Escitalopram and citalopram
(Redirected from Citalopram)
| Drug monograph · NCLEX study reference | |
| Trade names | Lexapro, Celexa |
|---|---|
| Therapeutic class | Antidepressant, antianxiety |
| Pharmacologic class | SSRIs |
| Onset / peak / duration | Mood effect over 2 to 4 weeks. |
| Half-life / level | Half-life about 27 to 32 hours; level not routine. |
| Routes | PO (oral) |
| High-alert (ISMP) | No |
| Black box warning | Yes (see Safety) |
| Antidote / reversal | Supportive care. |
| Pregnancy / lactation | Used when benefit outweighs risk. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Escitalopram and citalopram (brand names Lexapro, Celexa) — Antidepressant, antianxiety; SSRIs.
Identification
- Therapeutic class: Antidepressant, antianxiety.
- Pharmacologic class: SSRIs.
Pharmacology
- Mechanism of action: Block serotonin reuptake; escitalopram is the active enantiomer of citalopram.
- Onset / peak / duration: Mood effect over 2 to 4 weeks.
- Half-life / therapeutic level: Half-life about 27 to 32 hours; level not routine.
Clinical use
- Indications: Depression, generalized anxiety disorder.
- Usual dose, route, frequency: Escitalopram 10 to 20 mg PO daily; citalopram 20 to 40 mg PO daily.
- Maximum dose / adjustments: Citalopram limited to 40 mg/day (20 mg in elderly or hepatic impairment) because of QT prolongation; escitalopram max 20 mg/day.
Safety
- Contraindications: MAO inhibitor within 14 days; citalopram with QT-prolonging conditions.
- Black box warning: Suicidality in those under 25 (SSRI class).
- Interactions: QT-prolonging drugs (citalopram), serotonergic drugs, NSAIDs and anticoagulants.
- Pregnancy / lactation: Used when benefit outweighs risk.
- High-alert: No.
Adverse effects
- Common side effects: Nausea, insomnia, sexual dysfunction, headache.
- Serious effects to report: Suicidal thoughts, serotonin syndrome, QT prolongation (citalopram), hyponatremia.
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: Mood and suicide risk, ECG and electrolytes for citalopram.
- Interventions during therapy: Respect citalopram dose ceiling; monitor mood; taper to stop.
- Monitor: Mood, suicidality, ECG (citalopram), sodium.
- Evaluation / expected outcome: Improved mood and anxiety.
Patient teaching
- Patient teaching: Effect takes weeks; do not stop abruptly.
- Notify provider if: Suicidal thoughts, palpitations or fainting, agitation with fever.
- Administration tips: Same time daily.