Citalopram

Citalopram
ATC Code N06AB04
Formula C20H21FN2O
Molar Mass (g·mol−1) 324,39
Physical State solid
Melting Point (°C) 182-188
PKS Value 9.78
CAS Number 59729-33-8
PUB Number 2771
Drugbank ID DB00215
Solubility low in water

Basics

Citalopram is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, and social phobia. The antidepressant effect may have a latency of up to 4 weeks. It is taken by mouth and requires a prescription.

Pharmacology

Pharmacodynamics

The mechanism of action of citalopram is based on its inhibition of neuronal reuptake of serotonin (5-HT) in the CNS. The molecular target of citalopram is the serotonin transporter (solute carrier family 6 member 4, SLC6A4), whose serotonin reuptake in the synaptic cleft is inhibited. As a result, the extracellular serotonin concentration increases permanently, thus enhancing and prolonging the mood-lifting effect of serotonin.

Pharmacokinetics

Citalopram is rapidly and well absorbed from the GI tract. Maximal plasma concentrations occur within 4 hours after a single oral dose. Bioavailability is 80% after oral administration. Citalopram is 80% bound to plasma proteins. Citalopram is metabolized primarily in the liver via N-demethylation to its major metabolite, demethylcitalopram, by the two enzymes CYP2C19 and CYP3A4. Excretion is via the urine and the mean elimination time is 35 hours.

Drug Interactions

Citalopram should not be combined with other antidepressants (especially MAO inhibitors). In addition, concomitant use of drugs that are degraded by or induce the same enzymes (CYP2C19 and CYP3A4) should be avoided.

Toxicity

Side effects

Common side effects include nausea, sleep disturbances, sexual problems, shakiness, fatigue, and sweating.

Serious side effects include increased risk of suicide in people under 25 years of age, serotonin syndrome, glaucoma, and QT prolongation. It should not be used in individuals taking an MAO inhibitor.

Side effects and withdrawal symptoms may occur when discontinuing the antidepressant.

It is not recommended for use during pregnancy or lactation.

Toxicological data

LD50 (human, oral): 56 mg/kg

Sources

  • Drugbank
  • PubChem
  • Aktories, Förstermann, Hofmann, Starke: Allgemeine und spezielle Pharmakologie und Toxikologie, Elsvier, 2017
Markus Falkenstätter

Markus Falkenstätter
Author

Markus Falkenstätter ist Autor zu pharmazeutischen Themen in der Medizin-Redaktion von Medikamio. Er befindet sich im letzten Semester seines Pharmaziestudiums an der Universität Wien und liebt das wissenschaftliche Arbeiten im Bereich der Naturwissenschaften.

Mag. pharm Stefanie Lehenauer

Mag. pharm Stefanie Lehenauer
Lector

Stefanie Lehenauer ist seit 2020 freie Autorin bei Medikamio und studierte Pharmazie an der Universität Wien. Sie arbeitet als Apothekerin in Wien und ihre Leidenschaft sind pflanzliche Arzneimittel und deren Wirkung.

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