Talk:Citalopram/Archive 2

citalopram

Off-topic discussion

how long does it take to star working? — Preceding unsigned comment added by 69.143.102.51 (talk) 14:22, 17 June 2012 (UTC) Took a few days for me, once I got the correct dose. I don't know of any official data. Hope it helpsBevo74 (talk) 18:49, 17 June 2012 (UTC) Both my DR. and my Pharmacist told me it can take up to 3 weeks. I've been taking it for about a week now and it seems to be helping me. I can't seem to sleep for more than a few hours at a time though, i'm hoping that i will be able to overcome that. (i take citalopram in the morning.) — Preceding unsigned comment added by 72.226.120.167 (talk) 11:50, 26 August 2012 (UTC) Please remember: Wikipedia does not provide medical advice. We are not a substitute for your doctor! —me_and 21:54, 27 February 2013 (UTC)

Intro: Placebo Effect

It's time to let readers know that the efficacy of all SSRI's, including citalopram, is in question. "60 minutes" did an entire segment on the possibility that SSRI's are no more effective than placeboes. "Newsweek" ran an article. If someone is seeking information on this drug, the least wikipedia can do is mention these allegations. Making no mention of the subject would be a disservice. Any suggestions for improving/expanding the presentation of these matters? AmiLynch (talk) 05:16, 20 October 2012 (UTC)

I don't mind if this single study is mentioned in the article, but putting this in the lead in this fashion is not appropriate. The JAMA article cited does not even mention citalopram (at least that I can see) and in "Conclusions" it says "For patients with very severe depression, the benefit of medications over placebo is substantial." The way this is written now substantially misleads the reader. As written, someone looking at this article would believe citalopram is a fraud; this is not what the medical community believes as a whole, and it's not what the FDA has said publicly. Simishag (talk) 09:19, 20 October 2012 (UTC)

I agree with Simishag. As already pointed out above, the study published in JAMA does not specifically mention citalopram:

• Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J (2010). "Antidepressant drug effects and depression severity: a patient-level meta-analysis". JAMA. 303 (1): 47–53. doi:10.1001/jama.2009.1943. PMID 20051569. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Kirsch I (2010). "Review: benefits of antidepressants over placebo limited except in very severe depression". Evid Based Ment Health. 13 (2): 49. doi:10.1136/ebmh.13.2.49. PMID 21856612. {{cite journal}}: Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help); Unknown parameter |month= ignored (help)

Hence this citation would be more appropriate for the SSRI#Criticism section of the SSRI article. Furthermore for balance, it should be mentioned that SSRI treatment is effective for severe depression. Boghog (talk) 10:49, 20 October 2012 (UTC)

Hello, just want to mention that the article linked to as a reference for "critics" of anti-depressants is of very low journalistic quality, and is actually an ad for hypnosis therapy, so I'm not sure that's at all appropriate. — Preceding unsigned comment added by 2604:180:0:0:0:0:BFA6:4380 (talk) 14:31, 22 November 2012 (UTC)

Side Effects

Hi, the "adverse effects" section is a little difficult to read, but I'm going to list below the various side effects according to a leaflet that came with it. I'm not sure if this should be included on the main page instead of the essay-like layout, so I'm just putting it here. If anyone thinks this would be better, you should be able to just copy paste, right? (I'm still learning how to edit wiki pages lol) I could also copy the entire leaflet, as it has some pretty useful information which doesn't seem to be covered here

Collapsed to stop it making the discussion page too long :)

