MedWorm: Citalopram

  Metabolic acidosis and generalized seizures secondary to citalopram overdose: a case report

We report a case of citalopram overdose with metabolic acidosis and generalized seizure. To our best knowledge, this is the first case reported in Saudi Arabia. (Source: Journal of Clinical Pharmacy and Therapeutics)

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  Response to intravenous antidepressant treatment by suicidal vs. nonsuicidal depressed patients

Conclusions: Being suicidal may limit response to treatment in depressed major affective disorder patients, independent of diagnosis or overall symptomatic severity. (Source: Journal of Affective Disorders)

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  Antidepressants May Increase Risk of Cataracts

This study is the first to identify a statistical link between these antidepressants and cataracts in humans, although previous animal studies had shown that SSRIs could increase cataract risk. The authors note that this study does not prove causation, only that there is a statistical link between the two. They further note that the study was unable to account for smoking - which is a known risk factor for cataracts - and additional studies are needed to confirm their findings. The authors do not believe that this study should be cause for concern. "When you look at the trade-off of these drugs," said lead author Dr. Mahyar Etminan, "the benefits of treating depression - which can be life-threatening - still outweigh the risk of developing cataracts, which are treatable and relatively be...

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  Review: Intravenous anti-obsessive agents: a review

Oral antidepressants are currently the first-line pharmacotherapy for obsessive-compulsive disorder (OCD), but response rates can often be low and with delayed onset of therapeutic action. Some reports have suggested that intravenous (i.v.) anti-obsessive agents may have faster onset of action and greater efficacy. A Medline search was conducted for all reports pertaining to the use of i.v. antidepressants for OCD. Search terms included: ‘intravenous’, ‘clomipramine’, ‘selective serotonin reuptake inhibitor’, ‘tricyclic’, ‘citalopram’, ‘sertraline’, ‘paroxetine’, ‘fluvoxamine’, ‘SSRIs’ and ‘intravenous antidepressants’. Relevant articles mainly investigated clomipramine (...

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  Melatonin inhibits serotonin transporter activity in intestinal epithelial cells

This study shows, for the first time, that melatonin modulates SERT activity, thus demonstrating the feedback system between melatonin and the serotoninergic system in the gastrointestinal tract. (Source: Journal of Pineal Research)

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  Validity of the Definite and Semidefinite Questionnaire version of the Hamilton Depression Scale, the Hamilton Subscale and the Melancholia Scale. Part I

This study was longitudinal with 85 patients fulfilling the DSM-III-R diagnosis of Seasonal Affective Disorder. Self-reporting versions (definitely and semidefinitely anchored) corresponding to the Hamilton Depression Scale (HAMD), the Hamilton Subscale (HAM6), and the Bech–Rafaelsen Melancholia Scale (MES) were compared to each other and the clinician-rated version. The unidimensional property of the sum score in each scale was tested by the item-response theory model ad modum Rasch. The scales were also tested for their sensitivity to discriminate between placebo and citalopram therapy. The sum scores and the sum score variances of the definite self-rating versions did not differ significantly from the sum scores of the corresponding observer scales at any of the five time points...

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  Citalopram: QT-interval prolongation in an elderly patient: case report

(Source: Reactions)

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  Citalopram/paroxetine: Bruxism: 2 case reports

(Source: Reactions)

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  Aripiprazole as adjunct to a mood stabilizer and citalopram in bipolar depression: a randomized placebo-controlled pilot study

The use of atypical antipsychotics (AAPs) for the treatment of unipolar and bipolar depression has been more and more frequently evaluated, and aripiprazole showed positive effects in the treatment of unipolar depression. However, no placebo-controlled studies of adjunctive aripiprazole for the treatment of bipolar depression have been performed yet.In this prospective, double-blind, placebo-controlled, randomized trial, 23 inpatients with bipolar depression according to DSM-IV criteria were included. Before randomization, patients had to be on a constant mood stabilizer treatment with lithium or valproate for at least 1 week. After inclusion, all patients were openly treated with additional citalopram and with additional aripiprazole or placebo for 6 weeks. The primary outcome parameter w...

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  Association of Mu-Opioid Receptor Variants and Response to Citalopram Treatment in Major Depressive Disorder.

Conclusions These results suggest that rates of response to antidepressants and consequent remission from major depressive disorder are influenced by variation in the mu-opioid receptor gene as a result of either an effect on placebo response or true pharmacologic response. PMID: 20194481 [PubMed - as supplied by publisher] (Source: The American Journal of Psychiatry)

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  SSRIs Offer Model For Drug Development Opportunities To Treat Rheumatoid Arthritis

A new study found that fluoxetine (Prozac®) and citalopram (Celexa®) treatment significantly inhibited disease progression of collagen-induced arthritis (CIA) in mice. Research led by Sandra Sacre, Ph.D. from the Brighton and Sussex Medical School (BSMS) in the UK studied the anti-arthritic potential of these drugs, known as selective serotonin reuptake inhibitors (SSRIs), most commonly used to treat depression. Both SSRIs exhibited anti-inflammatory effects and may provide drug development opportunities for arthritic conditions such as rheumatoid arthritis (RA)... (Source: Health News from Medical News Today)

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  SSRIs Offer Model For Drug Development Opportunities To Treat Rheumatoid Arthritis

A new study found that fluoxetine (Prozac®) and citalopram (Celexa®) treatment significantly inhibited disease progression of collagen-induced arthritis (CIA) in mice. Research led by Sandra Sacre, Ph.D... (Source: Arthritis News From Medical News Today)

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  PERRIGO CITALOPRAM (Citalopram) Tablet [Contract Pharmacy Services-PA]

Updated Date: Feb 26, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  CITALOPRAM HYDROBROMIDEtablet [Contract Pharmacy Services-PA]

Updated Date: Feb 26, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Prozac and Celexa exhibit anti-inflammatory effects

A newly released study observed that fluoxetine (Prozac) and citalopram (Celexa) therapy significantly inhibited disease progression of collagen-induced arthritis (CIA) in mice. Research led by Sandra Sacre, Ph.D. from the Brighton and Sussex Medical School (BSMS) in the UK studied the anti-arthritic potential of these drugs, known as selective serotonin reuptake inhibitors (SSRIs), most usually used to treat depression. Both SSRIs exhibited anti-inflammatory effects and may provide drug development opportunities for arthritic conditions such as rheumatoid arthritis (RA). Full findings of this study are reported in the recent issue of Arthritis and Rheumatism, a journal of the American College of Rheumatology........ (Source: Medicineworld.org: New Article Alert)

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  Prozac and Celexa exhibit anti-inflammatory effects

(Wiley-Blackwell) A new study found that fluoxetine (Prozac) and citalopram (Celexa) treatment significantly inhibited disease progression of collagen-induced arthritis in mice. Research led by Sandra Sacre, Ph.D., from the Brighton and Sussex Medical School in the UK studied the anti-arthritic potential of these drugs, known as selective serotonin reuptake inhibitors most commonly used to treat depression. Full findings of this study are published in the March issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology. (Source: EurekAlert! - Medicine and Health)

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  Prozac and Celexa exhibit anti-inflammatory effects

A new study found that fluoxetine (Prozac) and citalopram (Celexa) treatment significantly inhibited disease progression of collagen-induced arthritis in mice. Researchers studied the anti-arthritic potential of these drugs, known as selective serotonin reuptake inhibitors most commonly used to treat depression. (Source: ScienceDaily Headlines)

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  Deaths involving serotonergic drugs. - Pilgrim JL, Gerostamoulos D, Drummer OH.

Serotonin-active drugs are detected relatively frequently in Victorian deaths. During 2002-2008, there were 1123 fatalities where one or more of the serotonin-active drugs tramadol, venlafaxine, fluoxetine, sertraline, citalopram, paroxetine and MDMA, were... (Source: SafetyLit: All (Unduplicated))

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  Impact and Clinical Management of Depression in Patients with Coronary Artery Disease

Pharmacotherapy 30(3): 304-322 Abstract The rates of major adverse coronary events, including recurrent ischemic events and death, in patients with coronary artery disease (CAD) have been shown to be significantly increased in patients with depression. In addition, health care costs are higher and health-related quality of life is lower in depressed patients with CAD. Several pathophysiologic mechanisms have been proposed for the association of increased events seen in this population. Studies have focused on antidepressants (specifically, selective serotonin reuptake inhibitors and mirtazapine), psychotherapy (cognitive behavioral therapy and interpersonal psychotherapy), and a wide range of other nonpharmacologic interventions. Pharmacologic and nonpharmacologic treatments are known to i...

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  fMRI tracks reductions in repetitive behaviors in autism: Two case studies.

Authors: Dichter GS, Sikich L, Mahorney S, Felder JN, Lam KS, Turner-Brown L, Bodfish J Autism is characterized by abnormal prefrontal brain activation during cognitive control, a potential biomarker of repetitive behaviors. In this proof-of-principle study, functional magnetic resonance imaging (fMRI) was used to examine brain activity during an oddball task in two high-functioning males with autism before and after 12 weeks of treatment with citalopram, a selective serotonin reuptake inhibitor. One participant showed marked reductions in repetitive behaviors whereas the other showed mild worsening. Brain activation in relevant prefrontal regions increased in only the participant whose repetitive behavior symptoms improved. These findings suggest that fMRI may elucidate potential mech...

