Details
Stereochemistry | RACEMIC |
Molecular Formula | C20H21FN2O.C2H2O4 |
Molecular Weight | 414.4268 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
OC(=O)C(O)=O.CN(C)CCCC1(OCC2=C1C=CC(=C2)C#N)C3=CC=C(F)C=C3
InChI
InChIKey=KTGRHKOEFSJQNS-UHFFFAOYSA-N
InChI=1S/C20H21FN2O.C2H2O4/c1-23(2)11-3-10-20(17-5-7-18(21)8-6-17)19-9-4-15(13-22)12-16(19)14-24-20;3-1(4)2(5)6/h4-9,12H,3,10-11,14H2,1-2H3;(H,3,4)(H,5,6)
Citalopram (brand names: Celexa, Cipramil, and others) is an antidepressant drug of the selective serotonin reuptake inhibitor (SSRI) class. It has U.S. Food and Drug Administration approval to treat major depression,[2]which it received in 1998, and is prescribed off-label for other conditions. In Australia, the UK, Germany, Portugal, Poland, and most European countries, it is licensed for depressive episodes and panic disorder with or without agoraphobia. In Spain, it is also used for obsessive-compulsive disorder. Citalopram HBr is a racemic bicyclic phthalane derivative designated (±)-1-(3-dimethylaminopropyl)-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-5carbonitrile, HBr. The mechanism of action of citalopram HBr as an antidepressant is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT). In vitro and in vivo studies in animals suggest that citalopram is a highly selective serotonin reuptake inhibitor (SSRI) with minimal effects on norepinephrine (NE) and dopamine (DA) neuronal reuptake. The single-and multiple-dose pharmacokinetics of citalopram are linear and dose-proportional in a dose range of 10-60 mg/day. Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours.
Originator
Sources: https://lakemedelsverket.se/LMF/Lakemedelsinformation/?nplid=19980626000180Bigler, Allan J., et al. 'Quantitative structure-activity-relationships in a series of selective 5-HT uptake inhibitors.' EUROPEAN JOURNAL OF MEDICINAL CHEMISTRY 12.3 (1977): 289-295.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL228 Sources: https://www.ncbi.nlm.nih.gov/pubmed/19616061 |
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Target ID: CHEMBL228 Sources: https://www.ncbi.nlm.nih.gov/pubmed/23265880 |
0.78 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | CELEXA Approved UseCitalopram HBr is indicated for the treatment of depression. The efficacy of citalopram HBr in the treatment of depression was established in 4 to 6 week, controlled trials of outpatients whose diagnosis corresponded most closely to the DSM-III and DSM-III-R category of major depressive disorder (see CLINICAL PHARMACOLOGY ). A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation. The antidepressant action of citalopram HBr in hospitalized depressed patients has not been adequately studied. The efficacy of citalopram HBr in maintaining an antidepressant response for up to 24 weeks following 6 to 8 weeks of acute treatment was demonstrated in two placebo-controlled trials (see CLINICAL PHARMACOLOGY ). Nevertheless, the physician who elects to use citalopram HBr for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient. Launch Date1998 |
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Primary | Celexa Approved UseINDICATIONS AND USAGE. Celexa (citalopram HBr) is indicated for the treatment of depression. Launch Date1998 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
3.2 ng/mL |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
8.5 ng/mL |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
6.1 ng/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
21.7 ng/mL |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
43.7 ng/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
65.6 ng/mL |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
10.6 ng/mL |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
204.5 ng × h/mL |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
1153.2 ng × h/mL |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
843.7 ng × h/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
1010.4 ng × h/mL |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
2070.3 ng × h/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
2946.5 ng × h/mL |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
533.2 ng × h/mL |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
77.5 h |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
79.3 h |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
38.5 h |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
40 h |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
39.5 h |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
36.3 h |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
26% |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
26% |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
26% |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
DESMETHYLCITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
18% |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
