SSRI·Psychiatry - Antidepressants

Citalopram

Major Depressive Disorder, Panic Disorder

PBSSSRICelapram, Cipramil20 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

40 mg/day

Half-life

35 h

High risk: QTc Risk

CRITICAL

Caution: Elderly Max

20 mg/day

Cautions

Avoid / Cautions

Baseline QTc > 500 ms, concurrent MAOI use. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Racemic SSRI. Very effective and highly tolerable, but strictly dose-capped worldwide due to a high, dose-dependent risk of fatal QTc prolongation.

Clinical Focus

Do not exceed 20 mg in the elderly. Historically, doses of 60mg were used, but this is now heavily contraindicated due to sudden cardiac death.

Bottom Line

Citalopram is an SSRI for depression and anxiety disorders, but has a dose-dependent QTc prolongation risk with a maximum dose of 40 mg/day (20 mg in elderly).

Formulation & Access

Brand Names

Celapram, Cipramil

Oral Routes

Tablets (20 mg, 40 mg). Oral liquid.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder, Panic Disorder.

Clinical Place

First-line SSRI option, though increasingly superseded by Escitalopram (which isolates the active S-enantiomer and has a slightly better safety profile).

Quick reference

Class & Role

SSRI — Racemic SSRI.

Route / Formulation

Tablets (20 mg, 40 mg). Oral liquid. (Celapram, Cipramil)

Usual Dose & Max

Start PO 20 mg OD. May increase to Max 40 mg/day after 2-4 weeks.

Key Indication Doses

Depression / Anxiety: Start PO 20 mg OD. May increase to Max 40 mg/day after 2-4 weeks. Elderly / Hepatic Impairment: Max PO 20 mg OD.

Best Uses

Citalopram is an SSRI for depression and anxiety disorders, but has a dose-dependent QTc prolongation risk with a maximum dose of 40 mg/day (20 mg in elderly).

Key Risks

Cardiovascular: Dose-dependent QTc prolongation, potentially leading to Torsades de Pointes. (Highest risk among all SSRIs). Metabolic: Hyponatremia (SIADH) in the elderly. Gastrointestinal: Nausea, dry mouth.

Key Interactions

Avoid mixing with other QTc prolonging drugs (e.g., Amiodarone, Haloperidol, Sotalol). Omeprazole inhibits CYP2C19, spiking Citalopram levels. Max dose is 20mg if on Omeprazole.

Monitoring

Baseline ECG to check QTc before escalating to 40 mg, or in any patient > 60 years. Check U&E (sodium) at 2-4 weeks in the elderly.

Clinical Pearl

Citalopram contains 50% inactive 'R' enantiomer. This inactive half does not help depression, but it DOES block the heart's potassium channels, causing the QTc prolongation. Switching to Escitalopram removes this 'R' garbage, lowering the cardiac risk.

Access

Celapram, Cipramil20 mg tablet

Brand: Celapram, Cipramil
Formulation: Tablets (20 mg, 40 mg). Oral liquid.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

SSRI·Psychiatry - Antidepressants

Citalopram

Major Depressive Disorder, Panic Disorder

PBSSSRICelapram, Cipramil20 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

40 mg/day

Half-life

35 h

High risk: QTc Risk

CRITICAL

Caution: Elderly Max

20 mg/day

Cautions

Avoid / Cautions

Baseline QTc > 500 ms, concurrent MAOI use. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Racemic SSRI. Very effective and highly tolerable, but strictly dose-capped worldwide due to a high, dose-dependent risk of fatal QTc prolongation.

Clinical Focus

Do not exceed 20 mg in the elderly. Historically, doses of 60mg were used, but this is now heavily contraindicated due to sudden cardiac death.

Bottom Line

Citalopram is an SSRI for depression and anxiety disorders, but has a dose-dependent QTc prolongation risk with a maximum dose of 40 mg/day (20 mg in elderly).

Formulation & Access

Brand Names

Celapram, Cipramil

Oral Routes

Tablets (20 mg, 40 mg). Oral liquid.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder, Panic Disorder.

Clinical Place

First-line SSRI option, though increasingly superseded by Escitalopram (which isolates the active S-enantiomer and has a slightly better safety profile).

Quick reference

Class & Role

SSRI — Racemic SSRI.

Route / Formulation

Tablets (20 mg, 40 mg). Oral liquid. (Celapram, Cipramil)

Usual Dose & Max

Start PO 20 mg OD. May increase to Max 40 mg/day after 2-4 weeks.

Key Indication Doses

Depression / Anxiety: Start PO 20 mg OD. May increase to Max 40 mg/day after 2-4 weeks. Elderly / Hepatic Impairment: Max PO 20 mg OD.

Best Uses

Citalopram is an SSRI for depression and anxiety disorders, but has a dose-dependent QTc prolongation risk with a maximum dose of 40 mg/day (20 mg in elderly).

Key Risks

Key Interactions

Avoid mixing with other QTc prolonging drugs (e.g., Amiodarone, Haloperidol, Sotalol). Omeprazole inhibits CYP2C19, spiking Citalopram levels. Max dose is 20mg if on Omeprazole.

Monitoring

Baseline ECG to check QTc before escalating to 40 mg, or in any patient > 60 years. Check U&E (sodium) at 2-4 weeks in the elderly.

Clinical Pearl

Access

Celapram, Cipramil20 mg tablet

Brand: Celapram, Cipramil
Formulation: Tablets (20 mg, 40 mg). Oral liquid.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.