Citalopram: a comprehensive review

Citalopram is a selective serotonin re-uptake inhibitor that has demonstrated antidepressant efficacy in numerous controlled clinical trials. Additional studies have shown that the drug benefits patients with other illnesses that are related in some way to serotonergic dysfunction, including anxiety, panic disorder, obsessive-compulsive disorder, premenstrual dysphoria, alcohol dependence and the behavioural disturbances of dementia. This paper reviews the full spectrum of citalopram’s clinical efficacy, as well as its safety and tolerability, in a range of patients.

[1]  N. Damsbo,et al.  Citalopram and imipramine in the treatment of depressive patients in general practice. A Nordic multicentre clinical study , 1994, International clinical psychopharmacology.

[2]  M. Fava,et al.  Residual symptoms in depressed patients who respond acutely to fluoxetine. , 1999, The Journal of clinical psychiatry.

[3]  R. Frey,et al.  Suicide by antidepressant intoxication identified at autopsy in Vienna from 1991–1997: the favourable consequences of the increasing use of SSRIs , 2000, European Neuropsychopharmacology.

[4]  P. Benfield,et al.  CITALOPRAM : A REVIEW OF ITS PHARMACOLOGY, CLINICAL EFFICACY AND TOLERABILITY IN THE TREATMENT OF DEPRESSION , 1997 .

[5]  D. Shaw,et al.  A Comparison of the Antidepressant Action of Citalopram and Amitriptyline , 1986, British Journal of Psychiatry.

[6]  K. Behnke,et al.  Efficacy and tolerability of mirtazapine versus citalopram: a double-blind, randomized study in patients with major depressive disorder. Nordic Antidepressant Study Group. , 1999, International clinical psychopharmacology.

[7]  S. Montgomery,et al.  The optimal dosing regimen for citalopram‐a meta‐analysis of nine placebo‐controlled studies , 1994, International clinical psychopharmacology.

[8]  J. Samet,et al.  Food and Drug Administration , 2007, BMJ : British Medical Journal.

[9]  A. Nierenberg,et al.  Evidence of early onset of antidepressant effect in randomized controlled trials. , 2001, The Journal of clinical psychiatry.

[10]  C. Moorehead.  All rights reserved , 1997 .

[11]  F. Rouillon,et al.  Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy. , 2001, The British journal of psychiatry : the journal of mental science.

[12]  D. Nutt,et al.  Antidepressant drugs and the cardiovascular system: a comparison of tricylics and selective serotonin reuptake inhibitors and their relevance for the treatment of psychiatric patients with cardiovascular problems , 1997, Journal of psychopharmacology.

[13]  Dan J Stein,et al.  Citalopram 20 mg, 40 mg and 60 mg are all effective and well tolerated compared with placebo in obsessive-compulsive disorder , 2001, International clinical psychopharmacology.

[14]  L. Teri,et al.  Behavior and caregiver burden: behavioral problems in patients with Alzheimer disease and its association with caregiver distress. , 1997, Alzheimer disease and associated disorders.

[15]  F. Müller-Spahn.  Behavioral disturbances in dementia , 2003, Dialogues in clinical neuroscience.

[16]  M. Fava,et al.  Weight gain and antidepressants. , 2000, The Journal of clinical psychiatry.

[17]  G. Andersen,et al.  Effective Treatment of Poststroke Depression With the Selective Serotonin Reuptake Inhibitor Citalopram , 1994, Stroke.

[18]  M. Simanyi,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 , 2000, International journal of geriatric psychiatry.

[19]  Candace S. Brown,et al.  Citalopram in the Treatment of Depression , 2000, The Annals of pharmacotherapy.

[20]  H. Petersen,et al.  Citalopram versus mianserin , 1985, Acta psychiatrica Scandinavica.

[21]  L. Timmerman,et al.  A double-blind comparative clinical trial of citalopram vs maprotiline in hospitalized depressed patients. , 1987, International clinical psychopharmacology.