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  Taking Antidepressants During Pregnancy Doubles Heart Defect Risk of Newborn

(NaturalNews) Women who take certain antidepressant drugs while pregnant may double their child's risk of being born with a certain variety of heart defect, according to a study conducted by researchers from Aarhaus University in Denmark and published in the medical journal BMJ."Anyone who is pregnant or considering becoming pregnant and has any concerns about the treatment for depression should speak to their doctor," said Cathy Ross of the British Heart Foundation.Researchers compared the risk of birth defects in 1,370 children born to women who took at least one selective serotonin reuptake inhibitor (SSRI) while pregnant with the risk in 400,000 other children whose mothers had not taken any SSRIs while pregnant. They found that the drugs fluoxetine (marketed as Prozac), sertraline (ma...

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  Repeated intermittent methylenedioxymethamphetamine exposure protects against the behavioral and neurotoxic, but not hyperthermic, effects of an MDMA binge in adult rats

We have recently shown that chronic intermittent exposure of adolescent rats to 3,4-methylenedioxymethamphetamine (MDMA or Ecstasy) completely blocks the reduction in serotonin transporter (SERT) binding and the hypoactivity seen following a subsequent MDMA binge treatment. The present study determined whether a similar neuroprotective effect also occurs in rats given the same intermittent MDMA exposure in adulthood. Adult male Sprague-Dawley rats were given either MDMA (10 mg/kg × 2) or saline, every fifth day, from postnatal day (PD) 60 to PD 85. The MDMA-induced latency until seminal plug production was reduced over the course of intermittent treatments. After a 1-week wash-out period, animals received either a low- or high-dose MDMA binge (2.5 or 5.0 mg/kg × 4). Core body temperature...

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  Citalopram not effective for repetitive behaviour in autistic spectrum disorders

(Source: Evidence-Based Mental Health)

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  Breast cancer recurrence risk related to concurrent use of SSRI antidepressants and tamoxifen.

This study provides epidemiologic evidence to support this recommendation. Material and methods. We conducted a case-control study of breast cancer recurrence nested in the population of female residents of Denmark who were diagnosed with non-metastatic estrogen-receptor positive breast cancers between 1994 and 2001 and who took tamoxifen for at least one year. We ascertained complete prescription histories by linking cases' and controls' civil registration numbers to the Danish national prescription registry. We estimated the association between SSRI use while taking tamoxifen and risk of recurrent breast cancer. Results. About the same proportion of recurrent cases (37 of 366) and matched controls (35 of 366) received at least one prescription for citalopram or its s-stereoisomer while t...

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  Inhibitory and facilitory actions of isocyanine derivatives at human and rat organic cation transporters 1, 2 and 3: A comparison to human alpha(1)- and alpha(2)-adrenoceptor subtypes.

In conclusion, D24, other isocyanine congeners and chemically-related adrenergic agents inhibit OCT-mediated [(3)H]MPP(+) transport, and all drugs display significant activity at alpha(1)- and alpha(2)- adrenoceptor subtypes, expanding previous reports of promiscuity between pharmacophores recognising alpha- adrenoceptors and OCTs. PMID: 20170649 [PubMed - as supplied by publisher] (Source: European Journal of Pharmacology)

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  Is Escitalopram Really Relevantly Superior to Citalopram in Treatment of Major Depressive Disorder? A Meta-analysis of Head-to-head Randomized Trials.

Conclusion. Presently, the claims about clinically relevant superiority of escitalopram over citalopram in short-to-medium term treatment of major depressive disorder are not supported by evidence. PMID: 20162747 [PubMed - in process] (Source: Croatian Medical Journal)

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  Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not ade...

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  Pharmacologically Induced/Exacerbated Restless Legs Syndrome, Periodic Limb Movements of Sleep, and REM Behavior Disorder/REM Sleep Without Atonia: Literature Review, Qualitative Scoring, and Comparative Analysis

Conclusion: Based on scores ≥ 10 and trials of medication reduction/cessation, the strongest evidence available for drug induced RLS are for the following drugs: escitalopram; fluoxetine; L-dopa/carbidopa and pergolide; L-thyroxine; mianserin; mirtazapine; olanzapine; and tramadol. Since none of the PLMS articles assessed PLMI in trials of medication reduction/cessation, the strongest evidence based on scores ≥ 10 are for the following drugs: bupropion, citalopram, fluoxetine, paroxetine, sertraline, and venlafaxine. Based on scores ≥ 10 and/or trials of medication cessation, the strongest evidence for drug induced RBD/RSWA is for the following drugs: clomipramine, selegiline, and phenelzine. Keywords: Pharmacologically induced, periodic limb movements of sleep, rapid eye movemen...

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  CITALOPRAM HYDROBROMIDE Tablet [Stat Rx USA]

Updated Date: Feb 12, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Paxil May Raise Death Risk for Those Taking Tamoxefin

Breast cancer patients who are taking Tamoxefin to prevent a recurrence of the disease should not take the antidepressant Paxil (paroxetine), a new study suggests. Women in the study who took both drugs together had a greater than average risk of dying from breast cancer. The study looked at medical records for 2,430 breast cancer patients who had been taking tamoxefin. About 1 out 4 of these women had also taken Paxil; and, on average, about 41% of the time that the women were taking tamoxefin they were also taking Paxil. The researchers found that there was about one extra death from breast cancer for every 20 women who had taken the two drugs together. The researchers believe that the risk of death from breast cancer was increased because Paxil interferes with the cancer-preventing a...

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  Understanding and Promoting Effective Self-Care During Heart Failure

Opinion statement  Heart failure (HF) self-care relates to the decisions made outside clinical settings by the individual with HF to maintain life, healthy functioning, and well-being. The people who help patients most (ie, caregivers/family members) should be involved in care, and general principles of health behavior change should be used to guide support. Medicines should be prescribed with once-daily dosing, with pharmacists providing medication review and support. Pill boxes should be provided and patients’ health literacy levels assessed. Psychosocial interventions for smoking cessation should be undertaken. Regular aerobic exercise may benefit patients with mild to moderate HF and some with severe but stable HF; therefore, referral to cardiac rehabilitation should ...

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  Risk of sudden cardiac death or near death with venlafaxine compared with other antidepressants

Source: BMJ Area: News According to the results of this nested case control study published early online in the British Medical Journal (BMJ), the use of venlafaxine was not associated with a higher risk of sudden cardiac death or near death than fluoxetine, dosulepin, or citalopram, in patients with depression or anxiety.   The authors of the study note the cardiac cautions/contra-indications with venlafaxine, and advice issued by the MHRA in 2006 (revision of previous advice) that patients at very high risk of ventricular arrhythmia or with uncontrolled hypertension should not use venlafaxine.  They note that that there has to their knowledge been no systematic study evaluating the risk of haemodynamically significant (malignant) arrhythmias or sudden cardiac death associa...

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  This isn't the life I dreamed of ...

Carole Jahme shines the cold light of evolutionary psychology on reader's problems. This week: depressionFeeling downtroddenFrom Linda, age 48Dear Carole, The last decade has been a pretty awful one with bad things happening one after the other. My husband had a heart attack and treble heart bypass. This was followed by his being made redundant not once but twice in a relatively short space of time, with all the consequent money worries and stress that brought. My one and only professional job ended in disaster due to bullying. After this, I vowed I would never work for anybody again because I was sick of the nastiness of some women in the workplace as well the failure of organisations to do anything about it. I have since set up a little business from home as a freelancer providing editor...

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  Does comorbid substance use disorder impair recovery from major depression with SSRI treatment? An analysis of the STAR*D level one treatment outcomes

Abstract: Many patients with major depressive disorder (MDD) present with concurrent substance use disorders (SUDs), which has been thought to impair their response to antidepressants. Clinicians often delay antidepressant treatment until sustained sobriety has been established. Unfortunately, these comorbid subjects are typically excluded from depression treatment trials, leaving a gap in understanding the treatment outcomes. In the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, 2876 adult outpatients diagnosed with nonpsychotic MDD were prospectively treated with the selective serotonin-reuptake inhibitor (SSRI), citalopram, and returned for at least one post-baseline visit. Participants with SUD (29%) and without SUD (71%) were compared in regard to baseline clin...

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  Serotonin modulates glutamatergic transmission in the rat olfactory tubercle

The olfactory tubercle (OT) is found in the brains of mammals that are highly dependent on their sense of smell. Its human analogue is the poorly understood anterior perforated substance. Previous work on rat brain slices identified two types of field potential responses from the OT. The association fibre (AF) pathway was sensitive to muscarinic modulation, whereas the lateral olfactory tract (LOT) fibre pathway was not. Here, we establish that serotonin (5-hydroxytryptamine; 5-HT) also inhibits field potential excitatory postsynaptic potentials (EPSPs) in the AF, but not in the LOT fibre, pathway. Parallel experiments with adenosine (ADO) excluded ADO mediation of the 5-HT effect. Exogenous 5-HT at 30 [mu]m caused a long-lasting [sim]40% reduction in the amplitude of AF postsynaptic respo...

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  CITALOPRAM (Citalopram Hydrobromide) Tablet, Film Coated [Physicians Total Care, Inc.]

Updated Date: Feb 4, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  What evidence is available for the use of antidepressants for the management of menopausal hot flushes?

