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Celexa equivalent to zoloft


Sertraline hydrochloride is a white crystalline powder that is slightly soluble in water and isopropyl alcohol, and sparingly soluble in ethanol.. ZOLOFT tablets for oral administration contain mg, mg and mg sertraline hydrochloride equivalent to 25, 50 and mg of sertraline and the following inactive ingredients: dibasic calcium phosphate dihydrate, D & C Yellow # Guardian Pharmacy Online Indonesia. Allopurinol initiation diflucan and kidney damage hydrochlorothiazide olmesartan buspirone hcl oral diltiazem proteinuria coregonus artedi most popular breeds captopril brands dexamethasone negative charge valtrex in early pregnancy creatinine bump on lasix depo provera generic brand diltiazem meds medicine alendronate sodium pickles and warfarin . Viagra comes as a tablet containing sildenafil citrate, to take by mouth. For most men, the recommended dose is 50 mg. taken, as needed, approximately 1 hour before sexual activity.
Compare prices and print coupons for Celexa (Citalopram) and other Depression drugs at CVS, Walgreens, and other pharmacies. Prices start at $ Celexa® (citalopram) is an orally administered selective serotonin reuptake inhibitor (SSRI) with a chemical structure unrelated to that of other SSRIs or of tricyclic, tetracyclic, or other available antidepressant agents. Zoloft is the brand name of sertraline, an antidepressant used to treat major depressive disorders. Zoloft is in a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs.


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In vitro binding studies showed that nefazodone had no significant affinity for the following receptors: Angle-closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants. The physician may consider tapering fluvoxamine maleate tablets in the third trimester. Celexa equivalent to zoloft The mg dosage of Celexa is different with Zoloft. The initial dose of Zoloft is 50 mg while the dose of Celexa is 20 mg once a day.  The initial dose of Zoloft is 50 mg while the dose of Celexa is 20 mg once a day. Tuesday, January 22 Source: genericcialistadalafil.online (I've tried Celexa, Zoloft, Paxil, & Effexor.) I took the generic for a month and didn't notice any difference in it's effectiveness versus Lexapro. Comment.  I found out that 20 mg of Lexapro (what I used to take) is equivalent to mg of Zoloft, yet I was only taking 50 mg. Additionally, in the past I had to switch to Celexa due to insurance coverage and my doctor put me on 20 mg of that well guess what? The dosages aren't interchangeable, even though the drugs are very similar. The psychiatrist told me that 20 mg of Lexapro is equal to 60 mg of Celexa, so of course that didn't work for me. So, my point is, if one drug doesn't work, don't be afraid to try another, but try to stick it out as long as you can. Zoloft To Celexa. By Torontoguy, May 9, in Zoloft/Lustral (sertraline). Recommended Posts. Torontoguy 3.  I would like to transition from one day mg of zoloft to say 20mg of cipram if that is equivalent, What is the equivalent to mg of zoloft? I would like to be able to differentiate between if i have zoloft withdrawal or start up effects of new drug. I have been on zoloft 8 years and was off for a month and back on for 3 months but it is not working anymore and i feel anxiety and dry heave genericcialistadalafil.online info appreciated i can also get 10mg lexapro brand name here but it is expensive. I guess i could break into 5mg but is that a good enough dose to work? or is it considered not much of a do.

And weight gain can be a common side effect of both of these classes of drugs. Keep in mind that patients may react differently to different medications within these classes. If side effects, like weight gain, become bothersome, it sometimes helps to switch medications.

Consult your health care provider for specific recommendations. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications.

Zoloft sertraline is a medication that is used to treat depression or anxiety. It is in a group of medications called selective serotonin reuptake inhibitors SSRIs that work to balance out the chemical, serotonin, in the brain that causes depression symptoms when there is too little to go around.

The prescribing information lists weight gain as a side effect of this medication. The occurrence of weight gain was not common during clinical studies of the medication, seen in 1 percent of patients taking Zoloft. If you are noticing an unexplained weight gain with Zoloft it would be best to consult with your physician as to the best way to handle this side effect.

For more information on Zoloft, click on this link: I am withdrawing from Zoloft mg after years of taking it. I have been without it for four days and I feel dizzy. Zoloft sertraline is classified as a selective serotonin reuptake inhibitor SSRI. According to medical references, Zoloft has warnings associated with withdrawal syndrome.

It is recommended that Zoloft should be gradually tapered down when discontinuing the medication. If intolerable symptoms occur after stopping the medication, the recommendation is made for the physician to consider resuming the previous dosage and then begin a more gradual taper.

All dosing and tapering of dosages should only be done as directed by your physician. Signs and symptoms of withdrawal syndrome include: Zoloft sertraline is a selective serotonin reuptake inhibitor SSRI antidepressant used to treat depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety disorder.

The most common side effects with Zoloft are dizziness, fatigue, headache, decreased libido, nausea, diarrhea, dry mouth. Alopecia hair loss was reported as an infrequent side effect with Zoloft. This is not a complete list of the side effects associated with Zoloft. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat.

Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects.

Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U. Food and Drug Administration by visiting www. Why do I have bad dreams every time I start a new course of Zoloft but then it tapers off? Zoloft is indicated for depression, obsessive-compulsive disorder, panic disorder, anxiety, and premenstrual dysphoric disorder PMDD. Common side effects of Zoloft include drowsiness, nausea, dry mouth, sleep problems, and changes in weight and appetite.

A search of prescribing information did not specifically list abnormal dreams as a side effect of zoloft. What's the safest way to stop taking Zoloft? I'm not sure it's working, and the sweating is driving me crazy. Zoloft sertraline is a selective serotonin reuptake inhibitor antidepressant used to treat depression and other conditions as prescribed by your doctor. It is important to remember that it can take up to 6 weeks to see the full effects of the medication so it is best not to judge its effectiveness before this time.