[22]  R. Findling,et al.  Antidepressant treatment during breast-feeding. , 1996, The American journal of psychiatry.

[23]  K. Schmidt,et al.  Citalopram and breast-feeding: serum concentration and side effects in the infant , 2000, Biological Psychiatry.

[24]  E. Eriksson.  Serotonin reuptake inhibitors for the treatment of premenstrual dysphoria. , 1999, International clinical psychopharmacology.

[25]  J. Harten.  Clinical Pharmacokinetics of Selective Serotonin Reuptake Inhibitors , 1993 .

[26]  A. Nierenberg,et al.  Evolution of remission as the new standard in the treatment of depression. , 1999, The Journal of clinical psychiatry.

[27]  O. Spigset,et al.  Fatal overdose with citalopram , 1996, The Lancet.

[28]  T. Bougerol,et al.  Citalopram and Fluoxetine in Major Depression , 1997 .

[29]  S. Stahl.  Placebo-controlled comparison of the selective serotonin reuptake inhibitors citalopram and sertraline , 2000, Biological Psychiatry.

[30]  J. Feighner,et al.  Multicenter, placebo-controlled, fixed-dose study of citalopram in moderate-to-severe depression. , 1999, The Journal of clinical psychiatry.

[31]  C. Naranjo,et al.  Variations in response to citalopram in men and women with alcohol dependence. , 2000, Journal of psychiatry & neuroscience : JPN.

[32]  S. Montgomery.  Efficacy in long-term treatment of depression. , 1996, The Journal of clinical psychiatry.

[33]  S. Sindrup,et al.  Citalopram: Interaction Studies with Levomepromazine, Imipramine, and Lithium , 1993, Therapeutic drug monitoring.

[34]  P. Bech,et al.  Citalopram in Depression—Meta‐analysis of Intended and Unintended Effects , 1992, International clinical psychopharmacology.

[35]  P. Rolan,et al.  Investigation of multiple dose citalopram on the pharmacokinetics and pharmacodynamics of racemic warfarin. , 2003, British journal of clinical pharmacology.

[36]  S. Montgomery,et al.  A 24‐week study of 20 mg citalopram, 40 mg citalopram, and placebo in the prevention of relapse of major depression , 1993, International clinical psychopharmacology.

[37]  F. Musshoff,et al.  Fatality caused by a combined trimipramine-citalopram intoxication. , 1999, Forensic science international.

[38]  A. Zwinderman,et al.  Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. , 1998, Journal of clinical psychopharmacology.

[39]  P. Tanghøj,et al.  Cardiac safety of citalopram: prospective trials and retrospective analyses. , 1999, Journal of clinical psychopharmacology.

[40]  D. Jeste,et al.  Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. Risperidone Study Group. , 1999, The Journal of clinical psychiatry.

[41]  E. Eriksson,et al.  Citalopram in premenstrual dysphoria: is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle? , 1998, Journal of clinical psychopharmacology.

[42]  J. Hyttel.  Pharmacological characterization of selective serotonin reuptake inhibitors (SSRIs) , 1994, International clinical psychopharmacology.

[43]  C. Astrup,et al.  A double‐blind comparison of citalopram (Lu 10–171) and amitriptyline in depressed patients , 1987, Acta psychiatrica Scandinavica.

[44]  M. Paech,et al.  Citalopram and demethylcitalopram in human milk; distribution, excretion and effects in breast fed infants. , 2000, British journal of clinical pharmacology.

[45]  W. Abramowitz,et al.  Lack of Effect of a Single Dose of Ketoconazole on the Pharmacokinetics of Citalopram , 2001, Pharmacotherapy.

[46]  É. Zarifian,et al.  Citalopram versus maprotiline: A controlled, clinical multicentre trial in depressed patients , 1987, Acta psychiatrica Scandinavica.