Source: Wessex Drug and Medicines Information Centre Area: Evidence > Medicines Q & A . To help reduce hot flushes, women should be encouraged to take regular exercise, reduce stress and wear lighter clothing. Any trigger factors should be avoided.   . Antidepressants are unlicensed for the management of hot flushes but may be considered for women who have contra-indications to or concerns about HRT. Limited evidence from a recent meta-analysis suggests that venlafaxine, paroxetine, citalopram or fluoxetine are effective in reducing the frequency and severity of menopausal hot flushes.     . The Royal College of Obstetricians and Gynaecologists suggests that the most convincing data available are for venlafaxine at a dose of 37.5mg twice daily. Furthe...

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  Prinzmetal-variant angina in a patient using zolmitriptan and citalopram

We report a case of 48-year-old woman presenting with chest pain and diffuse ST-segment elevation on electrocardiography during an episode of angina, while she was taking zolmitriptan 5 mg/d and citalopram 20 mg/d for migraine and depression, respectively. Coronary angiography (performed because of prolonged angina and presence of diffuse ST-segment elevation on electrocardiography) revealed that diffuse narrowing of left anterior descending coronary artery alleviated after intracoronary nitrate therapy. The most likely cause of myocardial infarction was coronary artery spasm because of the possible increased serotonergic activity secondary to concomitant use of zolmitriptan and citalopram. (Source: The American Journal of Emergency Medicine)

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  Efficacy and tolerability of antidepressants for treatment of depression in coronary artery disease: a meta-analysis.

Conclusion: Treatment with ADs for depression in CAD results in significant therapeutic effects without substantially increased rates of discontinuation. PMID: 20181304 [PubMed - in process] (Source: Canadian Journal of Psychiatry)

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  Increases in serotonergic neuronal activity following intracerebroventricular administration of AF64A in rats.

Authors: Park SH, Lim DK Changes in the serotonergic nervous system after the intracerebroventricular (i.c.v.) administration of ethylcholine aziridinium (AF64A, 3 nmol/each ventricle) were studied in rats. Two weeks after the infusion of AF64A, the levels of 5-HT and 5-HIAA in microdialysed cerebrospinal fluid (CSF), the levels of total 5-HT and 5-HIAA, the density of serotonin uptake sites and the activities of tryptophan hydroxylase (TPH) and monoamine oxidase (MAO) in various brain regions were determined. After AF64A administration, the concentrations of 5-HT in lateral ventricle were increased and the levels of 5-HIAA were decreased. However, the hippocampal levels of total 5-HT were decreased without changes in the levels of 5-HIAA and the hippocampal turnover rates of 5-HT incr...

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  Aging impairs the antidepressant-like response to citalopram in male rats.

The objective of this study was to establish if aging impairs the response to an antidepressant by using an animal model. For this purpose, young and middle-aged male Wistar rats (of around 4 and 14months, respectively) were exposed to a chronic mild stress schedule for 3weeks. After this period, the animals that developed anhedonia, reflected as a reduction in sucrose solution (1%) intake, were treated with citalopram (10mg/kg/day) during 21days while still maintained under the chronic mild stress schedule. Non-stressed animals were included as controls. In young rats citalopram reversed the reduction in sucrose consumption induced by chronic mild stress after one week of treatment, while in middle-aged animals a similar reversion occured after three weeks. Citalopram did not importantly ...

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  A common mechanism of action of the selective serotonin reuptake inhibitors citalopram and fluoxetine: Reversal of chronic psychosocial stress-induced increase in CRE/CREB-directed gene transcription in transgenic reporter gene mice.

Authors: Böer U, Noll C, Cierny I, Krause D, Hiemke C, Knepel W The transcription factor CREB regulates adaptive responses like memory consolidation, addiction, and synaptic refinement. Recently, chronic psychosocial stress as animal model of depression has been shown to stimulate CREB transcriptional activity in the brain; this stimulation was prevented by treatment with the antidepressant imipramine, which inhibits both noradrenaline and serotonin reuptake. However, it was unknown whether the selective inhibition of serotonin reuptake is sufficient for inhibition of stress-induced CREB activation, as it is for the clinical antidepressant effect. Therefore, the effect of two selective serotonin reuptake inhibitors (SSRIs), citalopram and fluoxetine, was examined in this study. Tr...

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  Serotonin Modulates Sensitivity to Reward and Negative Feedback in a Probabilistic Reversal Learning Task in Rats

Authors: Andrea Bari, David E Theobald, Daniele Caprioli, Adam C Mar, Alex Aidoo-Micah, Jeffrey W Dalley & Trevor W Robbins Keywords: serotonin, depression, psychopharmacology, behavioral science, citalopram, probabilistic reversal learning (Source: Neuropsychopharmacology)

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  CITALOPRAM HYDROBROMIDEtablet [Caraco Pharmaceutical Laboratories, Ltd.]

Updated Date: Jan 25, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  The B-VITAGE trial: A randomized trial of homocysteine lowering treatment of depression in later life

Conclusions: The results of this trial will clarify whether the systematic use of B-vitamins improves the response of older adults to standard antidepressant treatment. We anticipate that our findings will have implications for clinical practice and health policy development.Trial RegistrationThe trial is registered with the Australian Clinical Trials Registry,trial number ACTRN12609000256279. (Source: Trials)

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  The 5-HT(7) receptor as a mediator and modulator of antidepressant-like behavior.

Authors: Sarkisyan G, Roberts AJ, Hedlund PB The 5-HT(7) receptor has been suggested as a target for treating depression since inactivation or blockade of the receptor has an antidepressant-like behavioral effect. The present study investigated possible interactions between various classes of drugs with antidepressant properties and blockade or inactivation of the 5-HT(7) receptor. Immobility despair in the tail suspension test and the forced swim test was evaluated in mice lacking the 5-HT(7) receptor (5-HT(7)(-/-)) and in wild-type controls (5-HT(7)(+/+)) following acute drug treatments. Citalopram, a selective serotonin reuptake inhibitor and widely used antidepressant, dose-dependently reduced immobility in the tail suspension test in both 5-HT(7)(+/+) and 5-HT(7)(-/-) mice. Combin...

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  Serotonergic neurons mediate ectopic release of dopamine induced by L-DOPA in a rat model of Parkinson's disease.

Authors: Navailles S, Bioulac B, Gross C, De Deurwaerdère P Benefit and motor side-effects of L-DOPA in Parkinson's disease have been related to dopamine transmission in the striatum. However, the putative involvement of serotonergic neurons in the dopaminergic effects of L-DOPA suggests that the striatum is not a preferential target of L-DOPA. By using microdialysis in a rat model of Parkinson's disease, we found that L-DOPA (3-100 mg/kg) increased dopamine extracellular levels monitored simultaneously in four brain regions receiving serotonergic innervation: striatum, substantia nigra, hippocampus, prefrontal cortex. The increase was regionally similar at the lowest dose and 2-3 times stronger in the striatum at higher doses. Citalopram, a serotonin reuptake blocker, or the dest...

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  Citalopram: Clitoral priapism in a newborn following in utero exposure?: case report

(Source: Reactions)

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  Changes in antidepressant metabolism in pregnancy evidenced by metabolic ratios in hair: A novel approach

Conclusion: It is important that variations in drug metabolism during pregnancy be considered as these changes may necessitate a dosage adjustment to ensure that therapeutic failure does not occur during pregnancy. (Source: Forensic Science International)

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  Mutational Mapping and Modeling of the Binding Site for (S)-Citalopram in the Human Serotonin Transporter [Membrane Transport, Structure, Function, and Biogenesis]

The serotonin transporter (SERT) regulates extracellular levels of the neurotransmitter serotonin (5-hydroxytryptamine) in the brain by facilitating uptake of released 5-hydroxytryptamine into neuronal cells. SERT is the target for widely used antidepressant drugs, including imipramine, fluoxetine, and (S)-citalopram, which are competitive inhibitors of the transport function. Knowledge of the molecular details of the antidepressant binding sites in SERT has been limited due to lack of structural data on SERT. Here, we present a characterization of the (S)-citalopram binding pocket in human SERT (hSERT) using mutational and computational approaches. Comparative modeling and ligand docking reveal that (S)-citalopram fits into the hSERT substrate binding pocket, where (S)-citalopram can adop...

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  The Two Enantiomers of Citalopram Bind to the Human Serotonin Transporter in Reversed Orientations

Journal of the American Chemical Society, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Journal of the American Chemical Society)

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  Fluoxetine and citalopram exhibit potent antiinflammatory activity in human and murine models of rheumatoid arthritis and inhibit toll-like receptors

Selective serotonin reuptake inhibitors (SSRIs), in addition to their antidepressant effects, have been reported to have antiinflammatory effects. The aim of this study was to assess the antiarthritic potential of 2 SSRIs, fluoxetine and citalopram, in murine collagen-induced arthritis (CIA) and in a human ex vivo disease model of rheumatoid arthritis (RA).Following therapeutic administration of SSRIs, paw swelling was assessed and clinical scores were determined daily in DBA/1 mice with CIA. Joint architecture was examined histologically at the end of the treatment period. Cultures of human RA synovial membranes were treated with SSRIs, and cytokine production was measured. Toll-like receptor (TLR) function was examined in murine and human macrophages, human B cells, and human fibroblast-...