Discontinuation or withdrawal symptoms can occur with abrupt discontinuation of Zoloft. These symptoms can include change in mood, irritability, agitation, confusion, anxiety and insomnia.

It is important to avoid abrupt discontinuation. The package information for Zoloft recommended tapering the dose slowly by gradually decreasing the dose before stopping the medication. Your doctor can advise you on a tapering schedule. Zoloft sertraline is an antidepressant that is used in the treatment of depression, panic disorder, anxiety disorder, obsessive-compulsive disorder OCD , post-traumatic stress disorder PTSD , and pre-menstrual dysphoric disorder PMDD.

Weight gain or changes in appetite are a side effect that occurs with the use of sertraline. Does Zoloft cause bloating and weight gain? According to medical references, the most common gastrointestinal side effects associated with Zoloft include: Other reported gastrointestinal side effects include decreased appetite, constipation, upset stomach, flatulence, vomiting and weight gain. The feeling of bloatedness can be associated with some of these possible side effects.

These are not all of the possible side effects associated with Zoloft. If you think that you are experiencing a side effect from your medication, talk with your physician. Do not stop taking or change the dose of your medication without first talking to your physician. Regards, Jen Marsico, RPh. If I don't see a difference with Zoloft should I go off of it?

There is a possibility that the medication may be helping you, but you don't realize it. Sometimes patients stop their antidepressants, and then realize that it was actually helping them. However, if you feel as though it is not working, then you, along with your doctor, may need to consider a different dosage of Zoloft sertraline or treatment with a different antidepressant.

One very important thing about Zoloft is that it should not be discontinued abruptly and no medication should be stopped without the permission and guidance from your health care provider. For additional information regarding depression: I am on Zoloft and have trouble sleeping. Will drinking wine make me more depressed? There is no drug interaction between alcohol and Zoloft. Side effects to alcohol include: This is not a complete list of side effects.

Alcohol can cause impaired judgment, alertness, and sleeping problems. Talk to your doctor about your concerns with Zoloft and alcohol. Do not start or stop any medications or treatments without first talking to your doctor. I believe you will find the following links at everydayhealth. Can Zoloft cause headaches and joint issues? Zoloft sertraline belongs to the group of drugs known as selective serotonin reuptake inhibitors SSRIs. Zoloft is used for the treatment of depression, obsessive-compulsive disorder, and anxiety disorders.

According to the package insert, the most common side effects of Zoloft are nausea, diarrhea, insomnia, dry mouth, tiredness, dizziness, and tremor. Headache, muscle pain, muscle weakness, and joint pain have all been reported in patients taking Zoloft. Food and Drug Administration by visiting http: I have recently started taking sertraline. I am worried about the side effects. Is there weight gain? And does it affect a person's sex drive?

According to Lexi-Comp, sertraline Zoloft does have possible adverse effects that could affect weight. The listed adverse effects of sertraline involving weight include anorexia, increased appetite and weight gain. Decreased libido sexual desire has also been reported in greater than 10 percent of patients taking sertraline during clinical trials.

As always, talk with your health care provider regarding concerns you have about your medication and possible side effects. I've been prescribed Zoloft generic version for depression. I'm also 33 weeks pregnant. Is it safe for me to take this drug for the rest of my pregnancy? Zoloft sertraline is a pregnancy category C medicine, meaning that the medication could potentially cause harm to your unborn child. This is especially true during the third trimester of pregnancy. A health care provider may still prescribe a pregnancy category C medicine to a pregnant woman if he or she believes that the benefits to the woman outweigh the possible risks to the unborn child.

Also, babies exposed to Zoloft late during pregnancy are at increased risk for developing persistent pulmonary hypertension of the newborn PPHN. PPHN is associated with significant complications and even death. It's possible that your physician may recommend reducing your dosage, or weaning you off Zoloft during the third trimester of pregnancy.

You really should have a discussion with the physician about taking this medication throughout the entire pregnancy. Is Zoloft all right to take while nursing? Substantial human data demonstrates minimal risk to an infant through lactation in patients taking Zoloft sertraline.

Zoloft is usually acceptable with breastfeeding. My doctor started me on Zoloft 50 mg to take for seven days and then changed to mg. I am on day five of the 50 mg. The problem that I am having is with my jaw. I keep trying to clench my teeth throughout the day and at night a couple of hours after taking the medication.

My jaw feels like it is locked up and is getting sore. I have already noticed the decrease in sexual desire also.

Is this a common complaint from the medicine? I am currently taking my medicine around lunchtime. Zoloft sertraline is a selective serotonin reuptake inhibitor SSRI used to treat depression and other disorders. During initial clinical trials, there were no reports of jaw pain or teeth grinding with Zoloft. Since the medication has been on the market, there have been case reports of teeth grinding and clenching especially at night by patients on Zoloft and other SSRIs.

Grinding or clenching teeth can cause damage to your teeth and cause pain. Discuss this side effect with your health care provider, they may want to try you on a different medication. Sexual side effects are common with the SSRIs. I am prescribed the generic of Zoloft for depression during my pregnancy. I am now 33 weeks pregnant. Is it okay to continue taking it until the birth?

Zoloft sertraline is a pregnancy Category C medicine, meaning that the medication could potentially cause harm to your unborn child. A health care provider may still prescribe a pregnancy Category C medicine to a pregnant woman if he or she believes that the benefits to the woman outweigh the possible risks to the unborn child. It is possible that your physician may recommend reducing your dosage, or weaning you off Zoloft during the third trimester of pregnancy.

Zoloft sertraline is a selective serotonin reuptake inhibitor SSRI antidepressant. Zoloft is approved for the treatment of major depressive disorder, obsessive-compulsive disorder OCD , panic disorder, social anxiety disorder, post-traumatic stress disorder PTSD and premenstrual dysphoric disorder PMDD. It may also be used to treat other conditions as determined by your healthcare provider. Some of the most commonly reported side effects associated with Zoloft treatment include drowsiness, dizziness, feeling tired, nausea, upset stomach, constipation, dry mouth, changes in weight or appetite, difficulty sleeping and decreased sex drive or difficulty having an orgasm.