[47]  P. Thomsen,et al.  Child and adolescent obsessive-compulsive disorder treated with citalopram: findings from an open trial of 23 cases. , 1997, Journal of child and adolescent psychopharmacology.

[48]  L. Fabre,et al.  Double‐blind comparison of citalopram and placebo in depressed outpatients with melancholia , 1999, Depression and anxiety.

[49]  Effect of citalopram on plasma levels of oral theophylline. , 2000, Clinical therapeutics.

[50]  J. Balldin,et al.  Effect of citalopram on alcohol intake in heavy drinkers. , 1994, Alcoholism, clinical and experimental research.

[51]  S. Montgomery,et al.  An assessment of selective serotonin reuptake inhibitor discontinuation symptoms with citalopram , 2000, International clinical psychopharmacology.

[52]  A. Nolting,et al.  Lack of Interaction Between Citalopram and the CYP3A4 Substrate Triazolam , 2000, Pharmacotherapy.

[53]  C. Hoogduin,et al.  Efficacy and tolerability of citalopram in comparison with fluvoxamine in depressed outpatients: a double‐blind, multicentre study , 1996 .

[54]  I. Hindmarch,et al.  Citalopram Compared to Dothiepin and Placebo: Effects on Cognitive Function and Psychomotor Performance , 1997 .

[55]  Global Survey Examines Impact of Depression , 2000, Science.

[56]  E. Leinonen,et al.  Citalopram controls phobic symptoms in patients with panic disorder: randomized controlled trial. , 2000, Journal of psychiatry & neuroscience : JPN.

[57]  M. Catalano,et al.  Effects of fluvoxamine and citalopram in maintaining abstinence in a sample of Italian detoxified alcoholics. , 1998, Alcohol and alcoholism.

[58]  D. Greenblatt,et al.  Citalopram and desmethylcitalopram in vitro: human cytochromes mediating transformation, and cytochrome inhibitory effects , 1999, Biological Psychiatry.

[59]  L. Knorring,et al.  A double‐blind multicenter trial comparing sertraline and citalopram in patients with major depression treated in general practice , 1997, International clinical psychopharmacology.

[60]  M. Humble,et al.  Serotonin, Panic Disorder and Agoraphobia: Short‐term and Long‐term Efficacy of Citalopram in Panic Disorders , 1992, International clinical psychopharmacology.

[61]  U. Ahlfors,et al.  Clinical multicentre study of citalopram compared double-blindly with mianserin in depressed patients in Finland , 1988 .

[62]  S. Møller,et al.  Lack of Effect of Citalopram on the Steady-State Pharmacokinetics of Carbamazepine in Healthy Male Subjects , 2001, Journal of clinical psychopharmacology.

[63]  S. Montgomery,et al.  Dose Response Relationship of Citalopram 20 mg, Citalopram 40 mg and Placebo in the Treatment of Moderate and Severe Depression , 1992 .

[64]  M. Dahl,et al.  Citalopram Causes No Significant Alterations in Plasma Neuroleptic Levels in Schizophrenic Patients , 1997, The Journal of international medical research.

[65]  E. Leinonen,et al.  Citalopram in the treatment of social phobia: a report of three cases. , 1994, Pharmacopsychiatry.

[66]  C. Kyle,et al.  Comparison of the tolerability and efficacy of citalopram and amitriptyline in elderly depressed patients treated in general practice , 1998, Depression and anxiety.

[67]  M. Guazzelli,et al.  Increased remission rates with venlafaxine compared with fluoxetine in hospitalized patients with major depression and melancholia , 2000, International clinical psychopharmacology.

[68]  U. Meyer,et al.  Identification of three cytochrome P450 isozymes involved in N-demethylation of citalopram enantiomers in human liver microsomes. , 1997, Pharmacogenetics.

[69]  B. Pollock,et al.  Plasma levels of citalopram enantiomers and metabolites in elderly patients. , 1997, Psychopharmacology bulletin.

[70]  S. Roose,et al.  SSRI safety in overdose. , 1998, The Journal of clinical psychiatry.

