ewood79
16-02-12, 23:53
Hi everyone,
I notice this discussion with some interest as im on 70 mg cip at the moment and have been on 80 mg before with no side effects. (2 years)
I have had dozens of ECGs during this time due to my health anxiety and even had an appt with the cardiologist to put my mind at ease. All results normal.
I just recently went to a review by a psychiatrist (this week) and im going to change from cip to lexapro just because its newer and cleaner but he is like totally fine with people taking a dose of 60mg as long as it dosnt cause any of those side effects.... if you have had ECGs and they are normal then you are not affected.....
So dont be worried about the high dose, its just your anxiety talking!!!
cheers
---------- Post added at 19:33 ---------- Previous post was at 19:00 ----------
From Australia.....
The TGA is advising that citalopram should no longer be used at doses greater than 40 mg per day. For some patients, the maximum recommended dose is now only 20 mg per day (see below).
In addition, it is now advised that people who have been diagnosed with a heart condition known as "congenital long QT syndrome" should not take citalopram.
A recent study by the Forest Research Institute in the USA has shown
that higher doses of citalopram can cause abnormal changes in the electrical activity of the heart. In rare cases these changes can result in serious heart problems.
Citalopram is a member of the class of drugs called selective serotonin reuptake inhibitors (SSRIs) and is used to treat major depression. Brand names include:
Cipramil
Celapram
Talam
Ciazil
Citalobell
Celica
Pharmacor Citalo 20 and
others with the word "citalopram" in their name
Information for patients
You should talk to your doctor about changing your dose if:
You are taking more than 40 mg of citalopram a day
You are taking more than 20mg per day and:
are over 65 years of age
have reduced liver function or
are also taking medicines, such as cimetidine or omeprazole, which interfere with the metabolism of citalopram.
You should talk to your doctor about changing your treatment if:
You have been diagnosed with congenital long QT syndrome.
You should NOT stop taking citalopram or change the dose without first consulting your doctor. Stopping citalopram suddenly may result in withdrawal symptoms including:
dizziness
anxiety
insomnia
emotional instability
headache
diarrhoea
vomiting
palpitations.
Information for health professionals
The recent study found dose-dependent QT prolongation with citalopram. As higher doses may result in life-threatening or fatal arrhythmias in some people, the following new dosage recommendations and contraindications are advised:
The maximum recommended daily dose of citalopram is now 40 mg.
A maximum recommended daily dose of 20 mg now applies to patients:
greater than 65 years of age
with liver dysfunction
with poor CYP2C19 activity or
taking concomitant CYP2C19 inhibitors (eg cimetidine or omeprazole).
In patients aged over 65 years, the recommended starting dose is now 10 mg daily.
Citalopram should not be used in patients with congenital long QT syndrome.
Citalopram should be used with caution in patients at higher risk of developing prolongation of the QT interval, including those with:
congestive heart failure
bradyarrhythmias
predisposition to hypokalaemia
predisposition to hypomagnesaemia
concomitant medicines that prolong the QT interval.
There are new monitoring recommendations for patients on citalopram:
Hypokalaemia and hypomagnesaemia should be corrected prior to initiation of treatment and potassium and magnesium levels should be periodically monitored.
More frequent ECG monitoring should be considered for patients at higher risk of QT prolongation.
If citalopram is discontinued or the dose reduced, the patient should be monitored closely for the re-emergence or worsening of any symptoms of depression.
The sponsor of Cipramil (citalopram hydrobromide), Lundbeck Australia, is writing to health professionals advising them of these changes.
The Product Information documents for citalopram products will be updated with the findings of the study and the new recommendations.
As my ECG's are normal, im 33, had my checks etc i could actually keep taking the higher dose but im going to change to lexapro as its newer and you dont have to take as much!
This warning is for people who obviosuly have a heart condition, who are over 65 and have the other problems mentioned above.
