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- Pathways
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- Related Diseases
- Datasets
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Overview
| Generic Names: | Citalopram Hydrobromide; Citalopramum [INN-Latin] |
|---|---|
| Trade Names: | Celexa; Cipram; Nitalapram |
| PharmGKB Accession Id: | PA449015 |
Description
A furancarbonitrile that is one of the serotonin uptake inhibitors used as an antidepressant. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia in preference to tricyclic antidepressants, which aggravate this condition. PubChem (source: Drug Bank)
Indication
For the treatment of depression. (source: Drug Bank)
ATC Therapeutic Category
- N06AB:Selective serotonin reuptake inhibitors
Pharmacology, Interactions, and Contraindications
Mechanism Of Action
The antidepressant, antiobsessive-compulsive, and antibulimic actions of Citalopram are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. Citalopram blocks the reuptake of serotonin at the serotonin reuptake pump of the neuronal membrane, enhancing the actions of serotonin on 5HT<sub>1A</sub> autoreceptors. SSRIs bind with significantly less affinity to histamine, acetylcholine, and norepinephrine receptors than tricyclic antidepressant drugs. (source: Drug Bank)
Pharmacology
Citalopram is one of a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It is used to treat the depression associated with mood disorders. It is also used on occassion in the treatment of body dysmorphic disorder and anxiety. The antidepressant, antiobsessive-compulsive, and antibulimic actions of Citalopram are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. <i>In vitro</i> studies show that Citalopram is a potent and selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. Citalopram has no significant affinity for adrenergic (alpha1, alpha2, beta), cholinergic, GABA, dopaminergic, histaminergic, serotonergic (5HT<sub>1A</sub>, 5HT<sub>1B</sub>, 5HT<sub>2</sub>), or benzodiazepine receptors; antagonism of such receptors has been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular effects for other psychotropic drugs. The chronic administration of Citalopram was found to downregulate brain norepinephrine receptors, as has been observed with other drugs effective in the treatment of major depressive disorder. Citalopram does not inhibit monoamine oxidase. (source: Drug Bank)
Food Interactions
Avoid St.John's Wort.
Avoid alcohol.
Take without regard to meals.
(source:
Drug Bank)
Absorption, Distribution, Metabolism, Elimination & Toxicity
Biotransformation
Hepatic. (source: Drug Bank)
Protein Binding
50% (source: Drug Bank)
Absorption
Bioavailability is 80% following oral administration. (source: Drug Bank)
Toxicity
Symptoms most often accompanying citalopram overdose, alone or in combination with other drugs and/or alcohol, included dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In more rare cases, observed symptoms included amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, and ECG changes (including QTc prolongation, nodal rhythm, ventricular arrhythmia, and very rare cases of torsade de pointes). Acute renal failure has been very rarely reported accompanying overdose. (source: Drug Bank)
Isomeric SMILES Code:
CN(C)CCCC1(c2ccc(cc2CO1)C#N)c3ccc(cc3)F (source: Drug Bank)
In-Depth Annotations (
)
-
rs59421388
at chr22:40853554
in
CYP2D6
This variant is part of the reduced functioning haplotype CYP2D6*29, which is found at an estimated allele frequency of 20% in African Tanzanians.- Variant Name:
- CYP2D6: 3183G>A; 3271G>A
- Related Drugs:
- citalopram, codeine, desipramine, fluoxetine, fluvoxamine, gefitinib, haloperidol, imipramine, morphine, tramadol
- Related Diseases:
- Cystic Fibrosis, Depression, Hypertension, Neoplasms, Pain, Parkinson Disease, Schizophrenia
- Evidence:
-
http://www.pharmgkb.org/.../variant.jsp
-
rs61736512
at chr22:40855078
in
CYP2D6
This variant is part of the reduced functioning haplotype CYP2D6*29, which is found at an estimated allele frequency of 20% in African Tanzanians.- Variant Name:
- CYP2D6: 1659G>A; 1747G>A
- Related Drugs:
- citalopram, codeine, desipramine, fluoxetine, fluvoxamine, gefitinib, haloperidol, imipramine, morphine, tramadol
- Related Diseases:
- Cystic Fibrosis, Depression, Hypertension, Neoplasms, Pain, Parkinson Disease, Schizophrenia
- Evidence:
-
http://www.pharmgkb.org/.../variant.jsp
Curated Annotations (
)
-
rs7569963
at chr2:208181429
In a nested case-control study derived from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study this SNP in the CREB1 gene was associated with treatment-emergent suicidality among men with depression.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:17548750
-
rs4675690
at chr2:208216052
In a nested case-control study derived from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study this SNP in the CREB1 gene was associated with treatment-emergent suicidality among men with depression.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:17548750
-
rs6808874
at chr3:121040541
in
GSK3B
This variant is associated with antidepressant treatment response in Chinese major depressive disorder. In a four-locus haplotype analysis (rs334558; rs13321783; rs2319398; rs6808874), the GSK3B TAGT carriers showed a poorer response to antidepressants than carriers with other haplotype groups.- Variant Name:
- GSK3B: IVS11+4251 T>A
- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major
- Evidence:
-
PMID:18195730
-
rs2319398
at chr3:121095632
in
GSK3B
This variant is associated with antidepressant treatment response in Chinese major depressive disorder. In a four-locus haplotype analysis (rs334558; rs13321783; rs2319398; rs6808874), the GSK3B TAGT carriers showed a poorer response to antidepressants than carriers with other haplotype groups.- Variant Name:
- GSK3B: IVS7+9227 A>G
- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major