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  Drug Shows Little Benefit for Irritable Bowel Syndrome

The selective serotonin reuptake inhibitor citalopram does not relieve symptoms or improve quality of life in patients with irritable bowel syndrome better than placebo, according to a study in the January issue of Clinical Gastroenterology and Hepatology. (Source: Modern Medicine)

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  In vivo effects of a combined 5-HT1B receptor/SERT antagonist in experimental pulmonary hypertension

Conclusion 5-HT1B receptor and serotonin transporter inhibition are effective at preventing and reversing experimental PAH and serotonin-induced proliferation of PASMCs derived from IPAH patients. Targeting both the serotonin transporter and 5-HT1B receptor may be a novel therapeutic approach to PAH. (Source: Cardiovascular Research)

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  Answers to your questions about SSRIs.

Authors: White C, Wigle PR, Albert LG, Eichel E, Udorn L Avoid prescribing a highly activating SSRI, such as fluoxetine, for patients for whom agitation is a presenting symptom. Consider citalopram and escitalopram, which have less potential for drug interactions and less complex dose titration compared with other SSRIs, as first-line agents for depressed patients with complex medication profiles. For patients with sexual side effects caused by SSRIs, consider augmentation therapy with bupropion or mirtazapine; for male sexual dysfunction, a trial of a phosphodiesterase inhibitor is another alternative. PMID: 20074497 [PubMed - in process] (Source: The Journal of Family Practice)

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  The Relationship between Antidepressant Use and Smoking Cessation in Pregnant Women in Treatment for Substance Abuse.

Conclusions: Trend for greater decrease in smoking for the bupropion vs. citalopram/escitalopram group [-6.4 vs. -.4 cigarettes/day (p = .276)], although the bupropion decrease was similar to that seen in the no antidepressant group [-5.3 cigarettes/day]. Scientific Significance: Data support continued study of bupropion in depressed pregnant substance-dependent smokers. PMID: 20141396 [PubMed - in process] (Source: The American Journal of Drug and Alcohol Abuse)

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  CITALOPRAM HYDROBROMIDEsolution [Silarx Pharmaceuticals, Inc]

Updated Date: Dec 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  CITALOPRAM (Citalopram Hydrobromide) Tablet, Film Coated [Rebel Distributors Corp.]

Updated Date: Dec 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Diminished Neural Processing of Aversive and Rewarding Stimuli During Selective Serotonin Reuptake Inhibitor Treatment

Conclusions: Our findings are the first to show that treatment with SSRIs can diminish the neural processing of both rewarding and aversive stimuli. The ability of SSRIs to decrease neural responses to reward might underlie the questioned efficacy of SSRIs in depressive conditions characterized by decreased motivation and anhedonia and could also account for the experience of emotional blunting described by some patients during SSRI treatment. (Source: Biological Psychiatry)

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  In Response to van Gorp F. et al

We read with great interest the recent paper discussing escitalopram overdose. Because serotonin syndrome constitutes a well-described set of recognizable symptoms, we were most interested in QT prolongation given that it is often asymptomatic but has grave implications. Many patients who ingest citalopram warrant prolonged telemetry monitoring because the QT prolonging effect of the metabolite didesmethylcitalopram can be delayed. Since it is unclear if delayed QT prolongation also occurs following escitalopram ingestion, we therefore commend the authors for their effort to investigate the clinical effects of this drug and for attempting to confirm ingestion with quantitative analysis. (Source: Annals of Emergency Medicine)

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  In reply

I thank Lugassy et al for their interest in our study. However, they provide poor reasoning for citalopram overdoses requiring prolonged monitoring. Although the metabolite didesmethylcitalopram has been associated with cardiac toxicity in dogs, this has not been shown in humans and Lugassy et al confirm this in the case they reference where only citalopram and desmethylcitalopram were detected. In a full pharmacokinetic-pharmacodynamic analysis of citalopram in overdose there was a delay in peak QT prolongation compared to peak drug concentrations. However, simulations based on the model showed that after 13 hours the chance of an abnormal QT occurring in a patient with a normal QT was less than 1%. In the single case reported by Tarabar et al the patient had QT prolongation on admission ...

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  CITALOPRAM HYDROBROMIDEtablet [Torrent Pharmaceuticals Limited]

Updated Date: Dec 24, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Aurobindo unit gets Australia nod for anti-depression drug

Drug-maker Aurobindo Pharma today said its Australian unit has received approval in that country for the registration of anti-depression drug Citalopram Hydrobromide. (Source: The Economic Times Healthcare and Biotech News)

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  Aurobindo unit gets Australia nod for anti-depression drug

Drug-maker Aurobindo Pharma today said its Australian unit has received approval in that country for the registration of anti-depression drug Citalopram Hydrobromide. (Source: The Economic Times Healthcare and Biotech News)

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  Citalopram/methylthioninium chloride interaction: Encephalopathy: case report

(Source: Reactions)

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  Antidepressants May Raise Women's Stroke Risk

Older women who take antidepressants have a small, but statistically significant, increased risk of having a stroke or dying, compared to women who do not take antidepressants, says a new study. The study compared six-year data on 5,500 postmenopausal women who began taking antidepressants after enrolling in the Women's Health Initiative trial to data on over 130,000 women who did not take an antidepressant. The researchers found that women taking selective serotonin reuptake inhibitors (SSRIs) - a class of drugs including the popular antidepressants Celexa, Paxil, Prozac and Zoloft - had a 45% increase in risk for stroke and a 32% increase in risk for dying from any cause. Similar results were found for another class of antidepressants called tricyclics. Overall risk for any given wome...

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  PERRIGO CITALOPRAM (Citalopram) Tablet [Perrigo New York Inc]

Updated Date: Dec 14, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  PERRIGO CITALOPRAM (Citalopram) Tablet [Perrigo New York Inc]

Updated Date: Dec 14, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  PERRIGO CITALOPRAM (Citalopram) Tablet [Perrigo New York Inc]

Updated Date: Dec 14, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  A Perfect Storm in the Emergency Department

Conclusion  Serotonin syndrome should be considered in the differential when elderly patients present with severe myoclonus. If unrecognized, this syndrome can lead to more severe manifestations including rhabdomyolysis, renal failure, and coma. Content Type Journal ArticleCategory Practical PearlDOI 10.1007/s12028-009-9309-6Authors Alan H. Yee, Mayo Clinic Department of Neurology 200 First Street SW Rochester MN 55905 USAEelco F. M. Wijdicks, Mayo Clinic Department of Neurology 200 First Street SW Rochester MN 55905 USA Journal Neurocritical CareOnline ISSN 1556-0961Print ISSN 1541-6933 (Source: Neurocritical Care)

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  Antagonists and substrates differentially regulate serotonin transporter cell surface expression in serotonergic neurons.

Authors: Kittler K, Lau T, Schloss P The serotonin transporter (SERT) terminates serotonergic neurotransmission by the rapid removal of serotonin (5-hydroxytryptamine, 5-HT) from the extracellular space back into serotonergic neurons. SERT therefore controls the concentration of extracellular 5-HT, and thus one mechanism to regulate the efficacy of serotonergic neurotransmission is via modulation of the density of SERT molecules on the cell membrane. We have studied effects of prolonged exposure to various selective serotonin re-uptake inhibitors (SSRIs), as well as cocaine and the transport substrates 5-HT and 3,4-methylenedioxy-methamphetamine (MDMA), on SERT cell surface expression in cultured serotonergic neurons. This was achieved via quantification of the amount of cell surface-e...

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  Modulatory effects of neuropsychopharmaca on intracellular pH of hippocampal neurones in vitro

Conclusion and implications: These data substantiate the view that clinically relevant concentrations of neuroleptics and antidepressants can mediate changes in neuronal pHi, which may contribute to their pharmacological mode of action. Effects on pHi should be taken into account when therapeutic or even harmful effects of these drugs are evaluated. (Source: British Journal of Pharmacology)

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  CITALOPRAM HYDROBROMIDEtablet [Major Pharmaceuticals]

Updated Date: Dec 7, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Do Depressed Patients With Diabetes Experience More Side Effects When Treated With CitalopramThan Their Counterparts Without Diabetes? A STAR*D Study.

CONCLUSIONS: Participants with DM reported experiencing side effects at lower rates than those without DM. After statistical adjustment, the groups did not differ significantly regarding types of side effects experienced. PMID: 19956455 [PubMed - as supplied by publisher] (Source: Primary Care Companion to the Journal of Clinical Psychiatry)

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  Ethnic differences in antidepressant response: a prospective multi site clinical trial

Conclusions: These results confirm the growing body of evidence, including recent studies using measurement-based care, that patients from minority groups have outcomes that are similar to those of Caucasians. The provision of measurement-based care and encouragement of patient participation can reduce ethnic differences in response to treatment for depression. Depression and Anxiety 0:1-7, 2009. Published 2009 Wiley-Liss, Inc. (Source: Depression and Anxiety)

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  CITALOPRAM (Citalopram Hydrobromide) Tablet, Film Coated [Aurobindo Pharma Limited]

Updated Date: Dec 2, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  [In Process Citation]

We report on a 76 year old woman who fainted on her way to the restroom during the night. At the emergency department, a prolonged QT-interval was noticed in addition to sinusbradycardia and marginal hypokalemia. The QT-interval normalized promptly after citalopram was discontinued. Taking into account the clinical picture and the ascertained orthostatic dysregulation, a diagnosis of orthostatic syncope was made. Because of the lengthened QT-interval, drug-induced torsade de pointes ventricular arrhythmia was considered as a differential diagnosis. We describe that citalopram was most probably the cause for the prolonged QT-interval. In our article we discuss the pathophysiology of drug-induced long QT syndrome (LQTS), the most important drugs involved, and finally the prophylaxis and trea...