Zoloft should be taken with a full glass of water and may be taken with our without food. According to the prescribing information, patients being treated with Zoloft should avoid alcohol. Although studies did not show an increase in mental or motor skill impairment with alcohol, patients taking Zoloft are still advised to avoid alcohol.

Patients should also be advised regarding the risk for developing serotonin syndrome while being treated with Zoloft. Serotonin syndrome is a potentially life-threatening medical condition, which can be fatal if left untreated. According to the National Institutes of Health NIH , serotonin syndrome most often occurs when a patient takes two medications that affect serotonin levels. Serotonin syndrome may develop with the concomitant use of Zoloft and other serotonergic medications, such as the triptans medications used to treat migraine headaches , tramadol, serotonin norepinephrine reuptake inhibitor SNRI medications, such as Cymbalta duloxetine , Savella milnacipran , Effexor venlafaxine or Pristiq desvenlafaxine , or other SSRIs, such as Prozac fluoxetine , Paxil paroxetine , Celexa citalopram or Lexapro escitalopram.

Symptoms of serotonin syndrome include agitation, confusion, increased heart rate and blood pressure, sweating, headache, diarrhea, loss of muscle coordination and possibly fever and seizures. Seek immediate medical attention if you experience any signs and symptoms associated with serotonin syndrome. Treatment with antidepressants, including Zoloft, may worsen depression and cause the emergence of suicidal ideation and behavior or unusual changes in behavior in certain patients during the early phases of treatment.

It remains unknown whether this risk extends to long-term treatment beyond a few months. Patients taking Zoloft should be monitored and closely observed for symptoms of clinical worsening of depression, suicidal ideation or behavior and unusual behavioral changes, during initiation of treatment and at time of dose changes.

Symptoms should be reported to a health care provider immediately and may include anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, restlessness, hypomania, mania and unusual changes in behavior or suicidal ideation or behavior. Patients taking Zoloft should be cautioned regarding the risk for bleeding.

Zoloft may increase the risk for bleeding event s and this risk is increased with the concomitant use of Zoloft and non-steroidal ant-inflammatory drugs NSAIDs , aspirin, warfarin or other mediations that affect coagulation. There have been reports of the development of adverse events upon discontinuation of Zoloft.

These symptoms occurred particularly upon abrupt discontinuation. Symptoms may include irritability, agitation, dizziness, sensory disturbances, dysphoric mood, confusion, headache, lethargy, anxiety and insomnia.

It is recommended that patients, under the supervision of a physician, gradually reduce the dose of Zoloft rather than abruptly discontinue treatment to avoid unpleasant adverse reactions. How do you treat anxiety disorders with Zoloft? To treat anxiety disorders with Zoloft sertraline , the relationship between dosage and therapeutic effect was not established.

However, most patients were treated with a dose ranging from 50 to mg per day during clinical trials. To treat anxiety disorders with Zoloft, treatment should be started at a dose of 25 mg once daily. Subsequently, after one week of treatment the dose should be increased to 50 mg administered once daily.

This the recommended initial therapeutic dose to treat anxiety disorders with Zoloft. In those patients who are unresponsive to the initial dose of Zoloft, there may be added benefit of increasing the dose up to a maximum of mg daily. Changes in dose to treat anxiety disorder with Zoloft should not occur at intervals of less than one week of treatment as a result of the elimination half-life of Zoloft. Zoloft should be administered once daily, either in the morning or evening.

Patients are advised to take their dose of Zoloft at the same time each day. Anxiety disorders are often times chronic conditions that may warrant long-term treatment with Zoloft to maintain a therapeutic response. However, patients should be periodically reassessed to determine if long-term treatment is still required.

Based on clinical evaluation, there is demonstrated efficacy to treat anxiety disorders with Zoloft for periods up to 24 weeks following an initial 20 weeks of treatment with Zoloft at a dose ranging from 50 mg to mg administered daily. Physicians are advised to maintain patients on the lowest therapeutically effective dose of Zoloft to treat anxiety disorders.

Zoloft is an antidepressant medication classified as a serotonin reuptake inhibitor SSRI. Zoloft is indicated for the treatment of many different conditions including anxiety disorders. The mechanism of action of Zoloft appears to be related to its ability to inhibit central nervous system CNS uptake of serotonin.

There is currently a generic equivalent available for Zoloft sertraline , known as sertraline. Food and Drug Administration FDA requires that generic medications be bioequivalent to the brand-name medication and, therefore, work the same way in the body.

Generic medications are considered, by the FDA, to be identical to the brand-name counterparts in dose, strength, route of administration, safety, efficacy and intended use.

Generic medications will appear differently and may have different inactive ingredients, however, the labeling and directions for use remain the same.

For most medications, generic equivalents are a lower-cost alternative to the more expensive brand-name medication, and the majority of patients observe no changes in therapeutic effect. However, some patients will experience a change in effect and must continue treatment with the brand-name medication. Generic Zoloft, sertraline, is a selective serotonin reuptake inhibitor SSRI type of antidepressant which is approved for the treatment of depression, obsessive-compulsive disorder OCD , certain anxiety disorders, panic disorder, premenstrual dysphoric disorder PMDD and post-traumatic stress disorder PTSD.

Frequently reported side effects for generic Zoloft are similar those observed in patients being treated with the brand-name medication and may include somnolence, dizziness, headache, nausea, diarrhea, fatigue, insomnia, dry mouth, tremor, increased sweating and sexual dysfunction. The warnings and precautions associated with Zoloft are also possible with the generic Zoloft. According to the prescribing information for Zoloft, warnings and precautions, possible with treatment, include clinical worsening of depression and suicide risk, serotonin syndrome, activation of mania or hypomania, weight loss, seizures, abnormal bleeding and withdrawal symptoms upon abrupt discontinuation of treatment.

