Nothing Essay

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CITALOPRAM | INDICATIONS DepressionCONTRAINDICATIONSConcomitant use with pimozide and MAOIsHypersensitivity to citalopram | DOSAGE: with/without food morning/eveningInitial Treatment: 20 mg once daily, target dose: 40 mg/dayTitration to 40 mgday only for nonresponding elderly and hepatic impairment patientsEfficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment | WARNINGS AND PRECAUTIONSClinical Worsening and Suicide RiskNot approved for use in bipolar depressionAllow 14 days after stopping citalopram tablets before starting an MAOIconcomitant use with serotonergic agents may cause serotonin syndromeGradual reduction in the dose rather than abrupt cessation is recommendedAbnormal bleeding due to concomitant use with NSAIDs, aspirin, or drugs that affect coagulationDiscontinuation should be considered in patients with symptomatic hyponatremiaActivation of Mania/Hypomania in patients with a history of mania and SeizuresLower maximum dosage is recommended in subjects with hepatic and renal impairment Treating pregnant women: the physician may consider tapering citalopram in the third trimester | DRUG INTERACTIONSSerotonergic Drugs, Triptans: may cause serotonin syndromeDrugs That Interfere With Hemostasis (NSAIDs, Aspirin, Warfarin): potential for of upper gastrointestinal bleeding, altered anticoagulant effectsCimetidine - increase in citalopram AUC and Cmax Lithium - may enhance the serotonergic effects of citalopramPimozide – mean increase in QTc values Sumatriptan – appropriate observation is advisedWarfarin - increased prothrombin timeCarbamazepine - might increase the clearance of citalopramKetoconazole : decreases the Cmax and AUC of ketoconazoleMetoprolol - Increases metoprolol plasma levels Imipramine and Other Tricyclic Antidepressants : increases concentration of imipramine metabolite desipramine |

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