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  Citalopram/fluoxetine: Intercostal pain with both drugs and first report of carotidynia with fluoxetine: case report

(Source: Reactions)

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  Decreased expression of serotonin 1A receptor in the dentate gyrus in association with chronic mild stress: A rat model of post-stroke depression

Abstract: Alterations of serotonin (5-HT) neurotransmission are implicated in post-stroke depression (PSD). Serotonin 1A (5-HT1A) receptor-based abnormalities have been the focus of intensive study in depression. Here we investigated the expression of the 5-HT1A receptor and gene in the hippocampal dentate gyrus (DG) by chronic mild stress (CMS) after stroke and the effect of citalopram. Male Sprague–Dawley rats were separated into control, stress only, ischemic stroke, PSD and citalopram-treated groups. The putative PSD animal model involved cerebral ischemia induced by left middle cerebral artery occlusion (MCAO) followed by exposure to CMS combined with single housing. All animals were assessed for depression-like behavior. The 5-HT1A receptor and mRNA level in DG were quantified by W...

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  CITALOPRAM HYDROBROMIDEsolution [Roxane Laboratories, Inc]

Updated Date: Nov 19, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Trace analysis of antidepressants in environmental waters by molecularly imprinted polymer-based solid-phase extraction followed by ultra-performance liquid chromatography coupled to triple quadrupole mass spectrometry.

Authors: Demeestere K, Petrović M, Gros M, Dewulf J, Van Langenhove H, Barceló D This paper presents the development, optimization, and validation of an innovative method to analyze trace concentrations of seven selected psychoactive pharmaceuticals in environmental waters. Hereby, the solid-phase extraction (SPE) potential of molecularly imprinted polymers (MIPs) in terms of extraction recovery, breakthrough, precision, and selectivity is studied for the first time. Instrumental analysis by ultra-performance liquid chromatography coupled to triple quadrupole mass spectrometry allowed a rapid (run time = 7.5 min) and sensitive (instrumental detection limit </=7 pg injected) quantification of the target analytes. A systematic optimization study revealed that, among the sev...

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  Learn About Lexapro

Lexapro is one of the SSRI antidepressants and was created from Celexa (citalopram). The generic name of Lexapro is escitalopram, but Lexapro is not currently available in generic form. There are several warnings about Lexapro, especially about mixing it with other drugs and over-the-counter supplements, and discontinuing Lexapro treatment too quickly can cause a variety of unpleasant side effects. Our Lexapro Drug Profile will give you in-depth information about this antidepressant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Learn more or join the conversation! NEWSLETTER | FORUM | BIO | TWITTER | FACEBOOK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Learn About Lexapro originally appeared on Abou...

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  Metabolite identification in rat brain microdialysates by direct infusion nanoelectrospray ionization after desalting on a ZipTip and LTQ/Orbitrap mass spectrometry.

Authors: Erve JC, Beyer CE, Manzino L, Talaat RE Analyzing brain microdialysate samples by mass spectrometry is challenging due to the high salt content of the artificial cerebral spinal fluid (aCSF), low analyte concentrations and small sample volumes collected. A drug and its major metabolites can be examined in brain microdialysates by targeted approaches such as selected reaction monitoring (SRM) which provides selectivity and high sensitivity. However, this approach is not well suited for metabolite profiling in the brain which aims to determine biotransformation pathways. Identifying minor metabolites, or metabolites that arise from brain metabolism, remains a challenge and, for a drug in early discovery, identification of metabolites present in the brain can provide useful infor...

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  Today's Antidepressants: Some Sad Facts

    There are a lot of sad facts about today's antidepressants.  The list is a long one.  I'm going to put down what I reckon are the saddest of the sad facts; others are welcome to add their own.    I want to emphasize the word "facts."  In this post I report the findings of scientific research.  Findings aren't opinions, they are findings.  They may not jibe with your personal experience, but that alone is not invalidating.    I should also emphasize, for the sake of maximum clarity, the word "today's."  I'm talking about newer antidepressants, mainly those SSRIs that so dominate the marketplace.  I am not talking about tricyclics or MAOIs.    One last thing.  By publishing this post I am ...

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  Differential inhibitory effects of drugs acting at the noradrenaline and 5-hydroxytrptamine transporters in rat and human neocortical synaptosomes

Conclusions and implications: This study provides the first compilation of drug potency at native human neocortical SERT and NET. The significant species differences (viz., human vs. rat) in drug potency suggest that the general use of rodent data should be limited to predict clinical efficacy or profile. (Source: British Journal of Pharmacology)

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  Peduncular hallucinosis: A polysomnographic and spect study of a patient and efficacy of serotonergic therapy

Abstract: Peduncular hallucinosis (PH) consists of formed and coloured visual images, which the patient knows are unreal; it is often associated with lesions of the pons, midbrain and diencephalon. A 72-year-old man had noted the sudden onset of visual hallucinations one year before, specifying the time and body position in a 4-week, 24-h diary. Thereafter, he underwent video-polysomnography (VPSG), brain magnetic resonance imaging (MRI), angiography (MRA), proton spectroscopy (1H MRS), and single photon emission tomography (SPECT). Patient’s diaries and VPSG showed a strong clustering of hallucinatory experiences during the evening/night time while lying in supine position, similar to hypnagogic hallucination and sleep paralysis in supine position. Repeated episodes of REM sleep behavio...

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  Table of Contents

Rasagiline Treatment Examined for Parkinson's Disease, Efficacy Questions RemainAtomoxetine Augmentation of Cholinesterase Inhibitor Therapy Yields No BenefitsPossible Neuroleptic Malignant Syndrome With Sertraline WithdrawalElderly Citalopram Nonresponders Show Greater Cognitive DeclineGastrointestinal Effects of Rivastigmine Plus Memantine in AD PatientsCommentary on the ADAGIO TrialNew Fact Sheet on Alzheimer's Research ParticipationElderly Driving on the Morning After Use of HypnoticsChorea Induced by Low-Dose GabapentinNew Approval: Guanfacine ERUpdated List of Authorized GenericsSafe Drug Disposal (Source: The Brown University Geriatric Psychopharmacology Update)

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  Citalopram: Aggravation of cerebral vasoconstriction?: case report

(Source: Reactions)

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  Effects of Selective Serotonin Reuptake Inhibitors on Timolol Metabolism in Human Liver Microsomes and Cryo-Preserved Hepatocytes

In conclusion, compounds known to be potent CYP2D6 inhibitors inhibited timolol metabolism in in vitro experiments. The present results strongly suggest that fluoxetine and paroxetine may significantly affect the metabolism of timolol also in vivo and may thus potentiate the adverse cardiovascular effects of topically administered timolol. (Source: Basic and Clinical Pharmacology and Toxicology)

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  Cipramil Drops 40mg/mL (citalopram) - Revised SPC

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC, includes updates to: Section 4.4 (Special warnings and precautions for Use) - now includes relevant warnings for serotonin syndrome, hyponatraemia and glaucoma. Section 4.8 (Undesirable Effects) - includes mydriasis (which may lead to acute narrow angle glaucoma). (Source: NeLM - SPC Changes)

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  Reduced parahippocampal and lateral temporal GABAA-[11C]flumazenil binding in major depression: preliminary results

Conclusion  The bilateral reduction in limbic parahippocampal and right temporal [11C]FMZ binding found in MDD indicates decreased GABAA-benzodiazepine receptor complex affinity and/or number. The inverse relationship between GABAA binding in the temporal lobe and HPA axis activity, suggests that HPA axis hyperactivity is partly due to reduced GABA-ergic inhibition. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00259-009-1292-9Authors Ursula M. H. Klumpers, VU University Medical Center Department of Psychiatry Amsterdam The NetherlandsDick J. Veltman, VU University Medical Center Department of Psychiatry Amsterdam The NetherlandsMadeleine L. Drent, VU University Medical Center Department of Endocrinology Amsterdam The NetherlandsRonald Boellaard, VU ...

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  Ziprasidone and Citalopram Use in Pregnancy and Lactation in a Woman With Psychotic Depression [Letters to the Editor]

(Source: Am J Psychiatry)

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  Treating Repetitive Behavior in ASD: Citalopram Not Effective

(Source: AAP Grand Rounds)

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  Onset of Citalopram Cardiotoxicity Can Be Delayed

3 out of 5 stars CITALOPRAM OVERDOSE: LATE PRESENTATION OF TORSADES DE POINTES (TdP) WITH CARDIAC ARREST. Tarabar AF et al.  J Med Toxicol 2008;4:101. Abstract Overdose of citalopram (Celexa) — a selective serotonin reuptake inhibitor antidepressant — can produce life-threatening cardiotoxicity.  Manifestations include prolonged QTc interval and torsades de pointes.  Because these effects are most likely related to a metabolite (didesmethylcitalopram), onset of significant toxicity can be delayed beyond 6 hours.  This case report describes a 36-year-old woman who developed transient TdP with syncope 32 hours after overdosing on 1000 mg of citalopram. The authors point out that although in this case — as with others in the literature — the time of ingestion may b...