Generic Zoloft should be administered exactly the same as the brand-name medication. Sertraline is indicated to be taken once daily at the same time of day, morning or evening.

Sertraline can be taken without regard to food. Generic Zoloft should be prescribed at the lowest therapeutically effective dose. There is currently a Zoloft sertraline liquid formulation available. The Zoloft liquid formulation is a clear, colorless solution with a menthol scent.

It is available in two ounce bottles with an accompanying dropper to ensure accurate dose measurement. Bottles of Zoloft Oral Concentrate should be stored at controlled room temperature away from moisture and heat. Zoloft liquid must be diluted prior to administration.

Do not mix the Zoloft Oral Concentrate with any other liquids than those recommended. Patients should be instructed to administer the dose immediately after mixing and caution not to mix in advance.

Often times a slight haze appears after mixing and is normal. According to the prescribing information, patients with a latex sensitivity should exercise caution as the dropper dispenser contains dry natural rubber. Zoloft Oral Concentrate is contraindicated with Antabuse disulfiram because of the alcohol content of the concentrate.

Zoloft liquid is an antidepressant belonging to the selective serotonin reuptake inhibitor SSRI class of medications which has been approved, by the U. Similar to Zoloft tablets, Zoloft liquid may take four weeks or longer to achieve full therapeutic activity and before patients begin to feel better.

Patients are advised not to discontinue treatment with Zoloft liquid without first consulting with a physician to avoid unpleasant withdrawal effects including agitation, irritability, dizziness, sensory disturbances, headache, confusion, insomnia, dysphoric mood, lethargy and anxiety. Zoloft sertraline is not considered a monoamine oxidase inhibitor MAOI. Rather, Zoloft is an antidepressant which is classified as a selective serotonin reuptake inhibitor SSRI.

MAOIs are antidepressants indicated for the treatment of depression. MAOIs are generally used in the treatment of patients with atypical depression and in those patients who do not respond to treatment with other antidepressants.

The mechanism of action of the MAO inhibitors involves the inhibition of the enzyme monoamine oxidase and, therefore, prevents the breakdown of neurotransmitters, such as norepinephrine, dopamine, epinephrine and serotonin, causing an increase in their concentration and availability.

As a result of the potentially life-threatening drug and dietary interactions with MAO inhibitors, this class of antidepressants is rarely a first-line treatment for depression and is typically reserved as a last-line of therapy. SSRIs are chemically unrelated to other available antidepressants. SSRIs are approved for a variety of indications. SSRIs are often times used as a first-line treatment for major depressive disorder.

Zoloft, specifically, is approved for the treatment of depression, obsessive-compulsive disorder OCD , panic disorder, post-traumatic stress disorder PTSD , premenstrual dysphoric disorder PMDD and social anxiety disorder.

The mechanism of action of the Zoloft is believed to be linked to the inhibition of central nervous system CNS neuronal uptake of serotonin. Zoloft does not inhibit monoamine oxidase. According to clinical studies of certain SSRIs, such as Zoloft, they may also exhibit weak effects on the reuptake of other neurotransmitters including norepinephrine and dopamine.

MAO inhibitors should not be administered concomitantly with, or within two weeks of, SSRIs, such as Zoloft, because of the potential for serious, life-threatening adverse reactions. What are the common Zoloft side effects? During clinical trials, the most common Zoloft sertraline side effects included nausea, ejaculation failure in men, insomnia, diarrhea, dry mouth, somnolence, dizziness, tremor, fatigue, increased sweating and decreased libido.

Some of the common Zoloft side effects that led to discontinuation of treatment include nausea, diarrhea and insomnia. Zoloft is a selective serotonin reuptake inhibitor type of antidepressant, commonly referred to as an SSRI. Zoloft has been approved, by the U. Zoloft is used for the treatment of certain anxiety disorders, panic disorder, post-traumatic stress disorder PTSD , premenstrual dysphoric disorder PMDD , obsessive-compulsive disorder OCD and major depressive disorder.

Zoloft exerts its antidepressant activity by inhibiting the neuronal uptake of serotonin in the central nervous system. Less common Zoloft side effects are also possible with treatment. If you experience more serious side effects while taking Zoloft, it is important to contact your physician immediately or seek medical attention when necessary.

Symptoms indicating a patient may be experiencing a more serious Zoloft side effect include changes in mood or behavior, suicidal ideation or behavior, anxiety, panic attacks, difficulty sleeping, impulsivity, irritability, agitation, hostility, aggressive behavior, restlessness, physical or mental hyperactivity, worsening depression, stiff muscles, high fever, sweating, rapid heartbeat, loss of appetite, loss of coordination, difficulty concentrating, memory disturbances, weakness, confusion, hallucinations, fainting, seizures or difficulty breathing.

In addition to the side effects possible with treatment, Zoloft also carries several warnings or precautions. Precautions with regard to Zoloft involve suicidality, serotonin syndrome, hypomania or mania, weight loss, seizures, abnormal bleeding, hyponatremia and altered platelet function.

It is important for patients to be counseled regarding these precautions prior to beginning treatment with Zoloft. How should I take Zoloft and Chantix together?

Although no documented drug interaction or contraindication exists between Zoloft sertraline and Chantix varenicline , both medications have similar black box warnings regarding the possible risk for suicidality and serious neuropsychiatric adverse events, respectively.

Therefore, taking Zoloft and Chantix together may increase the risk for worsening depression, suicidal thoughts and behaviors and precipitate a dangerous, life-threatening situation. According to the black box warning, there is a potential risk for serious neuropsychiatric events associated with treatment with Chantix. Possible neuropsychiatric events may include depression, suicidal ideation, suicide attempt and completed suicide have all been reported in patients being treated with Chantix.

