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Citalopram
Personalised Insights into a Groundbreaking Antidepressant
Introduction to Citalopram
Citalopram, a selective serotonin reuptake inhibitor (SSRI), first entered mainstream medicine in 1989 after being developed by the Danish pharmaceutical company Lundbeck. It rapidly became one of the most prescribed antidepressants globally, lauded for its efficacy and relatively favourable side-effect profile compared to earlier antidepressants such as tricyclics and monoamine oxidase inhibitors (MAOIs).
Initially approved for the treatment of major depressive disorder (MDD), its use has expanded over time to include anxiety disorders, obsessive-compulsive disorder (OCD), and panic disorders. Its versatility and tolerability have made it a cornerstone of mental health treatment for over three decades.
Citalopram and the Evolution of Mental Health Treatment
Citalopram emerged during a pivotal time in psychopharmacology when there was a significant push to develop medications with fewer side effects.
Unlike earlier antidepressants, citalopram targets serotonin specifically, improving mood regulation without significantly impacting other neurotransmitters. This precision dramatically improved patients' quality of life, as it reduced the risks of sedation, weight gain, and other unwanted side effects commonly associated with older antidepressants.
Citalopram Side Effects
How Your Body and Genes Process Citalopram
Personalising Citalopram with Pharmacogenetics
Sertraline is another SSRI commonly prescribed for depression and anxiety disorders. Like citalopram, sertraline's efficacy and tolerability can be influenced by genetic factors, particularly variations in the CYP2C19 and CYP2D6 enzymes. Pharmacogenomic testing can provide valuable information for optimising sertraline therapy, similar to citalopram.
Other SSRIs, such as fluoxetine, paroxetine, and escitalopram, also have their pharmacokinetics affected by genetic variations. Understanding these genetic influences is crucial for personalising treatment plans across different SSRIs.
Related Medications:
The Clinical Pharmacogenetics Implementation Consortium (CPIC), Dutch Pharmacogenetics Working Group (DPWG) and other regulatory institutions including tThe U.S. Food and Drug Administration (FDA) recognizes the impact of genetic variations on citalopram metabolism and has provided guidance on dosing adjustments based on CYP2C19 metabolizer status. For detailed information, refer to the FDA's Table of Pharmacogenetic Associations, or the CPIC Genes-Drugs Guidelines which outlines gene-drug interactions and associated dosing recommendations.
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