- Evidence:
-
PMID:18195730
-
rs13321783
at chr3:121098065
in
GSK3B
This variant is associated with antidepressant treatment response in Chinese major depressive disorder. In a four-locus haplotype analysis (rs334558; rs13321783; rs2319398; rs6808874), the GSK3B TAGT carriers showed a poorer response to antidepressants than carriers with other haplotype groups.- Variant Name:
- GSK3B: IVS7+11660 G>T
- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major
- Evidence:
-
PMID:18195730
-
rs334558
at chr3:121295972
in
GSK3B
This variant is in the promoter region of GSK3B. T allele is associated with greater transcription activity compared with the A allele. This variant is associated with antidepressant treatment response in Chinese major depressive disorder. In a four-locus haplotype analysis (rs334558; rs13321783; rs2319398; rs6808874), the GSK3B TAGT carriers showed a poorer response to antidepressants than carriers with other haplotype groups.- Variant Name:
- GSK3B: -50 T>C
- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major, Parkinsonian Disorders
- Evidence:
-
PMID:16315267
PMID:18195729
-
rs2518224
at chr6:102013370
in
GRIK2
This SNP in the GRIK2 gene was associated with treatment-emergent suicidal ideation during citalopram therapy in a clinically representative cohort of outpatients with major depressive disorder. DNA samples from 1,915 participants were genotyped.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:17898344
-
rs4148740
at chr7:86990039
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs10280101
at chr7:86991521
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs7787082
at chr7:86994987
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs2032583
at chr7:86998497
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs4148739
at chr7:86998985
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs11983225
at chr7:86999456
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs10248420
at chr7:87002922
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs2235040
at chr7:87003686
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs12720067
at chr7:87007292
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs2235015
at chr7:87037500
in
ABCB1
This variant is associated with differences in clinical efficacy of antidepressants, most likely by influencing their access to the brain.- Related Drugs:
- amitriptyline, citalopram, paroxetine, venlafaxine
- Related Diseases:
- Depression
- Evidence:
-
PMID:18215618
-
rs2227631
at chr7:100556258
in
SERPINE1
This variant was shown to be assoicated with antidepressant treatment response in a study consisting of 188 Chinese MDD patients and 346 controls.The G allele was less frequent in responders than nonresponders- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major
- Evidence:
-
PMID:18794724
-
rs1799889
at chr7:100556430
in
SERPINE1
This variant was shown to be assoicated with antidepressant treatment response in a study consisting of 188 Chinese MDD patients and 346 controls.The G allele was less frequent in responders than nonresponders- Related Drugs:
- citalopram, fluoxetine
- Related Diseases:
- Depression, Depressive Disorder, Major
- Evidence:
-
PMID:18794724
-
rs11188072
at chr10:96509051
in
CYP2C19
This promoter variant is part of CYP2C19*17 haplotype, which causes increased acitivity and increased transcription of CYP2C19. Patients carrying this allele may exhibit a lack of response to commonly prescribed dosages of certain proton pump inhibitors (PPIs) and antidepressants, due to ultrarapid clearance of these drugs. CYP2C19*17 carriers are more likely to benifit from tamoxifen treatment.- Variant Name:
- CYP2C19: -3402C>T
- Related Drugs:
- amitriptyline, citalopram, clomipramine, escitalopram, omeprazole, proguanil, tamoxifen
- Evidence:
-
PMID:16413245
PMID:17625515
PMID:18294333
-
rs12248560
at chr10:96511647
in
CYP2C19
This promoter variant is part of CYP2C19*17 haplotype, which causes increased acitivity and increased transcription of CYP2C19. Patients carrying this allele may exhibit a lack of response to commonly prescribed dosages of certain proton pump inhibitors (PPIs) and antidepressants, due to ultrarapid clearance of these drugs. CYP2C19*17 carriers are more likely to benifit from tamoxifen treatment.- Variant Name:
- CYP2C19: -806C>T
- Related Drugs:
- amitriptyline, citalopram, clomipramine, escitalopram, omeprazole, proguanil, tamoxifen
- Evidence:
-
PMID:16413245
PMID:18024866
-
rs1954787
at chr11:120168573
in
GRIK4
A study in 1,816 eligible patients from the STAR*D cohort found that genetic variation in a kainic acid-type glutamate receptor is reproducibly associated with response to the antidepressant citalopram.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:17671280
-
rs7997012
at chr13:46309986
in
HTR2A
In one study, subjects homozygous for allele A had a reduction in absolute risk of having no response to treatment with citalopram for major depressive disorder. The allele was found to be more frequent in white than in black subjects, and this is consistant with racial differences in response to antidepressant treatment.- Related Drugs:
- citalopram
- Related Diseases:
- Depressive Disorder, Major
- Evidence:
-
PMID:16642436
-
rs25531
at chr17:25588472
in
SLC6A4
This promoter SNP is not associated with depression remission frequency upon treatment with citalopram in white Hispanics, white non-Hispanics, or Blacks.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:18618621
-
rs4825476
at chrX:122269160
in
GRIA3
This SNP in the GRIA3 gene was associated with treatment-emergent suicidal ideation during citalopram therapy in a clinically representative cohort of outpatients with major depressive disorder. DNA samples from 1,915 participants were genotyped.- Related Drugs:
- citalopram
- Related Diseases:
- Depression
- Evidence:
-
PMID:17898344
The following genes are in curated knowledge about this drug.