While depressed mood may be an indication of a neuropsychiatric event, it may also be a symptom of nicotine withdrawal as patients have experienced depression, rarely associated with suicidal ideation, upon smoking cessation without treatment. Patients with a diagnosis of schizophrenia, bipolar disorder and major depressive disorder did not participate in the premarketing clinical studies of Chantix, therefore, the safety and efficacy in this population has not been established.

Neuropsychiatric events were observed in patients with and without pre-existing psychiatric illness. There were reports of patients experiencing a worsening of psychiatric illness with Chantix. The prescribing information advises that all patients being treated with Chantix be observed for neuropsychiatric symptoms or worsening of pre-existing psychiatric disease.

Neuropsychiatric symptoms include behavioral changes, hostility, agitation, depressed mood, suicidal ideation or behaviors or attempted suicide. During postmarketing studies of Chantix for smoking cessation, neuropsychiatric symptoms, worsening of psychiatric illness and suicide were all been reported.

The black box warning further recommends that the risks of Chantix should be weighed against the benefits. According to the black box warning for Zoloft, treatment with antidepressants may worsen depression and precipitate suicidal ideation and related behavior or unusual behavioral changes during initiation of therapy. Whether or not this risk exists with prolonged treatment is still inclear.

All patients treated with Zoloft should be appropriately monitored and closely observed for clinical worsening of depression, suicidality or unusual changes in behavior. Symptoms may include anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggression, impulsivity, restlessness, hypomania or mania, unusual changes in behavior or suicidal ideation or behaviors.

It is essential to consult with a physician regarding the risk of taking Zoloft and Chantix together, prior to beginning treatment. During controlled clinical trials of Zoloft sertraline , patients experienced a minimal one or two pound weight loss, on average. Patients did not report significant weight gain or difficulty losing weight during clinical studies or postmarketing experience with Zoloft. However, Zoloft has been reported to cause changes in appetite and weight. Zoloft is antidepressant that affects certain neurotransmitters in the brain, specifically serotonin.

Zoloft is a potent and selective inhibitor of neuronal serotonin reuptake in the central nervous system and therefore categorized as a selective serotonin reuptake inhibitor SSRI. Zoloft is used for the treatment of post-traumatic stress disorder PTSD , panic disorder, premenstrual dysphoric disorder PMDD , anxiety disorders, obsessive-compulsive disorder OCD and major depressive disorder.

In general, irrespective of drug therapy, the safest and most effective method for long-term weight loss is proper diet and exercise.

Eating a healthy, well-balanced diet full of fruits, vegetables and whole grains while limiting sugar, processed foods and alcohol typically people lose weight. According to the prescribing information, patients being treated with Zoloft are already cautioned to avoid alcohol. According to the National Heart Lung and Blood Institute NHLBI , a part of the National Institutes of Health NIH , to lose weight it is essential for individuals to make lifestyle changes which focus on reducing calories from food and drink, a healthy eating plan and proper portion control.

Furthermore, the NHLBI outlines a healthy eating plan to control portion sizes and include fruits, vegetables, whole grains and fat-free or low-fat dairy products. A healthy eating plan should also include lean meats, poultry, fish, beans, eggs and nuts and be low in saturated fat, trans fat, cholesterol, sodium and added sugars.

To safely and effectively lose weight, in general and while taking Zoloft, individuals need to expend more calories than they take in. Essentially, reduce the daily caloric intake from food and beverages and increase calories burned through physical exercise.

An appropriate diet and exercise regimen should initially be under the guidance of a physician. During marketing of Zoloft sertraline , withdrawal symptoms were reported upon discontinuation of treatment. These adverse reactions were observed particularly upon abrupt discontinuation.

However, the development of Zoloft withdrawal symptoms is possible even with gradual dose reduction, but this occurs less frequently.

Reported Zoloft withdrawal symptoms included dysphoric mood, irritability, agitation, dizziness, sensory disturbances, anxiety, confusion, headache, lethargy, excessive emotional reactions and frequent changes in mood, insomnia and hypomania.

This occurrence is also referred to as selective serotonin reuptake inhibitor SSRI discontinuation syndrome and according to a review article from the Journal of Psychiatry and Neuroscience written in , may be relatively common. To avoid unpleasant Zoloft withdrawal symptoms, patients are advised against abrupt discontinuation and are encouraged to gradually decrease the dose, under the supervision of a physician, when treatment is no longer required.

It is important to monitor a patient for Zoloft withdrawal symptoms upon discontinuing treatment. If unpleasant Zoloft withdrawal symptoms develop during a reduction in dosage, or upon discontinuation, and cannot be tolerated, it may require the physician to resume the previously prescribed dose and continue with a more conservative reduction in dosage going forward.

However, Zoloft withdrawal symptoms can recur upon later discontinuation. During clinical experience with Zoloft, most cases of adverse events, associated with discontinuation, were self-limiting and didn't require treatment. However, there were some reports of serious discontinuation symptoms.

Although in some cases, patients may experience symptoms for several weeks, most patients experience a resolution of symptoms within approximately a week. According to clinical experience with Zoloft for depression, the relationship between the dose of medication and desired therapeutic effect for depression has not been established.

However, patients were given doses ranging from 50 mg to mg daily during clinical trials. When beginning treatment with Zoloft for depression, it is recommended that treatment be initiated at a dose of 50 mg administered once daily. Patients who appear to be unresponsive to the initial dose may be titrated up to a maximum dose of mg daily.

Increases in dosage of Zoloft for depression should not occur at intervals of less than one week. Typically, patients need to take Zoloft for depression for several months or longer to achieve desired therapeutic outcomes.

