What is citalopram
Pro Research Analysisby 
Searched over 200M research papers
Understanding Citalopram: An Overview
Introduction to Citalopram
Citalopram is a selective serotonin reuptake inhibitor (SSRI) used primarily as an antidepressant. It enhances serotoninergic neurotransmission by selectively inhibiting the reuptake of serotonin, a neurotransmitter associated with mood regulation1 2 3. This mechanism makes it effective in treating major depressive disorders and other conditions related to serotonin dysfunction.
Therapeutic Efficacy of Citalopram
Depression Treatment
Citalopram has been shown to be significantly more effective than placebo in treating major depression. Clinical trials have demonstrated that it provides therapeutic efficacy comparable to other antidepressants such as amitriptyline, maprotiline, and imipramine, but with a better tolerability profile1 3 6. It is particularly effective in reducing symptoms of depressed mood and melancholia, with robust effects observed at doses of 40 and 60 mg/day6.
Other Psychiatric Disorders
Beyond depression, citalopram has shown efficacy in treating various anxiety disorders, including panic disorder and obsessive-compulsive disorder (OCD). Studies indicate that it is effective in reducing the frequency of panic attacks and symptoms of OCD, making it a versatile option for treating multiple psychiatric conditions2 4 9.
Binge-Eating Disorder
Citalopram has also been investigated for its potential in treating binge-eating disorder. A placebo-controlled trial found that citalopram significantly reduced the frequency of binge-eating episodes, body mass index (BMI), and overall severity of illness, highlighting its utility beyond traditional depressive and anxiety disorders8.
Pharmacokinetics and Safety Profile
Pharmacokinetics
Citalopram has an elimination half-life of approximately 33 hours, allowing for once-daily dosing1 3. It is metabolized into compounds that also inhibit serotonin reuptake, contributing to its sustained therapeutic effects4.
Safety and Tolerability
Citalopram is generally well tolerated, with a safety profile that includes minimal cardiotoxicity and a low incidence of seizures. Common side effects include mild and transient nausea, increased perspiration, headache, dry mouth, tremor, and insomnia, affecting 15-20% of patients1 3 6. Compared to tricyclic antidepressants, citalopram has fewer anticholinergic effects, making it a safer option for patients who cannot tolerate these side effects1 3.
Vulnerable Populations
Citalopram is considered safe for use in vulnerable populations, such as the elderly and patients with metabolic diseases. Its pharmacokinetic properties and minimal drug interaction potential make it a suitable choice for these groups2 7.
Comparative Efficacy
Versus Other Antidepressants
Citalopram has been compared with various other antidepressants, including tricyclics, other SSRIs, and non-conventional antidepressants. It has been found to be more effective than paroxetine and reboxetine, and more acceptable than tricyclics, reboxetine, and venlafaxine. However, it appears to be less effective than escitalopram10.
Conclusion
Citalopram is a well-tolerated and effective SSRI with a broad range of applications in treating depressive and anxiety disorders, as well as other conditions like binge-eating disorder. Its favorable safety profile and minimal drug interactions make it a valuable option for a wide range of patients, including those who are elderly or have comorbid conditions. Further research may expand its use in other psychiatric and medical conditions, solidifying its role in modern psychopharmacology.
Sources and full results
Most relevant research papers on this topic
Citalopram
Citalopram offers similar therapeutic efficacy and a better tolerability profile than tricyclic antidepressants, making it useful for patients who cannot tolerate anticholinergic or cardiovascular side effects.
Highly CitedCitalopram--a review of pharmacological and clinical effects.
Citalopram is a well-tolerated and effective SSRI antidepressant, with potential for treating other anxiety disorders and substance-use disorders.
Systematic ReviewHighly CitedCitalopram. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness.
Citalopram offers similar therapeutic efficacy and a better tolerability profile than tricyclic antidepressants, potentially benefiting patients with limited tolerance for anticholinergic or cardiovascular side effects.
Literature ReviewCitalopram — Pharmacological profile of a specific serotonin uptake inhibitor with antidepressant activity
Citalopram is a promising antidepressant drug due to its extreme specificity as a serotonin uptake inhibitor and absence of cardiotoxic effects.
Highly CitedCitalopram: a comprehensive review
Citalopram is an effective and safe antidepressant for various serotonergic dysfunctional illnesses, including anxiety, panic disorder, OCD, and alcohol dependence.
Literature ReviewHighly CitedMulticenter, placebo-controlled, fixed-dose study of citalopram in moderate-to-severe depression.
Citalopram is significantly more effective than placebo in treating moderate-to-severe major depression, especially depressed mood and melancholia, with particularly robust effects at 40 and 60 mg/day doses.
RCT
Large Human TrialHighly CitedCitalopram therapy for depression: a review of 10 years of European experience and data from U.S. clinical trials.
Citalopram is a superior and well-tolerated treatment for depression, with similar efficacy to tricyclic and tetracyclic antidepressants and other SSRIs, and linear pharmacokinetics and minimal drug interaction potential.
Systematic ReviewHighly CitedCitalopram in the treatment of binge-eating disorder: a placebo-controlled trial.
Citalopram effectively reduces binge-eating frequency, weight, and severity of illness and is generally well-tolerated in patients with binge-eating disorder.
RCTHighly CitedThe effect of Citalopram in panic disorder
Citalopram 20 or 30 mg/day is the most effective and well-tolerated treatment for panic disorder, with the most favorable benefit/risk ratio.
RCTLarge Human TrialHighly CitedCitalopram versus other anti-depressive agents for depression.
Citalopram is less effective than escitalopram for acute treatment of major depression, but more effective than paroxetine and reboxetine, with fewer side effects.
Meta-Analysis
Very Rigorous JournalHighly Cited