| Gene | Relationship | Evidence | |
|---|---|---|---|
|
ABCB1 |
|
Publications, Variants |
|
ADM |
|
Publications |
|
|
COMT |
|
Publications |
|
|
CREB1 |
|
Publications |
|
|
CYP1A2 |
|
Publications |
|
|
CYP2C19 |
|
Publications, Variants |
|
|
CYP2D6 |
|
Publications, Variants |
|
|
CYP3A |
|
Publications |
|
|
CYP3A4 |
|
Publications |
|
|
CYP3A5 |
|
Publications |
|
|
FKBP5 |
|
Publications |
|
|
GRIA3 |
|
Variants |
|
|
GRIK2 |
|
Variants |
|
|
GRIK4 |
|
Publications, Variants |
|
|
GSK3B |
|
Publications, Variants |
|
|
HTR1A |
|
Publications |
|
|
HTR1B |
|
Publications |
|
|
HTR2A |
|
Publications, Variants |
|
|
HTR3A |
|
Publications |
|
|
HTR3B |
|
Publications |
|
|
IL28RA |
|
Publications |
|
|
MAOA |
|
Publications |
|
|
MAOB |
|
Publications |
|
|
PAPLN |
|
Publications |
|
|
SERPINE1 |
|
Publications, Variants |
|
|
SLC6A4 |
|
Publications, Variants |
|
|
TPH2 |
|
Publications |
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
PharmGKB Curated Pathways
The following drugs are in curated knowledge about this drug.
| Drug | Relationship | Evidence | |
|---|---|---|---|
|
|
tamoxifen |
|
Publications |
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| acenocoumarol |
|
The SSRI increases the effect of anticoagulant (source: Drug Bank) |
| almotriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| carvedilol |
|
The SSRI increases the effect of the beta-blocker (source: Drug Bank) |
| clarithromycin |
|
Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| clozapine |
|
The antidepressant increases the effect of clozapine (source: Drug Bank) |
| dicumarol |
|
The SSRI increases the effect of anticoagulant (source: Drug Bank) |
| eletriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| erythromycin |
|
Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| isocarboxazid |
|
Possible severe adverse reaction with this combination (source: Drug Bank) |
| linezolid |
|
Combination associated with possible serotoninergic syndrome (source: Drug Bank) |
| metoprolol |
|
The SSRI increases the effect of the beta-blocker (source: Drug Bank) |
| moclobemide |
|
Possible serotoninergic syndrome (source: Drug Bank) |
| naratriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| oxycodone |
|
Increased risk of serotonin syndrome (source: Drug Bank) |
| phenelzine |
|
Possible severe adverse reaction with this combination (source: Drug Bank) |
| pimozide |
|
This SSRI increases the effect and toxicity of pimozide (source: Drug Bank) |
| propranolol |
|
This SSRI increases the effect of the beta-blocker (source: Drug Bank) |
| rizatriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| selegiline |
|
Possible severe adverse reaction with this combination (source: Drug Bank) |
| sibutramine |
|
Risk of serotoninergic syndrome (source: Drug Bank) |
| sumatriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| tramadol |
|
Increased risk of serotonin syndrome (source: Drug Bank) |
| tranylcypromine |
|
Possible severe adverse reaction with this combination (source: Drug Bank) |
| troleandomycin |
|
Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| warfarin |
|
The SSRI increases the effect of anticoagulant (source: Drug Bank) |
| zolmitriptan |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
Curated Information
The following diseases are in curated knowledge about this drug.
| Disease | Relationship | Evidence | |
|---|---|---|---|
|
|
Anxiety Disorders |
|
Publications |
|
|
Breast Neoplasms |
|
Publications |
|
|
Death |
|
Publications |
|
|
Depression |
|
Publications, Variants |
|
|
Depression, Postpartum |
|
Publications |
|
|
Depressive Disorder |
|
Publications |
|
|
Depressive Disorder, Major |
|
Publications, Variants |
|
|
Obsessive-Compulsive Disorder |
|
Publications |
Non-Curated Information
A list of non-curated publications that mention this drug along with other diseases is available.
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
LinkOuts
Common Searches
Search PubMed
Search Medline Plus
Search PubChem
Search CTD
Non-Curated Publications
A list of non-curated publications that mention this drug is available.