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  Altering endogenous extracellular serotonin concentrations can modulate network output in the neonatal mouse spinal cord.

Authors: Dunbar MJ, Tran MA, Whelan PJ Serotonin (5-HT) can potently activate and modulate spinal locomotor circuits in a variety of species. Many of these findings have been obtained by applying serotonin exogenously to the isolated spinal cord of in vitro preparations, which has the drawback of indiscriminately activating extrasynaptic receptors and neurons. To investigate the role of endogenously released serotonin in modulating locomotor networks, the selective serotonin reuptake inhibitor citalopram was used. Fictive locomotion was elicited by either electrical stimulation of the brainstem or the sacral 4 (S4) dorsal root. The addition of 20 muM of citalopram caudal to thoracic segment 5 (T5) had an overall inhibitory effect on the lumbar central pattern generator (CPG). Left-righ...

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  Involuntary Emotional Expression Disorder

, or IEED, is a condition in which a person experiences uncontrollable episodes of emotional expression. That is, they have episodes of crying, laughter, or anger that are not in line with their present mood. The condition is also known as labile affect, pseudobulbar affect, emotional lability, and pathological laughing and crying. It can have a severe impact on the lives of both patients and caregivers, as symptoms may leave sufferers feeling guilty, awkward, embarrassed and reluctant to take part in social interaction. IEED is seen most often following brain injury or in people with dementia, motor neuron disease, and multiple sclerosis. It can appear at any stage of the associated diseases. Its prevalence was estimated in 2007 by Walter Bradley, MD, of Miami University. His team survey...

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  Ziprasidone and citalopram use in pregnancy and lactation in a woman with psychotic depression.

Authors: Werremeyer A PMID: 19884241 [PubMed - in process] (Source: The American Journal of Psychiatry)

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  What Did STAR*D Teach Us? Results From a Large-Scale, Practical, Clinical Trial for Patients With Depression [Special Section on the Implications of STAR*D]

The authors provide an overview of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org), a large-scale practical clinical trial to determine which of several treatments are the most effective "next-steps" for patients with major depressive disorder whose symptoms do not remit or who cannot tolerate an initial treatment and, if needed, ensuing treatments. Entry criteria were broadly defined and inclusive, and patients were enrolled from psychiatric and primary care clinics. All participants began on citalopram and were managed by clinic physicians, who followed an algorithm-guided acute-phase treatment through five visits over 12 weeks. At the end of each sequence, patients whose depression had not fully remitted were eligible for subsequent randomized ...

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  Pharmacogenetics Studies in STAR*D: Strengths, Limitations, and Results [Special Section on the Implications of STAR*D]

Several lines of evidence support an important genetic contribution to the wide individual variation in therapeutic response to antidepressant medications. The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study provided the largest cohort assembled to date of DNA from patients with nonpsychotic major depressive disorder, uniformly treated with citalopram and followed prospectively for up to 12 weeks. This pivotal study changed the face of pharmacogenetics research by increasing the sample size by an order of magnitude as well as by providing detailed prospective information about antidepressant response and tolerability. Several groups have identified markers in genes and tested the replication of previous findings of genes associated with outcome and side effects of ant...

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  Attenuation of cocaine-induced reinstatement of drug seeking in squirrel monkeys: kappa opioid and serotonergic mechanisms

Conclusions  Results suggest that the capacity of kappa opioid agonists to increase extracellular 5-HT levels may at least partially underlie kappa agonist-induced modulation of cocaine seeking. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1705-2Authors Daniela Rüedi-Bettschen, Harvard Medical School New England Primate Research Center One Pine Hill Drive P.O. Box 9102 Southborough MA 01772-9102 USAJames K. Rowlett, Harvard Medical School New England Primate Research Center One Pine Hill Drive P.O. Box 9102 Southborough MA 01772-9102 USARoger D. Spealman, Harvard Medical School New England Primate Research Center One Pine Hill Drive P.O. Box 9102 Southborough MA 01772-9102 USADonna M. Platt, Harvard Medical School New England Pri...

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  Use of Antidepressants for Management of Hot Flashes

Pharmacotherapy 29(11): 1357-1374 Abstract A growing body of evidence suggests that antidepressant therapies, particularly selective serotonin reuptake inhibitors and venlafaxine, are effective in the management of hot flash symptoms. Several of these agents have the support of the American College of Obstetricians and Gynecologists and the North American Menopause Society. To review the literature on antidepressants for the treatment of hot flashes in women, we searched the PubMed, International Pharmaceutical Abstracts, and MEDLINE databases from inception through May 2009. All publication types that included human participants and that were published in English were eligible for review. These articles, relevant abstracts, and additional references were used to collect pertinent data. Al...

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  Effectiveness and tolerability of citalopram for the treatment of depression and anxiety disorders in children and adolescents: an open-label study

Abstract  To assess the effectiveness and tolerability of citalopram for the acute treatment of children and adolescents suffering from depression and/or anxiety disorders. As much as 78 outpatients, aged 7–18 years with a diagnosis of depressive and/or anxiety disorder, completed an 8-week open trial with citalopram (20–40 mg/day). Outcome, side effects and suicidality were assessed weekly to bi-weekly using appropriate rating scales. At endpoint 56% of subjects were found to be responders (Clinical Global Impression-Improvement [CGI-I] Scale ≤ 2). Subjects with less severe psychopathology and subjects with anxiety disorders showed a more favorable response. As much as 43% of depressed and 51% of anxious subjects had a 50% or greater reduction in s...

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  Monoamines, BDNF, IL-6 and corticosterone in CSF in patients with Parkinson’s disease and major depression

Abstract  The biochemical basis of major depression (MD) in Parkinson’s disease (PD) is largely unknown. To increase our understanding of MD in PD patients, the levels of monoamine metabolites (HVA, 5-HIAA and MHPG), BDNF, orexin-A, IL-6 and corticosterone were examined in cerebrospinal fluid. The analyses were performed in MD patients with (n = 11) and without (n = 12) PD at baseline and after 12 weeks’ of treatment with the antidepressant citalopram, and in patients with solely PD (n = 14) at baseline and after 12 weeks. The major findings were that PD patients with MD had significantly lower baseline levels of MHPG, corticosterone and IL-6 when compared to patients with solely MD. In response to citalopram treatment, patients wit...

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  Platelet serotonin (5-HT) levels in interferon-treated patients with hepatitis C and its possible association with interferon-induced depression

Background & Aims: Interferon-associated depression is a frequent side effect of antiviral therapy for chronic hepatitis C. The aim of the present study was to investigate the correlation between platelet serotonin (5-hydroxytryptamine, 5-HT) concentrations and IFN-induced depression.Methods: The study represents a secondary analysis of a previously published trial on the efficacy of SSRI medication in HCV patients on IFN therapy. Ninety-three patients were longitudinally assessed for depression and platelet serotonin. Evaluation time points were: prior to IFN therapy, at weeks 4, 12, and 24 of IFN treatment, and 4weeks after antiviral treatment. Depression was assessed using the Hospital Anxiety and Depression Scale (HADS). Platelet serotonin concentrations were measured by ELISA.Results:...

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  A Genomewide Association Study of Citalopram Response in Major Depressive Disorder

Conclusions: Although the findings reported here do not meet a genomewide threshold for significance, the regions identified from this study provide targets for independent replication and novel pathways to investigate mechanisms of antidepressant response. This study was not placebo controlled, making it possible that we are also observing associations to nonspecific aspects of drug treatment of depression. (Source: Biological Psychiatry)

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  Serotonergic and Noradrenergic Modulation of Emotion Processing by Single Dose Antidepressants

Authors: Annette Beatrix Brühl, Tina Kaffenberger & Uwe Herwig Keywords: emotion processing, citalopram, reboxetine, functional imaging, depression, treatment (Source: Neuropsychopharmacology)

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  Effects of Lorazepam and citalopram on human defensive reactions: ethopharmacological differentiation of fear and anxiety. - Perkins AM, Ettinger U, Davis R, Foster R, Williams SC, Corr PJ.

Drugs that are clinically effective against generalized anxiety disorder preferentially alter rodent risk assessment behavior, whereas drugs that are clinically effective against panic disorder preferentially alter rodent flight behavior. The theoretical p... (Source: SafetyLit: All (Unduplicated))

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  Targacept's P.2b depression study succeeds: 6-point difference on HAM-D

(Linnden Communications) Targacept Inc., a clinical-stage biopharmaceutical company developing a new class of drugs known as NNR Therapeutics, today announced the presentation of data from its recently completed Phase 2b clinical trial of TC-5214 as an augmentation treatment in subjects with major depressive disorder, or MDD, who did not respond adequately to first-line treatment with the representative SSRI citalopram hydrobromide. (Source: EurekAlert! - Social and Behavioral Science)

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  Evaluation of the influence of sex and CYP2C19 and CYP2D6 polymorphisms in the disposition of citalopram.

