Citalopram is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Citalopram is a selective serotonin reuptake inhibitor (SSRI). It helps to restore the brain's chemical balance by increasing the supply of serotonin, which helps improve mood.

Do NOT use Citalopram if:

• you are allergic to any ingredient in Citalopram
• you are taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) or St. John's wort within the last 14 days
• you are taking astemizole, pimozide, dexfenfluramine, fenfluramine, phenothiazines (eg, thioridazine), sibutramine, or terfenadine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Citalopram :

Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have suicidal tendencies or have attempted suicide, liver or kidney disease, stomach bleeding, seizures, or mania

Some MEDICINES MAY INTERACT with Citalopram. Tell your health care provider if you are taking any other medicines (especially any of the following):

• Cyproheptadine or risperidone because the effectiveness of Citalopram may be decreased
• Anorexiants (eg, phentermine), linezolid, lithium, or sumatriptan because side effects such as irritability or altered consciousness may occur
• Clozapine, H₁ antagonists (eg, diphenhydramine), metoclopramide, phenothiazines (eg, thioridazine), risperidone, or trazodone because the actions and side effects of these medicines may be increased
• Sumatriptan because the effectiveness of Citalopram may be decreased
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because of increased risk of bleeding of the stomach and bowels
• Fenfluramine and derivatives, MAO inhibitors (eg, phenelzine), selegiline, sibutramine, St. John's wort, and tramadol because the actions and side effects, such as irritability or altered consciousness, of these medicines may be increased
• Pimozide because the risk of a change in heart rhythm may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Citalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Citalopram :

Use Citalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Citalopram comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Citalopram refilled.
• Citalopram may be taken with or without food.
• You may notice improvement in your depression in 1 to 4 weeks. Continue to take your medicine as directed even when depression improves.
• If it is necessary to stop Citalopram , your doctor will need to reduce the dosage over a few days to a week.
• Do not miss any doses. If you miss a dose of Citalopram , skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Citalopram.

Important safety information:

• Citalopram may cause dizziness or drowsiness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Citalopram. Using Citalopram alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• If you experience a worsening of your symptoms (anxiety, agitation, insomnia, irritability, restlessness, or suicidal thinking) contact your doctor immediately.
• Citalopram will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Additional monitoring of your condition is recommended at the start of treatment with Citalopram and whenever a change in your dose is made.
• LAB TESTS may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.
• Citalopram is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Citalopram has been shown to cause harm to the human fetus. If you become pregnant, discuss with your doctor the benefits and risks of using Citalopram during pregnancy. If you are pregnant, talk with your doctor about gradually decreasing your dose during the last trimester of pregnancy. Citalopram is excreted in breast milk. Do not breast-feed while taking Citalopram.

Possible side effects of Citalopram :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Change in taste; decreased menstrual flow or painful periods; diarrhea; dry mouth; ejaculation disorder; impotence; increased sweating; loss of appetite; nausea; runny nose; sinus inflammation; tiredness; tremor; upset stomach; weight loss or gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); anxiety; cold sweat; confusion; dizziness; fatigue; hostility; impulsiveness; irritability; lack of concern; mania; mental/mood changes; panic attacks; restlessness; seizures; shakiness; sleeplessness; sore throat or fever; suicidal thoughts or behaviors; vision changes; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease.

Replantation: 1. Literally, the act of planting again. 2. In surgery, the restoration of any part of the body to its original site. Also known as reimplantation.

The Chinese surgeon Zhong Wei Chen (1929-2004) was the "father of replantation." Dr. Chen was the first to reattach a severed hand with success which he did in 1963. Dr. Chen also developed many microsurgical procedures including techniques for preserving severed extremities, reattaching amputated fingers and thumbs, reconstructing muscles and repairing nerves and blood vessels.

Rheumatism: Rheumatism is an older term, used to describe any of a number of painful conditions of muscles, tendons, joints, and bones.

Rheumatism conditions have been classified as either localized, regional, or generalized. Localized rheumatism conditions include bursitis and tendinitis. Regional rheumatism conditions include chest wall pain, temporomandibular joint pain, and myofascial pain syndromes. Generalized rheumatism conditions include fibromyalgia.

Another category of rheumatism is psychogenic rheumatism. With this term it is understood that the patient is reporting inconsistent pains of muscles and joints that do not correspond to true anatomy and physiology. The patient is felt to have underlying psychological causes for the symptoms.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

T cell: A type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders.

Immature T cells (termed T-stem cells) migrate to the thymus gland in the neck, where they mature and differentiate into various types of mature T cells and become active in the immune system in response to a hormone called thymosin and other factors. T-cells that are potentially activated against the body's own tissues are normally killed or changed ("down-regulated") during this maturational process.

There are several different types of mature T cells. Not all of their functions are known. T cells can produce substances called cytokines such as the interleukins which further stimulate the immune response. T-cell activation is measured as a way to assess the health of patients with HIV/AIDS and less frequently in other disorders.

T cell are also known as T lymphocytes. The "T" stands for "thymus" -- the organ in which these cells mature. As opposed to B cells which mature in the bone marrow.

Teleology: The study of the ultimate purpose of the design of something in nature.

For example, "what is the true purpose of the nose?" is a teleological question and, to say that all evolutionary changes occur for a definite purpose is a teleological explanation of evolution.

"Teleology" comes from ancient Greek roots but it (and teleological) did not enter English until the 18th century. It is a compound of the Greek "tele-, telos," meaning "end or purpose" + the ending "logos" meaning "the science or study of" = the study of the ends or purposes.

Testosterone: A "male hormone" -- a sex hormone produced by the testes that encourages the development of male sexual characteristics, stimulates the activity of the male secondary sex characteristics, and prevents changes in them following castration. Chemically, testosterone is 17-beta-hydroxy-4-androstene-3-one.

Testosterone is the most potent of the naturally occurring androgens. The androgens cause the development of male sex characteristics, such as a deep voice and a beard; they also strengthen muscle tone and bone mass.

High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits.

Testosterone may be given to treat medical conditions, including female (but not male) breast cancer, hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).