Thankyou all in advance..... i nearly fell off my chair when the shrink told me that these things had come up but he was like im not worried about you etc as youve had so man tests etc!![/QUOTE]
I notice this discussion with some interest as im on 70 mg cip at the moment and have been on 80 mg before with no side effects. (2 years)
I have had dozens of ECGs during this time due to my health anxiety and even had an appt with the cardiologist to put my mind at ease. All results normal.
I just recently went to a review by a psychiatrist (this week) and im going to change from cip to lexapro just because its newer and cleaner but he is like totally fine with people taking a dose of 60mg as long as it dosnt cause any of those side effects.... if you have had ECGs and they are normal then you are not affected.....
So dont be worried about the high dose, its just your anxiety talking!!!
cheers
---------- Post added at 19:33 ---------- Previous post was at 19:00 ----------
From Australia.....
The TGA is advising that citalopram should no longer be used at doses greater than 40 mg per day. For some patients, the maximum recommended dose is now only 20 mg per day (see below).
In addition, it is now advised that people who have been diagnosed with a heart condition known as "congenital long QT syndrome" should not take citalopram.
A recent study by the Forest Research Institute in the USA has shown
that higher doses of citalopram can cause abnormal changes in the electrical activity of the heart. In rare cases these changes can result in serious heart problems.
Citalopram is a member of the class of drugs called selective serotonin reuptake inhibitors (SSRIs) and is used to treat major depression. Brand names include:
Cipramil
Celapram
Talam
Ciazil
Citalobell
Celica
Pharmacor Citalo 20 and
others with the word "citalopram" in their name
Information for patients
You should talk to your doctor about changing your dose if:
You are taking more than 40 mg of citalopram a day
You are taking more than 20mg per day and:
are over 65 years of age
have reduced liver function or
are also taking medicines, such as cimetidine or omeprazole, which interfere with the metabolism of citalopram.
You should talk to your doctor about changing your treatment if:
You have been diagnosed with congenital long QT syndrome.
You should NOT stop taking citalopram or change the dose without first consulting your doctor. Stopping citalopram suddenly may result in withdrawal symptoms including:
dizziness
anxiety
insomnia
emotional instability
headache
diarrhoea
vomiting
palpitations.
Information for health professionals
The recent study found dose-dependent QT prolongation with citalopram. As higher doses may result in life-threatening or fatal arrhythmias in some people, the following new dosage recommendations and contraindications are advised:
The maximum recommended daily dose of citalopram is now 40 mg.
A maximum recommended daily dose of 20 mg now applies to patients:
greater than 65 years of age
with liver dysfunction
with poor CYP2C19 activity or
taking concomitant CYP2C19 inhibitors (eg cimetidine or omeprazole).
In patients aged over 65 years, the recommended starting dose is now 10 mg daily.
Citalopram should not be used in patients with congenital long QT syndrome.
Citalopram should be used with caution in patients at higher risk of developing prolongation of the QT interval, including those with:
congestive heart failure
bradyarrhythmias
predisposition to hypokalaemia
predisposition to hypomagnesaemia
concomitant medicines that prolong the QT interval.
There are new monitoring recommendations for patients on citalopram:
Hypokalaemia and hypomagnesaemia should be corrected prior to initiation of treatment and potassium and magnesium levels should be periodically monitored.
More frequent ECG monitoring should be considered for patients at higher risk of QT prolongation.
If citalopram is discontinued or the dose reduced, the patient should be monitored closely for the re-emergence or worsening of any symptoms of depression.
The sponsor of Cipramil (citalopram hydrobromide), Lundbeck Australia, is writing to health professionals advising them of these changes.
The Product Information documents for citalopram products will be updated with the findings of the study and the new recommendations.
As my ECG's are normal, im 33, had my checks etc i could actually keep taking the higher dose but im going to change to lexapro as its newer and you dont have to take as much!
This warning is for people who obviosuly have a heart condition, who are over 65 and have the other problems mentioned above.
Thankyou all in advance..... i nearly fell off my chair when the shrink told me that these things had come up but he was like im not worried about you etc as youve had so man tests etc!![/QUOTE]