18% |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
18% |
60 mg single, oral dose: 60 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
18% |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
CITALOPRAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
800 mg single, oral Overdose |
unknown, 14 years n = 1 Health Status: unknown Age Group: 14 years Sex: F Population Size: 1 Sources: |
Other AEs: Dizziness, Drowsiness... Other AEs: Dizziness (mild, 1 patient) Sources: Drowsiness (mild, 1 patient) |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Disc. AE: Asthenia, Nausea... AEs leading to discontinuation/dose reduction: Asthenia (1%) Sources: Nausea (4%) Dry mouth (1%) Vomiting (1%) Dizziness (2%) Insomnia (3%) Somnolence (2%) Agitation (1%) |
760 mg single, oral Overdose |
unknown, 25 years n = 1 Health Status: unknown Age Group: 25 years Sex: F Population Size: 1 Sources: |
Other AEs: Seizures, Tachycardia... Other AEs: Seizures (1 patient) Sources: Tachycardia (1 patient) Neuromuscular disorders NEC (1 patient) Hyperthermia (severe, 1 patient) |
360 mg 1 times / day multiple, oral Highest studied dose Dose: 360 mg, 1 times / day Route: oral Route: multiple Dose: 360 mg, 1 times / day Sources: |
unhealthy, adult |
|
2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
Other AEs: Dizziness, Sweating... Other AEs: Dizziness (grade 5) Sources: Sweating Nausea Vomiting Tremor Somnolence Sinus tachycardia |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Dizziness | mild, 1 patient | 800 mg single, oral Overdose |
unknown, 14 years n = 1 Health Status: unknown Age Group: 14 years Sex: F Population Size: 1 Sources: |
Drowsiness | mild, 1 patient | 800 mg single, oral Overdose |
unknown, 14 years n = 1 Health Status: unknown Age Group: 14 years Sex: F Population Size: 1 Sources: |
Agitation | 1% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Asthenia | 1% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Dry mouth | 1% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Vomiting | 1% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Dizziness | 2% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Somnolence | 2% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Insomnia | 3% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Nausea | 4% Disc. AE |
80 mg 1 times / day steady, oral (max) Studied dose Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18-66 years n = 1063 Health Status: unhealthy Condition: depression Age Group: 18-66 years Sex: M+F Population Size: 1063 Sources: |
Neuromuscular disorders NEC | 1 patient | 760 mg single, oral Overdose |
unknown, 25 years n = 1 Health Status: unknown Age Group: 25 years Sex: F Population Size: 1 Sources: |
Seizures | 1 patient | 760 mg single, oral Overdose |
unknown, 25 years n = 1 Health Status: unknown Age Group: 25 years Sex: F Population Size: 1 Sources: |
Tachycardia | 1 patient | 760 mg single, oral Overdose |
unknown, 25 years n = 1 Health Status: unknown Age Group: 25 years Sex: F Population Size: 1 Sources: |
Hyperthermia | severe, 1 patient | 760 mg single, oral Overdose |
unknown, 25 years n = 1 Health Status: unknown Age Group: 25 years Sex: F Population Size: 1 Sources: |
Nausea | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Sinus tachycardia | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Somnolence | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Sweating | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Tremor | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Vomiting | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
|
Dizziness | grade 5 | 2800 mg single, oral Overdose Dose: 2800 mg Route: oral Route: single Dose: 2800 mg Sources: |
unknown n = 1 Health Status: unknown Population Size: 1 Sources: |
PubMed
Title | Date | PubMed |
---|---|---|
[Severe and recent hyponatremia and hypokalemia associated to the use of hydrochlorothiazide, enalapril and citalopram. Clinical case]. | 1999 Oct |
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Citalopram and clozapine: potential drug interaction. | 2000 Apr |
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Low serum sodium concentrations during treatment with citalopram in elderly patients: relationship to serum citalopram levels and to platelet serotonin 5-HT2A receptor status. | 2000 Oct |
|
De novo onset of Parkinson's disease after antidepressant treatment with citalopram. | 2000 Sep |
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Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy. | 2001 Apr |
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Differential effects of fluvoxamine and other antidepressants on the biotransformation of melatonin. | 2001 Apr |
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Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care. | 2001 Apr |
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Some behavioural effects of antidepressant drugs are time-dependent. | 2001 Feb |