In conclusion, we demonstrate the influence of CYP2C19 and CYP2D6 in the disposition of citalopram, and we suggest that the influence of CYP2D6 is more probable in volunteers with at least one defective allele of CYP2C19. PMID: 19840783 [PubMed - as supplied by publisher] (Source: European Journal of Pharmacology)

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  Clinical and ECG Effects of Escitalopram Overdose

2.5 out of 5 stars CLINICAL AND ECG EFFECTS OF ESCITALOPRAM OVERDOSE van Gorp et al.  Ann Emerg Med September 2009;54:404-408. Abstract This Australian study reviewed 79 presentations (68 patients) of patients admitted to a toxicology unit with escitalopram overdose.  in 46 of these, there were no significant co-ingestants.  Ingested doses of escitalopram ranged from 20 – 560 mg.  In this group there was no occurence of death, arrhythmia, or seizures.  Potentially significant effects included clonus and hyperreflexia (representing serotonin effect) and prolonged QT  interval. Escitalopram (Lexapro) in the S-enantiomer of the selective serotonin reuptake inhibitor citalopram (Celexa). Since none of the patients in this study were really sick, and the population is a mixture of p...

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  Citalopram/paroxetine: Bruxism: 2 case reports

(Source: Reactions)

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  Acamprosate/citalopram/cyamemazine/dipotassium clorazepate withdrawal: Catatonia: case report

(Source: Reactions)

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  Citalopram: First report of central retinal vein occlusion: case report

(Source: Reactions)

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  Sibutramine overdose: Multiple toxicities, including those due to interactions with atomoxetine, methylphenidate and citalopram: 17 case reports

(Source: Reactions)

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  CITALOPRAM HYDROBROMIDEsolution [Aurobindo Pharma Limited]

Updated Date: Sep 30, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Cipramil (citalopram) Tablets - Revised SPC

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.4 (special warnings and precautions for use) has been updated to include relevant warnings for serotonin syndrome, hyponatraemia and glaucoma. Section 4.8 (undesirable effects) has been updated to include mydriasis (which may lead to acute narrow angle glaucoma). (Source: NeLM - SPC Changes)

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  Antidepressants and pregnancy

This study was not able to remove the possible effects of depression itself, as it was not able to identify and compare pregnant women with depression who were not taking antidepressants. This study was based on national databases of records about prescriptions, births and medical diagnoses. Some of the information in these databases may have been misrecorded or missed. It is possible that the newborns of those women known to be taking prescription drugs, may have been more thoroughly examined for defects at birth, which would tend to bias towards finding more defects in this group. However, the overall proportion of malformations found in exposed and unexposed children suggests that this is not the case. The women categorised as exposed had collected at least two prescriptions fo...

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  Maternal Use of Sertaline, Citalopram Linked to Septal Heart Defects in Offspring

(Source: Physician's First Watch current issue)

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  Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study

Source: BMJ Area: News According to research published early online in the British Medical Journal, there is an increased prevalence of septal heart defects among children whose mothers were prescribed a selective serotonin reuptake inhibitors SSRI in early pregnancy, particularly sertraline and citalopram.   The population based cohort study incorporated data based on 494,483 children born in Denmark during the period 1996 to 2003 (493,113 unexposed infants, and 1,370 exposed infants).  Researchers sought to evaluate associations between SSRI use during the first trimester of pregnancy, and major malformations.   The main outcome measures were of major malformations categorised according to Eurocat (European Surveillance of Congenital Anomalies), with additional di...

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  Citalopram: Thrombocytopenia and haemorrhage: case report

(Source: Reactions)

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  Citalopram/tramadol: Serotonin syndrome in an elderly patient: case report

(Source: Reactions)

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  The synergistic interaction between morphine and maprotiline after intrathecal injection in rats.

CONCLUSIONS: Selective norepinephrine reuptake inhibitors can significantly increase the intensity and duration of morphine antinociceptive activity via both alpha(2)-adrenergic and opioid receptors. This interaction was not observed with the selective serotonin inhibitor, citalopram. PMID: 19762762 [PubMed - in process] (Source: Anesthesia and Analgesia)

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  Citalopram Provides Little or No Benefit in Nondepressed Patients With Irritable Bowel Syndrome

Conclusions: Citalopram was not superior to placebo in treating non-depressed IBS patients. Changes in symptoms were not substantially correlated with changes in rectal sensation assessed by barostat. Any benefit of citalopram in non-depressed IBS patients is likely to be modest at best. (Source: Clinical Gastroenterology and Hepatology)

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  Chronic therapy with citalopram decreases regional cerebral glucose utilization in OBX, and not sham-operated, rats: an autoradiographic study

Conclusion  The results imply that chronic citalopram treatment, shown previously to result in behavioral normalization in OBX rats, establishes a new pattern of rCGU, rather than normalizing it to the pattern of the sham-CTP rats. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1659-4Authors Ivan Skelin, McGill University Cone Neurological Research laboratory, Department of Neurology and Neurosurgery 3801 University St. Montreal QC H3A2B4 CanadaHiroki Sato, McGill University Cone Neurological Research laboratory, Department of Neurology and Neurosurgery 3801 University St. Montreal QC H3A2B4 CanadaTomislav Kovačević, McGill University Cone Neurological Research laboratory, Department of Neurology and Neurosurgery 3801 University St. ...

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  The effect of serotonergic and noradrenergic antidepressants on face emotion processing in depressed patients

Conclusions: Antidepressants altered emotional processing in depressed patients with some similarities to the effects seen in healthy volunteers. The largest effect seen was increased recognition of disgust that may be specific to depressed patients. The correlation between increased accurate recognition of happy faces at two-weeks of treatment and clinical outcome at six-weeks of treatment suggests that early changes in emotional processing may underlie clinical response to antidepressants. (Source: Journal of Affective Disorders)

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  Citalopram: Herpes zoster (first report) in an elderly patient: 2 case reports

(Source: Reactions)

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  Effects of escitalopram in overdose

Source: Ann Emerg Med Area: News A case report paper discusses the main symptoms of escitalopram overdose based on 79 presentations.   Cardiac effects are unusual with SSRI overdose, however they have been reported with citalopram. The authors of this paper comment that there has been limited information on the effects of escitalopram in overdose. They therefore report experience with 68 patients who presented 79 times having taken escitalopram in doses between 20mg and 560mg (median 140mg). For 46 presentations, escitalopram was the only drug taken or all other substances taken were non-toxic. Serotonin toxicity (e.g. inducible clonus and hyperreflexia) was present in 8 patients altogether, but was most likely in those who had taken escitalopram alone (7). Bradycardia occurred i...

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  Citalopram efficacy study; interstitial 15q11-q13 duplication mouse

No Abstract (Source: Autism Research)

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  Haplotype analysis of single nucleotide polymorphisms in the vascular endothelial growth factor (VEGFA) gene and antidepressant treatment response in major depressive disorder

Abstract: Vascular endothelial growth factor (VEGF) has been implicated in neurotrophy and neurogenesis, which play a pivotal role in brain development and may be involved in antidepressant therapeutic mechanisms. Recent animal studies demonstrate that VEGF levels are increased by several antidepressants, including selective serotonin reuptake inhibitors, and that VEGF signalling is required for antidepressant-induced behavioural response. We hypothesized that common genetic variants in the VEGF gene (official gene name: VEGFA) may be associated with the therapeutic response to antidepressants in major depressive disorders (MDD). Seven VEGFA polymorphisms were genotyped in 351 patients with MDD who were treated with selective serotonin reuptake inhibitor (fluoxetine or citalopram) antidepr...

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  Antidepressant study design affects patient expectancy: a pilot study.

CONCLUSIONS: Randomization to comparator versus placebo-controlled administration of antidepressant medication produced greater expectancies of how much patients would improve during the trial. This expectancy difference may explain the higher response and remission rates that are observed in comparator versus placebo-controlled trials. PMID: 19732481 [PubMed - as supplied by publisher] (Source: Psychological Medicine)

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  Serotonergic Modulation of the Trigeminocardiac Reflex Neurotransmission to Cardiac Vagal Neurons in the Nucleus Ambiguus

Stimulation of the trigeminal nerve evokes a dramatic decrease in heart rate and blood pressure, and this reflex has generally been termed the trigeminocardiac reflex. A subset of the trigeminocardiac reflex is the diving reflex in which the nasal mucosa is stimulated with water or air-borne chemical irritants. Activation of the diving reflex evokes a pronounced bradycardia, mediated by increased parasympathetic cardiac activity, and is the most powerful autonomic reflex. However, exaggeration of this protective response could be detrimental and has been implicated in Sudden Infant Death Syndrome (SIDS). Despite the importance and strength of the trigeminocardiac reflex, there is little information about the cellular mechanisms and brain stem pathways that constitute this reflex. To addres...

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  Factors Associated with Concomitant Psychotropic Drug Use in the Treatment of Major Depression: A STAR*D Report.