It is essential that patients are periodically monitored and reassessed to determine if further treatment is required. When taking Zoloft for depression, each dose should be taken with a full glass of water and can be taken with or without food. Zoloft should be administered once daily, in the morning or evening. It is important to take each dose of Zoloft at the same time each day.

When taking Zoloft for depression, it may take four weeks or longer to begin to feel an improvement in symptoms. Do not stop taking Zoloft without consulting with a physician.

Abruptly discontinuing treatment may result in unpleasant adverse reactions. Patients are advised to avoid drinking alcohol while taking Zoloft for depression. Do not take any over the counter medications without first consulting with a health care provider as some over the counter products contain alcohol or other ingredients that may negatively interact with Zoloft, including many cough, cold and flu products and pain relievers.

Prior to beginning treatment with Zoloft for depression, it is essential to inform your physician of any other medications you are currently taking, including prescription medications, over the counter products and dietary or herbal supplements to avoid potentially dangerous interactions.

How do you treat obsessive-compulsive disorder with Zoloft? Several clinical studies have demonstrated the effectiveness of Zoloft sertraline for the treatment of obsessive-compulsive disorder OCD in both adults and children. To treat obsessive-compulsive disorder with Zoloft, the recommended initial dosage in adults is 50 mg administered once daily.

Maintenance doses for the treatment of obsessive-compulsive disorder with Zoloft range from 50 mg to mg per day. Changes in dosage should not occur at intervals of less than one week because of the long elimination half-life of Zoloft of 24 hours.

To treat obsessive-compulsive disorder with Zoloft, therapy often requires several months or longer. Patients should be re-evaluated, by their physician, periodically to determine if further treatment is required to maintain desired therapeutic outcomes. Treating obsessive-compulsive disorder in the pediatric population requires different dosage recommendations than those used to treat the adult population.

For children ages 6 to 12, the initial dose of Zoloft should be 25 mg administered once daily. For adolescents ages 13 to 17, treatment with Zoloft should be initiated at 50 mg administered once daily. For patients unresponsive to initial doses, Zoloft may be titrated up to a maximum daily dose of mg. As with treatment in adults, changes in dosage should not occur at intervals of less than one week. According to the prescribing information, to treat obsessive-compulsive disorder with Zoloft in children, caution should be exercised when increasing the dosage and their lower body weight should be considered to avoid excessive dosing.

To treat obsessive-compulsive disorder with Zoloft, in both adults and the pediatric population, the daily dose should be administered once daily, either in the morning or evening.

It is important to administered daily doses of Zoloft at the same time each day. Zoloft can be taken without regard to food and should be taken with a full glass of water.

What is the difference between Cymbalta versus Zoloft? The main differences between Cymbalta duloxetine versus Zoloft sertraline are mechanism of action, the way in which the drug works in the body, and indications for use approved by the U.

Cymbalta is a potent inhibitor of both serotonin and norepinephrine reuptake in the central nervous system, while Zoloft is a potent inhibitor of serotonin reuptake with only weak effects on norepinephrine. Cymbalta is classified as a serotonin norepinephrine reuptake inhibitor SNRI which is indicated for the treatment of major depressive disorder, generalized anxiety disorder GAD , diabetic peripheral neuropathic pain, fibromyalgia and chronic musculoskeletal pain.

Zoloft is classified as a selective serotonin reuptake inhibitor SSRI which is indicated for the treatment of major depressive disorder, social anxiety disorder, obsessive-compulsive disorder OCD , post-traumatic stress disorder PTSD , panic disorder and premenstrual dysphoric disorder PMDD. Another difference between Cymbalta versus Zoloft is use in the pediatric population. While Zoloft has been approved by the FDA for the treatment of obsessive-compulsive disorder in the pediatric population, both in children and adolescents, the safety and effectiveness of Cymbalta in the pediatric population have not been established.

Another difference between Cymbalta versus Zoloft is there is currently no generic equivalent available for Cymbalta, while Zoloft is available in a generic form, known as sertraline.

Additionally, Cymbalta is only available in capsule form and should be swallowed whole. Cymbalta should not be chewed or crushed, nor should the capsule be opened and sprinkled on food or mixed with liquids as a result of the enteric coated formulation of the capsule.

However, Zoloft is available in a liquid formulation for patients unable to swallow pills, known as Zoloft Oral Concentrate. Cymbalta and Zoloft have similar adverse reactions and precautions associated with use. Both medications are also indicated for once daily administration and can be taken without regard to meals. Antagonism of muscarinic, histaminergic, and adrenergic receptors has been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular effects of other psychotropic drugs.

Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours. With once daily dosing, steady state plasma concentrations are achieved within approximately one week. At steady state, the extent of accumulation of citalopram in plasma, based on the half-life, is expected to be 2. Following a single oral dose 40 mg tablet of citalopram, peak blood levels occur at about 4 hours. In humans, unchanged citalopram is the predominant compound in plasma.

At steady state, the concentrations of citalopram's metabolites, DCT and DDCT, in plasma are approximately one-half and one-tenth, respectively, that of the parent drug. In vitro studies show that citalopram is at least 8 times more potent than its metabolites in the inhibition of serotonin reuptake, suggesting that the metabolites evaluated do not likely contribute significantly to the antidepressant actions of citalopram.

Age - Citalopram pharmacokinetics in subjects 60 years of age were compared to younger subjects in two normal volunteer studies. No adjustment of dosage on the basis of gender is recommended. No adjustment of dosage for such patients is recommended. Citalopram would be expected to have little inhibitory effect on in vivo metabolism mediated by these enzymes. However, in vivo data to address this question are limited. However, coadministration of citalopram and the potent CYP3A4 inhibitor ketoconazole did not significantly affect the pharmacokinetics of citalopram.

Coadministration of a drug that inhibits CYP2D6 with Celexa is unlikely to have clinically significant effects on citalopram metabolism, based on the study results in CYP2D6 poor metabolizers. Study 1, a 6-week trial in which patients received fixed.

