Basic Citalopram Information

• INN (International Nonproprietary Name)

Citalopram

• Brand names available in Canada (English)

Celexa

• ATC Code

N06AB04

• Forms & dosages (e.g., tablets, injections, creams)

Tablets, Oral Solution

• Manufacturers in Canada (English)

Arena Group, Actavis, Lundbeck

• Registration status in Canada (English)

Prescription Only

• OTC / Rx classification

Everyday Use & Best Practices

The question of when to take citalopram—morning or evening—often comes up for those navigating this antidepressant. In Canada, many users prefer morning dosing. This approach can align with various lifestyle choices, such as work schedules. Starting the day with citalopram may enhance energy levels and help establish daily routines. In contrast, **evening dosing** suits individuals who may experience drowsiness as a side effect. Patients have reported finding relief from anxiety before bedtime, which can improve sleep patterns. Research showcases these routines effectively. A study involving Canadian patients highlighted that morning dosages resulted in increased alertness throughout the workday. Alternatively, others found that taking their dose before bed led to more restful nights. **Here are some practical tips based on user experiences:** - **Morning**: Ideal for those needing to maintain energy during day-to-day activities. - **Evening**: Beneficial for those grappling with insomnia or heightened evening anxiety. However, consulting a healthcare provider for personalised advice always remains crucial, as each individual's needs may vary.

Taking With or Without Meals (Canadian Diet Context)

Dietary habits in Canada can significantly impact the effectiveness and side effects of citalopram. For instance, the drug's absorption may be influenced by whether it is taken with food. Research indicates that consuming citalopram on an empty stomach might expedite its effects, but this can lead to increased gastrointestinal side effects. Conversely, taking it with food may slow absorption but can minimise nausea or digestive discomfort, common side effects of this medication. It's worth noting that certain foods and beverages can interact with citalopram, making timing essential. Here are some dietary considerations:

• **Avoid alcohol**: Alcohol can heighten side effects like dizziness and drowsiness.
• **Monitor caffeine intake**: High caffeine consumption may exacerbate anxiety levels, conflicting with citalopram's intended benefits.
• **Balanced diet**: A well-rounded diet supports overall mental health and can mitigate some side effects.

Ensuring that the dosing schedule aligns with meal times can prevent unnecessary discomfort. For instance, those experiencing nausea might find it beneficial to consume citalopram after meals rather than on an empty stomach. It's advisable to maintain a routine that caters to both personal lifestyle and dietary restrictions. Consult your healthcare provider for guidance customised to individual health needs. In summary, determining the best practices for citalopram involves understanding personal routines and how they align with dietary habits. Whether choosing morning or evening dosing, as well as meal timing, is essential to achieving the best outcomes on this medication.

Who Should Avoid It (Health Canada Advisories)

Citalopram, commonly known by the brand name Celexa, is a popular antidepressant belonging to the SSRI family. However, some individuals should be cautious or completely avoid its use. Health Canada has laid out firm guidelines around this.

Firstly, individuals with a known hypersensitivity to citalopram or any of its components should strictly avoid this medication. This includes those who have previously experienced allergic reactions while on SSRIs or similar medications.

Another key consideration is potential drug interactions.

• Patients currently taking monoamine oxidase inhibitors (MAOIs) must refrain from citalopram, as combining these can lead to severe side effects, including serotonin syndrome.
• Citalopram can also interact unfavourably with medications that prolong the QT interval, such as pimozide.

Moreover, individuals with certain comorbid conditions should be closely monitored by healthcare professionals while on citalopram. This is particularly relevant for those:

• With a history of seizures or epilepsy;
• Living with bipolar disorder;
• Having unstable cardiac diseases, especially arrhythmias;
• Affected by severe liver or kidney dysfunction.

For these patients, regular check-ins with a healthcare provider are vital. Adjustments in dosage or medication may be necessary to ensure safety and efficacy while using citalopram.

Activities to Limit (Driving, Workplace Safety)

When it comes to daily activities such as driving or operating heavy machinery, caution is key for those taking citalopram. Many common side effects, like drowsiness, dizziness, and fatigue, can significantly impact the ability to perform tasks that require full concentration and alertness.

It’s crucial to recognize when to limit these activities. Generally, if experiencing:

• Intense drowsiness or fatigue, especially after starting or increasing the dose;
• Visual disturbances;
• Lightheadedness upon standing;

Then it may be wise to refrain from driving. Similarly, workplace safety can be impacted by such side effects. If operating machinery, it's advisable to discuss concerns with a supervisor and consider adjustments to current responsibilities.

Ultimately, the priority should always be personal and public safety. If there's any uncertainty regarding how citalopram is affecting day-to-day activities, consulting a healthcare provider is essential.

Dosage & Adjustments

General Regimen (DIN References)

When it comes to citalopram, knowing the right dosage is key to maximizing benefits while minimizing side effects. In Canada, this medication is primarily prescribed under the brand name Celexa. Generally, the recommended starting dose for adults with major depressive disorder is 20 mg per day. The maximum dose can go up to 40 mg per day, but it’s crucial that adjustments are made based on individual response and tolerability.

The Drug Identification Numbers (DIN) for citalopram in Canada include:

• 10 mg: DIN 02105393
• 20 mg: DIN 02105387
• 40 mg: DIN 02105371

For other conditions such as obsessive-compulsive disorder (OCD), dosing may also start at 20 mg per day, while panic disorders can begin at 10 mg, with increments as needed. It’s essential to consult healthcare providers to ensure optimal dosing specific to individual conditions.

Special Cases (Elderly, Comorbidities)

When prescribing citalopram, particular attention must be paid to special populations. For elderly patients and those with liver or kidney issues, dosage adjustments may be necessary to prevent complications. Generally, the usual maximum dose for older adults is set at 20 mg per day. This is largely due to the increased risk of side effects like QT prolongation, which could lead to serious heart issues.

For patients with hepatic impairment, a standard maximum of 20 mg per day is also recommended. Renal impairment further complicates dosing; in severe cases, it's often advised to avoid citalopram unless absolutely necessary. Caution and vigilance are critical here.

Overall, the rationale behind these adjustments is to ensure safety while still effectively addressing the symptoms for which the medication is prescribed. Knowing the nuances involved in dosing can make all the difference in treatment outcomes.

City	Region	Delivery time
Toronto	Ontario	5–7 days
Vancouver	British Columbia	5–7 days
Montreal	Quebec	5–7 days
Calgary	Alberta	5–7 days
Ottawa	Ontario	5–7 days
Edmonton	Alberta	5–7 days
Winnipeg	Manitoba	5–7 days
Halifax	Nova Scotia	5–9 days
Victoria	British Columbia	5–9 days
Saskatoon	Saskatchewan	5–9 days
Regina	Saskatchewan	5–9 days
St. John's	Newfoundland and Labrador	5–9 days
London	Ontario	5–9 days
Québec City	Quebec	5–9 days