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Reboxetine plus citalopram for refractory depression not responding to venlafaxine: possible mechanisms. | 2001 Feb |
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Disinhibition of libido: an adverse effect of SSRI? | 2001 Feb |
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Lack of effect of a single dose of ketoconazole on the pharmacokinetics of citalopram. | 2001 Feb |
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Liquid-phase microextraction and capillary electrophoresis of citalopram, an antidepressant drug. | 2001 Feb 9 |
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Effect of subchronic lithium treatment on citalopram-induced increases in extracellular concentrations of serotonin in the medial prefrontal cortex. | 2001 Jan |
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An open trial of citalopram in adolescents with post-traumatic stress disorder. | 2001 Jan |
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Catalepsy induced by the 5-HT(1A) receptor antagonist WAY 100635 in rats pretreated with the selective serotonin reuptake inhibitor citalopram. | 2001 Jan 12 |
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Citalopram in refractory obsessive-compulsive disorder: an open study. | 2001 Jul |
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Down-regulation of the rat serotonin transporter upon exposure to a selective serotonin reuptake inhibitor. | 2001 Jul 20 |
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Involvement of adenosine in the effect of antidepressants on glutamate and aspartate release in the rat prefrontal cortex. | 2001 Jun |
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Citalopram versus nortriptyline in late-life depression: a 12-week randomized single-blind study. | 2001 Jun |
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Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. | 2001 Mar |
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Lack of citalopram effect on oral digoxin pharmacokinetics. | 2001 Mar |
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Functional consequences of 5-HT transporter gene disruption on 5-HT(1a) receptor-mediated regulation of dorsal raphe and hippocampal cell activity. | 2001 Mar 15 |
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Risk profile of SSrIs in elderly depressive patients with co-morbid physical illness. | 2001 May |
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Alzheimer's disease and related disorders. | 2001 May |
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Binding characteristics of selective serotonin reuptake inhibitors with relation to emission tomography studies. | 2001 Sep 1 |
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Citalopram-induced dyskinesia of the tongue: a video presentation. | 2016 Dec 23 |
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Insight gained from genome-wide interaction and enrichment analysis on weight gain during citalopram treatment. | 2017 Jan 10 |
Sample Use Guides
Initial Treatment Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, with an increase to a maximum dose of 40 mg/day at an interval of no less than one week. Doses above 40 mg/day are not recommended due to the risk of QT prolongation. Additionally, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg/day dose over the 40 mg/day dose. Special Populations 20 mg/day is the maximum recommended dose for patients who are greater than 60 years of age, patients with hepatic impairment, and for CYP2C19 poor metabolizers or those patients taking cimetidine or another CYP2C19 inhibitor.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/27271269
It was investigated the mechanisms of cytotoxic effects of in vitro and in vivo citalopram treatment on liver and the following cytolethal events. For in vitro experiments, freshly isolated rat hepatocytes were exposed to citalopram along with/without various agents. In the in vitro experiments, citalopram (500 µM) exposure demonstrated cell death, a marked elevation in ROS formation, mitochondrial potential collapse, lysosomal membrane leakiness, glutathione (GSH) depletion and lipid peroxidation. In vivo biochemistry panel assays for liver enzymes function (AST, ALT and GGTP) and histological examination confirmed citalopram (20 mg/kg)-induced damage. Citalopram-induced oxidative stress cytotoxicity markers were significantly prevented by antioxidants, ROS scavengers, MPT pore sealing agents, endocytosis inhibitors, ATP generators and CYP inhibitors.
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207559-01-1
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100000175895
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21871605
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B5RDX2419X
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PARENT (SALT/SOLVATE)
SUBSTANCE RECORD