Cital – contribution, action, price. When should you take an antidepressant medication?

Cital is an antidepressant drug containing citalopram. How does it work on the body? Are there any contraindications to its use? We check what the dosage of Cital looks like, as well as whether it interacts with other drugs.

Cital – action

Cital is an antidepressant medicine also known as a selective serotonin reuptake inhibitor. The active substance of the drug – citalopram – is strong, but does not inhibit 5-HT uptake with long-term treatment. In addition, it does not affect the cognitive and psychomotor performance of the patient.

Cital – composition

In addition to citalopramom (20 mg in one tablet), Cital contains substances that form the core of the tablet, which include:

1. lactose monohydrate, 
2. corn starch, 
3. microcrystalline cellulose, 
4. glycerol 85%, 
5. crospovidone 
6. croscarmellose sodium, 
7. magnesium stearate. 

The coating of Cital consists of:

1. opadry II: hypromeloza 29106cP, 
2. macrogol 3000,  
3. lactose monohydrate, 
4. triacetyna,  
5. titanium dioxide (E171). 

Cital – when can it be used?

The main indication for the use of Cital is the treatment of depression, as well as the prevention of recurrence of recurrent depressive disorders. The drug is also prescribed for patients who suffer from agoraphobic anxiety disorder (fear of crowds, fear of going out, the open space).

Cital – what is the dosage of the drug?

Take Cital only as prescribed by your doctor. Most often, the patient uses one dose a day. For the treatment of depression, 20 mg of the drug is taken. Your doctor may increase the dose to 40 mg.

If you are treating anxiety disorders with anxiety attacks, the starting dose is 10 mg for the first week. It is then increased to 20-30 mg daily.

People over 65 years of age, as well as patients with liver disease should not take more than 15-20 mg a day. Children and adolescents up to 18 years of age cannot use the drug. If Cital is nevertheless administered, the minor should be under special medical care due to the increased risk of side effects., mostly thoughts of suicide and hostility.

The duration of treatment with Cital depends on the patient’s disease. Most often it lasts about 6 months, even if the mood improves, because if you stop taking the drug too early, the symptoms of depression may come back.

Cital – contraindications to use

Cital should not be used in patients who are hypersensitive to citalopram or the excipient contained in the drug. In addition, people with congenital abnormal heart rhythms or an episode of abnormal heart rhythms visible on ECG should not take the preparation.

1. Find out about the most common heart diseases

It is also not recommended to combine Cital with MAO monoamine oxidase inhibitors. There should be a break between their use – two weeks after discontinuing MAO, you can start the Cital treatment; one week after discontinuing Cital, you can start treatment with MAO inhibitors.

Cital – recommended precautions

The recommended precautions apply primarily to patients who have:

1. manic episodes
2. panic anxiety
3. diabetes – Cital can affect your blood sugar levels. Because it is important to adjust the dose of insulin or oral medication,
4. epilepsy – Cital may increase the frequency of seizures,
5. bleeding tendency,
6. low sodium levels in the blood
7. heart disease or a history of a heart attack
8. dilated pupil of the eye. 

Precautions should also be considered for patients who have been treated with electroconvulsive therapy. It should also be remembered that taking Cital may disturb sexual function. It is also possible for a manic phase to occur in patients with bipolar disorder.

In addition, Cital may make you feel dizzy making it impossible to drive or operate machinery. Although the drug does not interact with alcohol, it should not be consumed while taking Cital.

Cital – interactions with other drugs

Cital may interact with other medications, so be careful when taking the preparation and:

1. MAO monoamine oxidase inhibitors containing phenelzine, iproniazid, isocarboxazid, nialamide and tranylcypromine,
2. reversible selective monoamine oxidase A (MAO-A) inhibitors with moclobemide,
3. linezolid,
4. bed,
5. tryptophan
6. imipramine and desipramine,
7. irreversible monoamine oxidase B (MAO-B) inhibitors with selegiline,
8. metoprolol,
9. St. John’s wort,
10. neuroleptics,
11. sumatriptan,
12. cimetidine, lansoprazole and omeprazole
13. meflochina,
14. drugs for the treatment of cardiac arrhythmias. 

Cital – can it be taken during pregnancy and breastfeeding?

If a woman is pregnant, she should consult a doctor about the Cital treatment due to the risk of dangerous occurrences in the baby after childbirth, such as breathing disorders, bluish skin, vomiting, difficulty in feeding, constant crying, lethargy, tremors.

A complication of taking Cital in the last three months of pregnancy may be Permanent Pulmonary Hypertension of the Newborn. Breastfeeding women should also not take Cital.

Cital – symptoms of overdose

If you take too much Cital, you may experience symptoms that are immediately life-threatening:

1. serotonin syndrome,
2. nausea,
3. cyanosis of the skin,
4. hyperventilation,
5. somnolence,
6. coma,
7. seizures 
8. Heart arythmia. 

After noticing the above symptoms, go with the patient to the nearest hospital or call an ambulance.

Cital – withdrawal symptoms

The appearance of withdrawal symptoms depends on how the treatment is ended. If it has been stopped abruptly, the following may appear:

1. sensory disturbances,
2. sleep disturbances,
3. sweating,
4. entanglement,
5. emotional lability,
6. vomiting,
7. anxiety,
8. irritability,
9. palpitations. 

Due to their appearance, the dose of Cital should be gradually reduced. Symptoms may not be noticeable for a week to several months after discontinuation.

Cital – side effects

The main side effects during treatment with Cital include:

1. metabolism and nutrition disorders – hyponatremia, increased appetite and weight gain,
2. mental disorders – agitation, decreased sex drive, anxiety, nervousness, confusional states, orgasm disorders in women, abnormal dreams, aggression, hallucinations, mania, depression,
3. nervous system disorders – somnolence / insomnia, headache, tremors, paresthesia, dizziness, fainting,
4. ear and labyrinth disorders – tinnitus,
5. respiratory system disorders – yawning,
6. gastrointestinal disorders – dry mouth, vomiting, diarrhea, constipation, nausea,
7. skin and subcutaneous tissue disorders – increased sweating, itching,
8. reproductive system disorders – impotence, ejaculation disorders, inability to ejaculate, menorrhagia. 

How to store Cital?

Cital should be kept out of the sight and reach of children in a room with a maximum of 25 degrees C. After the expiry date, you cannot take the drug.

How much does Cital cost?

Cital can only be obtained with a prescription. The cost of 10 tablets is PLN 5,60.