Uses of Arpolax: - Depression - Panic disorder Depressive illness, Bipolar disorder, Panic disorder, Substance abuse disorders, Alcohol dependence, Anxiety disorders including obsessive-compulsive disorder and social phobia, Post-traumatic stress disorder, Premenstrual syndrome, Idiopathic Parkinson's disease and Eating disorder. Hypersensitivity, concomitant admin with MAOIs or within 14 days of discontinuing MAOI treatment; children and adolescents <18 yr; treatment of depressive illness; lactation.

SSRIs & related anti-depressant drugs

Citalopram is bicyclic phthalane derivative and a selective serotonin re-uptake inhibitor, with little or no effect on noradrenaline, dopamine and GABA re-uptake. The inhibitory activity explains the antidepressant property of citalopram. It has no or very low affinity for 5-HT1AA, 5-HT2A, D1 and D2 receptors, α1, α2, β-adrenergic, histamine H1, muscarinic, cholinergic, benzodiazepine and opioid receptors.

How to use Citalopram Hydrobromide: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Citalopram Hydrobromide may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Depression; Depressive phase of bipolar disorder Adult: Initially, 20 mg/day, increased to max 40 mg/day after at least 1 wk. Elderly: 10 mg/day. Max: 20 mg/day. Hepatic impairment: Mild to moderate: 10 mg/day for the 1st 2 wk. Max: 20 mg/day. Panic disorder with or without agoraphobia Adult: Initially, 10 mg/day, increased to 20 mg/day after 1 wk. Elderly: 10 mg/day. Max: 20 mg/day. Hepatic impairment: Mild to moderate: 10 mg/day for the 1st 2 wk. Max: 20 mg/day. Child Dose: Child: Contraindicated. Renal Dose: Renal impairment: No dosage adjustment needed.

May increase anticoagulant effect w/ drugs affecting haemostatis (e.g. warfarin). Increased risk of hypomania w/ sibutramine. Increased lowering seizure threshold w/ TCAs and other SSRIs. Potentially Fatal: Increased risk of severe adverse effects (e.g. serotonin syndrome) w/ MAOI. QT interval prolongation w/ subsequent risk of torsade de pointes w/ QT-prolonging drugs (e.g. pimozide, quinidine, procainamide, chlorpromazine, thioridazine, amiodarone, sotalol, moxifloxacin, pentamidine, levomethadyl, methadone).

Hypersensitivity, concomitant admin with MAOIs or within 14 days of discontinuing MAOI treatment; children and adolescents <18 yr; treatment of depressive illness; lactation.

Common - Erectile dysfunction - Insomnia (difficulty in sleeping) - Low sexual desire - Nausea - Restlessness - Upset stomach - Vomiting >10% Dry mouth (20%),Nausea (21%),Somnolence (18%),Insomnia (15%),Xerostomia (20%),Increased sweating (11%) 1-10% Tremor (8%),Diarrhea (8%),Ejaculation disorder (6%),Rhinitis (5%),Upper respiratory infection (5%),Dyspepsia (5%),Fatigue (5%),Vomiting (4%),Anxiety (4%),Anorexia (4%),Abdominal pain (3%),Agitation (3%),Impotence (3%),Sinusitis (3%),Dysmenorrhea (3%),Decreased libido (2%),Yawning (2%),Arthralgia (2%),Myalgia (2%),Amenorrhea (>1%),Confusion (>1%),Cough (>1%),Flatulence (>1%),Increased saliva (>1%),Migraine (>1%),Orthostatic hypotension (>1%),Paresthesia (>1%),Polyuria (>1%),Pruritus (>1%),Rash (>1%),Tachycardia (>1%),Weight change (>1%) Potentially Fatal: Increased risk of suicidal thinking and behaviour especially in child and adolescents. Monitor closely for signs of clinical worsening, suicidality or unusual changes in behaviour.

Pregnancy: There are no adequate and well-controlled studies in pregnant women; therefore, Citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Lactation: Citalopram is excreted in human breast milk. So, the decision whether to continue or discontinue either nursing or Citalopram therapy should take into account the risks of Citalopram exposure for the infants and the benefits of Citalopram treatment for the mother.

Precaution: Caution should be taken in patients with epilepsy, concurrent electroconvulsive therapy, history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, history of bleeding disorders, hepatic and renal impairment. Abrupt withdrawal of Citalopram should be avoided. Gradual discontinuation of treatment if patient enters into manic phase; pregnancy. Increased risk of hyponatraemia and SIADH. May reduce convulsant threshold thus, citalopram should be used with care in epileptic patients. Lactation: Excreted in breast milk; use caution

Symptoms: Dizziness, sweating, nausea, vomiting, tremor, somnolence and sinus tachycardia. Rarely, amnesia, confusion, coma, seizures, hyperventilation, cyanosis, rhabdomyolysis and ECG changes (e.g. QT prolongation, sinus bradycardia, ventricular arrhythmias, nodal rhythm, torsade de pointes and left bundle branch block). Management: Symptomatic and supportive treatment. Maintain and ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Frequently monitor cardiac function and vital signs.

Store at 25° C.

SSRIs & related anti-depressant drugs

Citalopram is bicyclic phthalane derivative and a selective serotonin re-uptake inhibitor, w/ little or no effect on noradrenaline, dopamine and GABA re-uptake. The inhibitory activity explains the antidepressant property of citalopram. It has no or very low affinity for 5-HT1AA, 5-HT2A, D1 and D2 receptors, alpha 1, alpha2, beta-adrenergic, histamine H1, muscarinic, cholinergic, benzodiazepine and opioid receptors.

Pregnancy Pregnancy category: C Use late in the third trimester associated with complications in newborns and may require prolonged hospitalization, respiratory support, and tube feeding Lactation Excreted in breast milk; use caution