In three additional placebo-controlled depression trials, the difference in response to treatment between patients receiving Celexa and patients receiving placebo was not statistically significant, possibly due to high spontaneous response rate, smaller sample size, or, in the case of one study, too low a dose.

In both studies, patients receiving continued Celexa treatment experienced significantly lower relapse rates over the subsequent 6 months compared to those receiving placebo. Analyses of the relationship between treatment outcome and age, gender, and race did not suggest any differential responsiveness on the basis of these patient characteristics. Highly variable results have been seen in the clinical development of all antidepressant drugs.

Furthermore, in those circumstances when the drugs have not been studied in the same controlled clinical trial s , comparisons among the results of studies evaluating the effectiveness of different antidepressant drug products are inherently unreliable. Because conditions of testing e. 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: The antidepressant action of Celexa in hospitalized depressed patients has not been adequately studied.

Nevertheless, the physician who elects to use Celexa for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient. The use of MAOIs intended to treat psychiatric disorders with Celexa or within 14 days of stopping treatment with Celexa is contraindicated because of an increased risk of serotonin syndrome. Celexa is contraindicated in patients with a hypersensitivity to citalopram or any of the inactive ingredients in Celexa.

Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment.

Pooled analyses of short-term placebo-controlled trials of antidepressant drugs SSRIs and others showed that these drugs increase the risk of suicidal thinking and behavior suicidality in children, adolescents, and young adults ages with major depressive disorder MDD and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older.

The pooled analyses of placebo-controlled trials in children and adolescents with MDD, obsessive compulsive disorder OCD , or other psychiatric disorders included a total of 24 shortterm trials of 9 antidepressant drugs in over patients.

The pooled analyses of placebocontrolled trials in adults with MDD or other psychiatric disorders included a total of shortterm trials median duration of 2 months of 11 antidepressant drugs in over 77, patients. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied.

There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences drug vs.

These risk differences drug-placebo difference in the number of cases of suicidality per patients treated are provided in Table 1.

No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide. It is unknown whether the suicidality risk extends to longer-term use, i. However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants can delay the recurrence of depression.

All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness , hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric.

Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms.

Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers.

Prescriptions for Celexa should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose. Citalopram causes dose-dependent QTc prolongation, an ECG abnormality that has been associated with Torsade de Pointes TdP , ventricular tachycardia, and sudden death, all of which have been observed in postmarketing reports for citalopram.

Individually corrected QTc QTcNi interval was evaluated in a randomized, placebo and active moxifloxacin mg controlled cross-over, escalating multiple-dose study in healthy subjects. It is recommended that citalopram should not be used in patients with congenital long QT syndrome, bradycardia, hypokalemia or hypomagnesemia, recent acute myocardial infarction, or uncompensated heart failure.

Citalopram should also not be used in patients who are taking other drugs that prolong the QTc interval. Such drugs include Class 1A e. The citalopram dose should be limited in certain populations. Patients being considered for citalopram treatment who are at risk for significant electrolyte disturbances should have baseline serum potassium and magnesium measurements with periodic monitoring. ECG monitoring is recommended in patients for whom citalopram use is not recommended see above , but, nevertheless, considered essential.

These include those patients with the cardiac conditions noted above, and those taking other drugs that may prolong the QTc interval. If patients taking citalopram experience symptoms that could indicate the occurrence of cardiac arrhythmias, e.

Screening Patients for Bipolar Disorder: A major depressive episode may be the initial presentation of bipolar disorder. Whether any of the symptoms described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.

It should be noted that Celexa is not approved for use in treating bipolar depression. The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including Celexa, alone but particularly with concomitant use of other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, trytophan, buspirone, amphetamines, and St.

Serotonin syndrome symptoms may include mental status changes e. Patients should be monitored for the emergence of serotonin syndrome. Celexa should also not be started in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue. No reports involved the administration of methylene blue by other routes such as oral tablets or local tissue injection or at lower doses.

There may be circumstances when it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking Celexa. If concomitant use of Celexa with other serotonergic drugs including, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, amphetamines, trytophan and St.

Treatment with Celexa and any concomitant serotonergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated. The pupillary dilation that occurs following use of many antidepressant drugs including Celexa may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. During marketing of Celexa and other SSRIs and SNRIs serotonin and norepinephrine reuptake inhibitors , there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Celexa. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered.

Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anticoagulants may add to the risk. Case reports and epidemiological studies case-control and cohort design have demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding.

Patients should be cautioned about the risk of bleeding associated with the concomitant use of Celexa and NSAIDs, aspirin, or other drugs that affect coagulation. In many cases, this hyponatremia appears to be the result of the syndrome of inappropriate antidiuretic hormone secretion SIADH , and was reversible when Celexa was discontinued.

Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk see Geriatric Use. Discontinuation of Celexa should be considered in patients with symptomatic hyponatremia and appropriate medical intervention should be instituted.

Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. As with all antidepressants, Celexa should be used cautiously in patients with a history of mania. Although anticonvulsant effects of citalopram have been observed in animal studies, Celexa has not been systematically evaluated in patients with a seizure disorder. These patients were excluded from clinical studies during the product's premarketing testing.

In clinical trials of Celexa, seizures occurred in 0. Like other antidepressants, Celexa should be introduced with care in patients with a history of seizure disorder. Because any psychoactive drug may impair judgment, thinking, or motor skills, however, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities.

Clinical experience with Celexa in patients with certain concomitant systemic illnesses is limited. Due to the risk of QT prolongation, citalopram use should be avoided in patients with certain cardiac conditions, and ECG monitoring is advised if Celexa must be used in such patients. Electrolytes should be monitored in treating patients with diseases or conditions that cause hypokalemia or hypomagnesemia. In subjects with hepatic impairment, citalopram clearance was decreased and plasma concentrations were increased.