[71]  A. Avenoso,et al.  No Effect of Citalopram on Plasma Levels of Clozapine, Risperidone and their Active Metabolites in Patients with Chronic Schizophrenia , 1998 .

[72]  J. Lépine,et al.  Citalopram in doses of 20–60 mg is effective in depression relapse prevention: a placebo‐controlled 6 month study , 1995, International clinical psychopharmacology.

[73]  B. Källén,et al.  Delivery outcome after the use of antidepressants in early pregnancy , 1999, European Journal of Clinical Pharmacology.

[74]  G. Andersen,et al.  Citalopram for post-stroke pathological crying , 1993, The Lancet.

[75]  C. Muldoon.  The safety and tolerability of citalopram , 1996, International clinical psychopharmacology.

[76]  O. Olesen,et al.  Citalopram and desmethylcitalopram concentrations in breast milk and in serum of mother and infant. , 1997, Therapeutic drug monitoring.

[77]  H. Refsum,et al.  A controlled multicenter clinical study of citalopram and placebo in elderly depressed patients with and without concomitant dementia , 1992, Acta psychiatrica Scandinavica.

[78]  H. Persson,et al.  Citalopram overdose--review of cases treated in Swedish hospitals. , 1997, Journal of toxicology. Clinical toxicology.

[79]  D. Stein,et al.  Use of the selective serotonin reuptake inhibitor citalopram in the treatment of generalized social phobia. , 1998, Journal of affective disorders.

[80]  O. Spigset,et al.  Excretion of citalopram in breast milk. , 2003, British journal of clinical pharmacology.

[81]  G A Chase,et al.  Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. , 1990, The American journal of psychiatry.

[82]  P. Waller,et al.  A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms occurring on withdrawal. , 2003, British journal of clinical pharmacology.

[83]  D. Greenblatt,et al.  Human cytochromes and some newer antidepressants: kinetics, metabolism, and drug interactions. , 1999, Journal of clinical psychopharmacology.

[84]  R. Hardy,et al.  An unusual multiple drug intoxication case involving citalopram. , 2000, Journal of analytical toxicology.

[85]  W. Abramowitz,et al.  Steady‐State Pharmacokinetics of Citalopram in Young and Elderly Subjects , 2000, Pharmacotherapy.

[86]  E. Leinonen,et al.  A controlled, prospective, 1-year trial of citalopram in the treatment of panic disorder. , 1998, Journal of Clinical Psychiatry.

[87]  E. Leinonen,et al.  Citalopram in the treatment of early-onset panic disorder and school phobia. , 1996, Pharmacopsychiatry.

[88]  E. Smeraldi,et al.  Two-year maintenance treatment with citalopram, 20 mg, in unipolar subjects with high recurrence rate. , 1999, The Journal of clinical psychiatry.

[89]  C. Gottfries,et al.  The Clinical Efficacy of Citalopram in Treatment of Emotional Disturbances in Dementia Disorders a Nordic Multicentre Study , 1990, British Journal of Psychiatry.

[90]  F. Larsen,et al.  Single-dose pharmacokinetics of citalopram in patients with moderate renal insufficiency or hepatic cirrhosis compared with healthy subjects , 1998, European Journal of Clinical Pharmacology.

[91]  E. Leinonen,et al.  Citalopram in the treatment of obsessive‐compulsive disorder: an open pilot study , 1997, Acta psychiatrica Scandinavica.

[92]  T. Bougerol,et al.  Citalopram versus fluoxetine: a double‐blind, controlled, multicentre, phase III trial in patients with unipolar major depression treated in general practice , 1996, International clinical psychopharmacology.

[93]  K. Overø,et al.  Weight monitoring during two long-term trials of citalopram , 1999, European Neuropsychopharmacology.

[94]  U. Lepola,et al.  The effect of Citalopram in panic disorder , 1997, British Journal of Psychiatry.