popular anti-nausea medication often prescribed zofran or on dansatron um uh antihistamine anti-itching anti-anxiety medication that can be prescribed visceral

Or hydroxyzine so any of these and really many many more medications can be considered qtc prolonging meds which when combined with your citalopram can’t increase your risk even more of having an abnormal heart event and finally there are certain people it seems that are at higher risk for qtc prolongation which could then lead to that arrhythmia so risks can

Include being a female um having any kind of electrolyte imbalances so whether you have chronic diarrhea um whether you’re on medications that affect the electrolytes like water pills or diuretics um if you are either underweight or obese and if you have a low resting heart rate alright guys so that’s all for today just a little mini session on citalopram and

Next time we will be talking about another ssri option to treat your depression until then i am dr joy here with simplymental where our aim is to make mental illness and awareness easier for you and yours take care

Transcribed from video
SSRI Antidepressant Profile ++ Citalopram (Celexa) By Simply Mental