SERIOUS (Stop taking immediately and seek medical advice) - Difficulty breathing - Swelling of face, lips, tongue or throat that causes difficulty in swallowing or breathing - Severe itching of the skin (with raised lumps) - If you start having fits for the first time, or fits that you have suffered from in the past become more frequent - Behaviour changes because you feel elated or over excited - High fever, agitation, confusion, trembling or abrupt contractions of muscles - these may be signs of Serotonin Syndrome - Tiredness, confusion and twitching of muscles - may be signs of low blood level of sodium - Fast, irregular heart beat, fainting which could be symptoms of a life-threatening condition known as Torsades de Pointes MILD (The following side effects are often mild and usually diappear after a few days treatment) VERY COMMON (likely to affect more than 1 in 10 people) - Nausea - Dry mouth - Sweating - Sleepiness - Difficulty sleeping COMMON (likely to affect up to 1 in 10 people) - Lack of appetite - Agitation - Decreased sex drive - Anxiety - Nervousness - Confusion - Abnormal dreams - Tremor - Tingling or numbness in hands or feet - Ringing in the ears (tinnitus) - Yawning - Diarrhoea - Vomiting - Constipation - Itching - Pain in muscles and joints - For males, problems with ejaculation and erection - For females, failure to reach orgasm - Tiredness - Prickling of the skin - Weight loss UNCOMMON (likely to affect up to 1 in 100 people) - Bruising easily - Increased appetite - Aggression - Reduced emotions, indifference - Hallucinations - Mania - Fainting - Large pupils - Fast heart beat - Slow heart beat - Nettle rash - Loss of hair - Rash - Sensitivity to sunlight - Difficulties urinating - Vaginal bleeding - Swelling of the arms or legs - Increased weight RARE (likely to affect up to 1 in 1000 people) - Convulsions - Involuntary movements - Taste disturbances - Bleeding - Hepatitis UNKNOWN (some patients have reported the following, but frequency not known) - Thoughts of harming or killing themselves - Increase in bleeding or bruising caused by decrease in blood platelets - Rash (hypersensitivity) - Low potassium levels in blood (hypokalaemia) which can cause muscle weakness, twitching, or abnormal heart rhythms - Panic attack - Grinding teeth - Restlessness - Unusual muscle movements or stiffness - Involuntary movements of the muscles (akathisia) - Low blood pressure - Nose bleed - Bleeding disorders including skin and muscosal bleeding (ecchymosis) - In males, painful erections - Flow of breast milk in men, or in women who are not breast-feeding (galactorrhoea) - An increased risk of bone fractures SSRIs can, very rarely, increase the risk of bleeding, including stomach or intestinal bleeding. Let your doctor know if you vomit blood or develop black or blood stained stools. Also let your doctor know if you continue to have other symptoms associated with your depression. This might include hallucinations, anxiety, mania or confusion. Very rarely, some patients may find that they have an increased tendency to develop rashes when exposed to the sun. If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

Hope that helps :)
Nexomify (talk) 19:19, 14 May 2014 (UTC)

Support with a number of changes. "Patients" is prohibited terminology (we prefer "people", "person" or "individual") as per WP:MEDMOS. Plus, WP:MEDMOS tends to hate people using big lists. I do it personally and no one seems to be too pissed about me doing it, but you should columnise your lists if you do. You don't want to take up all the page. Plus we write in the third person and personal medical advise (like "let your doctor know") is also prohibited as per WP:MEDMOS. Plus Wikipedia is not a leaflet which sounds like what you're writing. Plus I think you're copying this from a consumer medicine information (CMI) leaflet, if so no dumping of big, low-quality lists or copied material from other sources, we respect copyright, here. Fuse809 (talk) 15:17, 15 May 2014 (UTC)

Citations needed

The section on Interactions needs some citations added for at least the critical part on weaning from the medication. (A few other parts in that section could use sources, too.) Author(s), please provide your sources. Thank you, Wordreader (talk) 14:32, 8 September 2014 (UTC)

brand names?

The treatment of brand names for drugs seems to be erratic. Is there any standardisation attempt? I just ordered them alphabetically, to ease editing/adding. I also referenced the Australian drugs to the central database (PBS), do others know of similar databases for other countries? ˥ Ǝ Ʉ H Ɔ I Ɯ (talk) 05:45, 10 September 2014 (UTC)

Badly sourced

Moving this here - this content argues with more strongly sourced content, using weaker sources. Per WP:MEDRS we don't do this. This kind of stuff needs to be sourced strongly.

Another large study found no elevated risks of ventricular arrhythmia or all-cause, cardiac, or noncardiac mortality associated with citalopram dosages >40 mg/day. Higher dosages were associated with fewer adverse outcomes, and similar findings were observed for a comparison medication, sertraline, not subject to the FDA warning. Based on these results, the authors suggest that continued merit of the FDA warning should be considered.

In response to that large study, the FDA admitted that even in drugs that unequivocally cause torsade de pointes, the incident rate is estimated to be in the range of 1 per 12,000 to 120,000 patients, too small to be detected even in large studies. They concede that no data exists to support drug-induced torsade de pointes.

References

- 19:24, 30 April 2016 (UTC)

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