Because citalopram is extensively metabolized, excretion of unchanged drug in urine is a minor route of elimination. Physicians are advised to discuss the following issues with patients for whom they prescribe Celexa. Patients should be cautioned about the risk of serotonin syndrome with the concomitant use of Celexa and triptans, tramadol or other serotonergic agents.

Patients should be advised that taking Celexa can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle closure glaucoma. Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure e.

Although in controlled studies Celexa has not been shown to impair psychomotor performance, any psychoactive drug may impair judgment, thinking, or motor skills, so patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities.

Patients should be told that, although Celexa has not been shown in experiments with normal subjects to increase the mental and motor skill impairments caused by alcohol, the concomitant use of Celexa and alcohol in depressed patients is not advised.

Patients should be advised to inform their physician if they are taking, or plan to take, any prescription or over-the-counter drugs, as there is a potential for interactions. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. While patients may notice improvement with Celexa therapy in 1 to 4 weeks, they should be advised to continue therapy as directed. Prescribers or other health professionals should inform patients, their families, and their caregivers about the benefits and risks associated with treatment with Celexa and should counsel them in its appropriate use.

The prescriber or health professional should instruct patients, their families, and their caregivers to read the Medication Guide and should assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have. The complete text of the Medication Guide is reprinted at the end of this document. Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking Celexa.

Clinical Worsening and Suicide Risk: Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness , hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.

Families and caregivers of patients should be advised to look for the emergence of such symptoms on a dayto-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms.

Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication. There have been rare postmarketing reports of serotonin syndrome with use of an SSRI and a triptan. CNS Drugs - Given the primary CNS effects of citalopram, caution should be used when it is taken in combination with other centrally acting drugs. Alcohol - Although citalopram did not potentiate the cognitive and motor effects of alcohol in a clinical trial, as with other psychotropic medications, the use of alcohol by depressed patients taking Celexa is not recommended.

Epidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin may potentiate the risk of bleeding. Patients receiving warfarin therapy should be carefully monitored when Celexa is initiated or discontinued. Nevertheless, plasma lithium levels should be monitored with appropriate adjustment to the lithium dose in accordance with standard clinical practice.

Because lithium may enhance the serotonergic effects of citalopram, caution should be exercised when Celexa and lithium are coadministered. Pimozide - In a controlled study, a single dose of pimozide 2 mg co-administered with citalopram 40 mg given once daily for 11 days was associated with a mean increase in QTc values of approximately 10 msec compared to pimozide given alone. Citalopram did not alter the mean AUC or C max of pimozide.

The mechanism of this pharmacodynamic interaction is not known. The effect of theophylline on the pharmacokinetics of citalopram was not evaluated. Sumatriptan - There have been rare postmarketing reports describing patients with weakness, hyperreflexia, and incoordination following the use of a SSRI and sumatriptan. If concomitant treatment with sumatriptan and an SSRI e. Although trough citalopram plasma levels were unaffected, given the enzyme-inducing properties of carbamazepine, the possibility that carbamazepine might increase the clearance of citalopram should be considered if the two drugs are coadministered.

Increased metoprolol plasma levels have been associated with decreased cardioselectivity. Coadministration of Celexa and metoprolol had no clinically significant effects on blood pressure or heart rate. The clinical significance of the desipramine change is unknown. Nevertheless, caution is indicated in the coadministration of TCAs with Celexa. A no-effect dose for this finding was not established. The relevance of these findings to humans is unknown.

Citalopram was mutagenic in the in vitro bacterial reverse mutation assay Ames test in 2 of 5 bacterial strains Salmonella TA98 and TA in the absence of metabolic activation.

It was clastogenic in the in vitro Chinese hamster lung cell assay for chromosomal aberrations in the presence and absence of metabolic activation. It was not clastogenic in the in vitro chromosomal aberration assay in human lymphocytes or in two in vivo mouse micronucleus assays. This dose was also associated with maternal toxicity clinical signs, decreased body weight gain.

Thus, teratogenic effects were observed at a maternally toxic dose in the rat and were not observed in the rabbit. When female rats were treated with citalopram 4. The no-effect dose of A no-effect dose was not determined in that study. There are no adequate and well-controlled studies in pregnant women; therefore, citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

SNRIs , late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying.

PPHN occurs in 1- 2 per 1, live births in the general population and is associated with substantial neonatal morbidity and mortality. Other studies do not show a significant statistical association. Physicians should also note the results of a prospective longitudinal study of pregnant women with a history of major depression, who were either on antidepressants or had received antidepressants less than 12 weeks prior to their last menstrual period, and were in remission. Women who discontinued antidepressant medication during pregnancy showed a significant increase in relapse of their major depression compared to those women who remained on antidepressant medication throughout pregnancy.

When treating a pregnant woman with Celexa, the physician should carefully consider both the potential risks of taking an SSRI, along with the established benefits of treating depression with an antidepressant. As has been found to occur with many other drugs, citalopram is excreted in human breast milk. There have been two reports of infants experiencing excessive somnolence, decreased feeding, and weight loss in association with breastfeeding from a citalopram-treated mother; in one case, the infant was reported to recover completely upon discontinuation of citalopram by its mother and in the second case, no follow-up information was available.

The decision whether to continue or discontinue either nursing or Celexa therapy should take into account the risks of citalopram exposure for the infant and the benefits of Celexa treatment for the mother.

Anyone considering the use of Celexa in a child or adolescent must balance the potential risks with the clinical need. Decreased appetite and weight loss have been observed in association with the use of SSRIs. Consequently, regular monitoring of weight and growth should be performed in children and adolescents treated with Celexa.

For more information on Zoloft, click on this link: A taper down is recommended after being on an antidepressant for a month. And is it safe to take diet pills with Zoloft? Celexa equivalent to zoloft
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