Some factors that affect citalopram dosage are the condition being treated, the patient's age, the patient's response, and other medical conditions or medications. Citalopram, an antidepressant, has a relatively narrow dose range. People receiving the drug generally begin with a lower dose and increase the medication if necessary. Since higher doses can correspond to higher side effects, the lowest effective dose is preferred.
Presently, citalopram is only indicated for the treatment of depression. Nevertheless, it may also be prescribed for other related conditions, like obsessive-compulsive disorder (OCD). In most cases, the dose for OCD is lower than the dose for depression.
One of the principal factors that determines citalopram dosage is age. The pediatric dose for depression tends to begin at 10 milligrams (mg), and it may rise to 20 mg. In contrast, adults usually begin the medication at a 20 mg dose, which may be increased to 40 mg or 60 mg, depending on how the patient responds to the drug. It is not necessary to increase the drug dosage when individuals have full benefit from lower doses.
Once a person has stabilized on the medication, and after some time has passed, physicians may also recommend lowering the dose to maintain freedom from depression. This, again, is highly individualized to the patient, but it is not clear that the highest doses are necessary for depression maintenance. A good argument for a slight decrease in citalopram dosage is that it may reduce the incidence of negative side effects.
Some medical conditions may affect citalopram dosage. Kidney or liver impairment might call for lower introductory amounts and lower maintenance amounts. Certain conditions may completely contraindicate the use of this medication. For example, citalopram has been shown to cause birth defects and it may affect nursing newborns. In these cases, physicians would search for more appropriate medications to control depression.
This antidepressant can interact with a variety of other drugs. In particular, using the medication with other drugs that potentiate serotonin, such as most selective serotonin reuptake inhibitors (SSRIs) or medications like lithium, could cause dangerously elevated levels of serotonin. Alternately, any type of medication that prolongs QT intervals, an electrical signal in the heart, may also be unsafe when taken with citalopram because the antidepressant and other drugs affecting these intervals may result in profound rhythm changes. To avoid these and other concerning interactions, patients should bring a list of all medications they presently take, including any over-the-counter drugs or herbal or naturopathic remedies.