Conclusion: CPMs are associated with greater illness burden, more Axis I comorbidities (especially anxiety disorders), and lower treatment effectiveness. This suggests that CPM use may identify a more difficult to treat population that needs more aggressive treatment. PMID: 19890231 [PubMed - in process] (Source: CNS Spectrums)

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  Table of Contents

Genomewide Study Examines Lithium Response in Patients With Bipolar DisorderNortriptyline Combined With ECT Found Effective for DepressionDrug Metabolism and Fluoxetine: A Case of TrismusPredictors of Sexual Dysfunction in Citalopram-Treated Depressed PatientsVenlafaxine Concentrations in Human Breast Milk and Infant PlasmaGenetic Disorders and Genomewide Association StudiesTranslocator Protein as Target for AnxiolyticsNational Patterns in Antidepressant Medication TreatmentRhabdomyolysis With Clozapine-Lithium CombinationSafety Review of ADHD MedicationsNew Approval: Lamotrigine Extended-ReleaseNew Approval: Invega® SustennaTM Extended Release (Source: The Brown University Psychopharmacology Update)

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  The impact of diabetes on depression treatment outcomes

Conclusions: Depressed patients with DM and depressed patients without DM appear to have similar rates of MDD remission, indicating that a diagnosis of DM per se has no impact on MDD remission. The findings of fewer side effects and psychiatric serious adverse events in participants with DM imply that depressed patients with DM may be excellent candidates for more aggressive SSRI dosing. This lower prevalence of side effects reported by depressed participants with DM warrants further exploration. (Source: General Hospital Psychiatry)

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  The Mothers Act Disease Mongering Campaign - Part IV

This article says Courtenay publishes a website about "postpartum depression among dads" called "www.saddaddy.com." However, when clicking on the saddaddy link, PostpartumMen comes up today.And surely by coincidence, Courtenay will soon have a new book for sale titled, "Sad Dads," which he is currently writing, according to his bio on the consulting firm's website."If you'd like to arrange an individual consultation with Dr. Courtenay, please call 415-346-6719," the PostpartumMen website states.And apparently postpartum depression in dads is catchy. "If you're experiencing PPND, it increases the likelihood that your partner is also depressed," Courtenay informs men on his website."It's important that she get help for herself as well," he kindly advises.He then provides a link to a page wit...

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  Treatment of subsyndromal depressive symptoms in middle-aged and older adults with schizophrenia: effect on functioning

Subsyndromal symptoms of depression (SSD) in patients with schizophrenia are common and clinically important. SSRI's appear to be helpful in alleviating depressive symptoms in patients with schizophrenia who have SSD in patients age 40 and greater. It is not known whether SSRI's help improve functioning in this population. We hypothesized that treating this population with the SSRI citalopram would lead to improvements in social, mental and physical functioning as well as improvements in medication management and quality of life.Participants were 198 adults [ges] 40 years old with schizophrenia or schizoaffective disorder who met study criteria for subsyndromal depression based on having two or more of the nine DSM-IV symptoms of a major depressive episode, for at least 2 weeks, and a Hami...

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  Selective serotonin reuptake inhibitors for the management of irritable bowel syndrome: a meta-analysis of randomized controlled trials

Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors stated that there was no statistically significant evidence that selective serotonin reuptake inhibitors (SSRIs) improved abdominal pain, bloating or irritable bowel syndrome (IBS) symptoms, although there was a trend for improvement in abdominal pain. In view of methodological limitations in the review, in particular the failure to adequately address heterogeneity, the conclusions may not be reliable.   [SSRIs used included fluoxetine, paroxetine and citalopram.]   CRD Commentary: The review objectives and inclusion criteria were clear. Relevant sources were searched without language restriction for published studies and abstracts. Steps were taken to minimise bias and error in the processes ...

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  Drug treatment of poststroke depression

CONCLUSION: The pharmacological management of PSD can be done prophylactic or therapeutically. In both methods, selective reuptake inhibitors, particularly fluoxetine, and in some instances, citalopram and reboxetine, seem to be the most appropriate medications to be used in PSD. Alternatively, nortriptyline, a tricyclic antidepressant, may be employed in some cases of PSD. (Source: Jornal Brasileiro de Psiquiatria)

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  Suicide Prevention Drug Pushing Racket - Part II

This study analyzed data from the national Medicaid Analytic Extract Files, including information from all 50 states, and determined that children who filled prescriptions for antidepressants after an inpatient stay were over 15 times more likely to die by suicide than kids who were not taking antidepressants.On May 25, 2007, MedPage Today reported a study that found young suicide victims were significantly more likely to have SSRIs in their bloodstream than were young homicide or accident victims."In an analysis of 'unnatural' deaths recorded by the Virginia Medical Examiner's Office for 1987 through 2003," MedPage wrote, "Antony Fernandez, MD, and colleagues, found that selective serotonin reuptake inhibitors or the serotonin-norepinephrine reuptake inhibitor venlafaxine appeared signifi...

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  I need some advice

Author: reaper1911 Posted: Wed Aug 19, 2009 10:40 am I was prescribed celexa with my suboxone as well and I am not trying to be comical here or any thing but I could not urinate number one celexa causes urinary retention! Number 2 I am on suboxone which is an opiate and opiates cause urinary retention. I could urinate but not normaly I had to push realy hard and my prostate felt as if it were inflated with air. So I dropped the celexa and went to another anti dep called lexapro that fixed the interaction and I was able to urinate normaly Lexapro is the mirror of celexa and I felt no difference when switching to the lexapro! (Source: Suboxone Forum)

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  CITALOPRAM HYDROBROMIDEtablet, Film Coated [Glenmark Generics Inc., USA]

Updated Date: Aug 19, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Acute citalopram administration may disrupt contextual information processing in healthy males.

Authors: Almeida S, Glahn DC, Argyropoulos SV, Frangou S Selective serotonin reuptake inhibitors (SSRI) are the most commonly prescribed antidepressants. It has been suggested however that SSRI administration may affect response inhibition and contextual processing but the available evidence is minimal. Therefore, the purpose of this study was to identify the effect size of acute (within 24 hours) and chronic (28 days) administration of the highly selective SSRI, Citalopram, compared to placebo on response inhibition (measured by the Degraded Symbol Continuous Performance Task [DS-CPT]) and contextual processing (assessed using a Delayed Non-Matching to Sample Task [DNMS]) in healthy males (n=20) using a randomised double-blind design. We found no effect of Citalopram on participants' ...

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  Neuroendocrine and subjective responses to pharmacological challenge with citalopram: a controlled study in male and female ecstasy/MDMA users

AbstractDespite evidence that ±3,4-methylenedioxymethamphetamine (MDMA; ‘ecstasy’) causes persistent alterations to the serotonergic system of animals, evidence for long-term neurological effects of ecstasy/MDMA in humans remains equivocal. The current study assessed serotonin functioning of nine male and 11 female recreational ecstasy polydrug users by measuring neuroendocrine (prolactin, cortisol) responses to pharmacological challenge with the selective serotonin reuptake inhibitor citalopram, compared with nine male and five female cannabis polydrug users and 11 male and 11 female non-drug using controls. A single-blind, randomised, placebo-controlled design was used. Subjective responses, other substance use, mood, personality traits and demographic variables were m...

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  Citalopram/clozapine overdose: Acute clozapine intoxication: case report

(Source: Reactions)

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  Specific effects of escitalopram on neuroendocrine response

Conclusion  This is the first study to prove that a single dose of escitalopram acts centrally and not peripherally, providing further support of the use of oral escitalopram as a probe for brain serotonergic function. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1633-1Authors Emily R. Hawken, Providence Care Centre-Mental Health Services Kingston ON CanadaJames A. Owen, Providence Care Centre-Mental Health Services Kingston ON CanadaRobert W. Hudson, Queen’s University Department of Medicine (Endocrinology) Kingston ON CanadaNicholas J. Delva, Providence Care Centre-Mental Health Services Kingston ON Canada Journal PsychopharmacologyOnline ISSN 1432-2072Print ISSN 0033-3158 (Source: Psychopharmacology)

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  Digest

Antidepressant RCTs meaningful?The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial of sequenced anti-depressant therapy recruited a broad population of patients representative of outpatients with depression seeking treatment. By contrast, most randomised controlled trials (RCTs) have more restrictive eligibility criteria. STAR*D investigators have now used their data to assess the impact of this aspect of trial design (Am J Psychiatry 2009;166:599-67).They divided 2855 STAR*D participants into a group meeting standard eligibility criteria based on HAM-D score >19, lack of comorbidity and duration of current episode less than 24 months (22 per cent) and a second group who did not meet these criteria.Those meeting standard criteria were more likely to be seen in special...

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  Cipramil (citalopram) Tablets - Revised SPC

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.4 (special warnings and precautions for use) now states that the tablets contain lactose monohydrate.  Patients with rare hereditary problems of galactose intolerance, the Lapp deficiency or glucose-galactose malabrsorption should not receive this medicine. (Source: NeLM - SPC Changes)

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  Amitriptyline/citalopram overdose: Cardiogenic shock in an elderly patient treated with insulin: case report

(Source: Reactions)

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  Citalopram for continuation therapy after repetitive transcranial magnetic stimulation in vascular depression.

CONCLUSION: More effective methods are needed to treat elderly patients with treatment resistant vascular depression and to prevent relapse among treatment responders. PMID: 19625785 [PubMed - in process] (Source: Am J Geriatr Psychia...)

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  Going off Meds, Part 1

From June to late August of 2005 I tapered off all of my bipolar disorder medications - Zyprexa, Topamax, Trazodone, Prozac / Celexa, Ativan, Gabitril and Wellbutrin. This is the first of three articles telling why I decided to do this and how the process unfolded through an episode of agitated depression coupled with serious back pain. (Source: About.com Bipolar Disorder)

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Top Viagra Store

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