The lost happiness of depression patients is restored by Citalopram. What should be paid attention to when taking it?

Recently, several friends who are suffering from depression asked Huazi if he could talk about Citalopram and why it can help patients with depression regain their lost happiness. There is also a drug called escitalopram. What is the difference between it and Citalopram? Is there anything to pay attention to when taking it?

Huazi said that Citalopram is a selective 5-HT (5-hydroxytryptamine) reuptake inhibitor that can increase the level of 5-HT in the synaptic clefts of the brain, thereby invigorating people's spirits and producing an anti-depressant effect.

1. Depression is a decrease in neurotransmitter levels. In many people’s minds, depression is a mental state, a “mental illness”. And “mental illness should be treated with heart medicine”, if the patient “let it go” and adjusts his mentality, depression will be cured. As a result, they do not trust drug treatment. Many patients also think that if they accept drug treatment, they will be “mentally ill”, and thus resist drug treatment.

But in fact, depression is usually a state of abnormal neurophysiological function caused by great mental trauma. Human emotions are generated by the connection between nerves, and the connection between nerves requires the previous nerve to release chemical transmitters and be received by the next nerve to form a normal conduction pathway.

When the human body falls into a state of depression, the release of emotion-related neurotransmitters, such as serotonin (5-HT) and norepinephrine (NA), decreases, causing people to experience depressive symptoms such as insomnia, fatigue, low mood, avoidance of social interactions, slow reaction, and memory loss. In severe cases, hallucinations may occur and even suicidal tendencies may occur.

When experiencing mental traumas such as the death of a loved one, a broken heart, a job failure, or a failed exam, everyone will fall into negative emotions. Although "time will destroy everything", most people will accept reality and return to normal as time goes by, but 10% of people will continue to amplify negative emotions, sink into them, and find it difficult to get out of it by their own strength, so they need the help of drugs.

2. Citalopram can increase the level of neurotransmitters. After 5-HT is released into the synaptic cleft, there are two ways to eliminate it. One is that it is reabsorbed back into the cell by nerve cells, and the other is that it is metabolized by monoamine oxidase. Citalopram is a selective 5-HT reuptake inhibitor that can prevent nerve cells from reabsorbing 5-HT, thereby increasing the level of 5-HT in the synaptic cleft, which can improve the depressed mood of depressed patients.

Huazi talked with a patient with depression about her experience taking the medicine, and the feedback she got was that before taking the medicine, she had been in self-doubt and self-denial, had no motivation to work, was not interested in anything, had a very low appetite, felt weak all over, cried all day long, had poor sleep, and even engaged in self-harm.

After taking the medicine, her mental state began to improve. She said that it felt like a person who had been unable to rest for a long time and was exhausted, finally found a warm and safe place to sleep peacefully. Then she opened her eyes and felt that the whole world had become happy. She thought she was cured at the time, and stopped taking the medicine after finishing a box of medicine, but then she fell into depression again.

When she went to see a psychiatrist again, the doctor told her to take medication regularly. Antidepressant treatment is a long-term process. Most patients need to adhere to treatment for at least 2 years. Stopping medication without authorization will cause the disease to recur or even worsen. She listened to the doctor's advice and insisted on taking medication for a long time, and then slowly reduced the dosage after the symptoms disappeared, and finally stopped taking the medication.

3. The difference between Citalopram and Escitalopram The ultimate recovery of depression patients is to get out of negative emotions by themselves, but in the treatment process, the help of drugs is also very important. Drugs can alleviate depression-related symptoms and help patients build confidence in overcoming the disease. In the process of using drugs, someone asked Huazi, there is another drug called escitalopram, which is very similar to Citalopram. What is the difference between them?

Escitalopram can actually be written as S-Citalopram, which means "half of Citalopram". Citalopram has two isomers, one is S-type and the other is R-type, each accounting for 50%. The R-type has no effect, and only the S-type can work. Therefore, escitalopram is the S-type of Citalopram that has been separated and purified. Compared with Citalopram, escitalopram uses a smaller dose, produces a faster and stronger effect, and has fewer side effects.

4. What should I pay attention to when using Citalopram? Compared with other selective 5-HT inhibitors, Citalopram is safer and can be used as long as you are not allergic to it. Common adverse reactions are mainly gastrointestinal symptoms, such as loss of appetite, nausea, dry mouth, diarrhea, constipation, etc. Some people also experience dizziness, headache, fatigue, insomnia or drowsiness and other neurological symptoms.

Adverse reactions usually occur 1 to 2 weeks after taking the drug. Most people experience mild symptoms. After continued treatment, adverse reactions will gradually decrease or disappear. However, after long-term use of the drug, it cannot be stopped suddenly. It takes at least 2 weeks to gradually reduce the dosage and stop the drug.

When using Citalopram, it is important to pay attention to interactions with other drugs.

1. It cannot be used in combination with monoamine oxidase inhibitors, otherwise 5-HT accumulation and poisoning will occur, causing 5-HT syndrome, which may lead to death. If monoamine oxidase inhibitors are needed after stopping the drug, it should be taken at least 14 days later.

2. When used in combination with hepatic enzyme inhibitors such as cimetidine, alprazolam, and imipramine, the blood concentration of citalopram may increase.

3. When used in combination with hepatic enzyme inducers such as carbamazepine and barbiturates, the metabolism of citalopram may be accelerated and the efficacy may be reduced.

4. When used with anticoagulants, the risk of bleeding may increase.

5. When used together with hypoglycemic drugs, it may affect the effect of the hypoglycemic drugs. Blood sugar needs to be monitored and the dosage of the hypoglycemic drugs needs to be adjusted according to changes in blood sugar.

In summary, Citalopram can improve the state of depression by selectively inhibiting the reuptake of 5-HT and increasing the level of 5-HT in the synaptic cleft of the brain. However, drugs are only a means of auxiliary rehabilitation. To cure depression, you need the help of professional psychiatrists to release the negative emotions in your heart. Drugs can also be taken safely under the guidance of a doctor. I am pharmacist Huazi, welcome to follow me and share more health knowledge.