Citalopram
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SSRI, Antidepressant
Citalopram
Celexa
Experience
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1 provider report · avg efficacy 40.0/100 · avg side-effect burden 40.0/100 · 10 patients managed total
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Effects
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8093618 [Strong]: Consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. If citalopram or escitalopram are clinically appropriate, and adequate efficacy is not achieved at standard maintenance dosing, consider titrating to a higher maintenance dose. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Dosage and Administration, Warnings, Clinical Pharmacology)
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CPIC rec 8093623 [Strong]: Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If citalopram or escitalopram are clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose as compared to normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Dosage and Administration, Warnings, Clinical Pharmacology)
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CPIC rec 8093624 [Strong]: Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If citalopram or escitalopram are clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose as compared to normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Dosage and Administration, Warnings, Clinical Pharmacology)
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CPIC rec 8093620 [Strong]: Initiate therapy with recommended starting dose CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427]
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CPIC rec 8093621 [Moderate]: Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427]
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CPIC rec 8093622 [Moderate]: Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427]
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CPIC rec 8093619 [Optional]: Initiate therapy with recommended starting dose. If patient does not adequately respond to recommended maintenance dosing, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Dosage and Administration, Warnings, Clinical Pharmacology)
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Patient experience
Fluoxetine via Category:Antidepressants exp n/a/5 outcome n/a (n=1) exp 1.0/5 outcome +33.0 (n=1)
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- checking this mechanism here
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Summary
Classes
SSRI, Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Selective serotonin reuptake inhibitor