Oral (p.o.) administration has a delayed onset time of several weeks and moderate efficacy in obsessive-compulsive disorder (OCD), therefore a more rapidly effective treatment is required. The aim of this paper was to review available data detailing the clinical outcome of intravenously (i.v.) administered antiobsessional drug in OCD patients. Review of the research indicates that i.v. administration exhibits a faster onset and greater improvement than p.o. administration. I.v. pulse administration showed clinically significantly faster onset than i.v. gradual administration. I.v. administration was safe and rapidly effective in treatment resistant OCD patients and might be a valuable new treatment.
Administration, Intravenous ; Citalopram ; Clomipramine ; Humans ; Obsessive-Compulsive Disorder

Escitalopram is a selective serotonin reuptake inhibitor antidepressant approved by the Food and Drug Administration for the treatment of major depressive disorder and generalized anxiety disorder. A 34-year-old female patient with major depressive disorder developed amenorrhea and had a false-positive urine pregnancy test after initiation of escitalopram treatment. To our knowledge, no published case report of amenorrhea and false-positive urine pregnancy tests in women taking escitalopram exists. This case report suggests that women of child-bearing age should be carefully monitored for amenorrhea while they are on an antidepressant treatment regimen.
Adult ; Amenorrhea* ; Anxiety Disorders ; Citalopram ; Depressive Disorder, Major ; Female ; Humans ; Hyperprolactinemia ; Pregnancy ; Pregnancy Tests* ; Pregnancy Tests, Immunologic ; Pregnancy* ; Serotonin ; Serotonin Uptake Inhibitors ; United States Food and Drug Administration

A sensitive and selective LC-MS/MS method for determination of citalopram in human plasma was established to study the bioequivalence of different formulations containing citalopram. The samples were simply pretreated by protein precipitation using acetonitrile, and then analyzed on a Zorbax Extend C8 column. The mobile phase consisted of acetonitrile-water-formic acid (60:40:0.2), at a flow-rate of 0.5 mL x min(-1). A Thermo Finnigan TSQ Quantum Ultra tandem mass spectrometer equipped with electrospray ionization source was used as detector and was operated in the positive ion mode. Selected reaction monitoring using the precursor to product ion combinations of m/z 325 --> m/z 109 and m/z 265 --> m/z 167 was performed to quantify citalopram and the internal standard, respectively. The pharmacokinetic parameters of citalopram in different formulations were calculated by non-compartment model. The linear calibration curves were obtained in the concentration range of 0.10-100 microg x L(-1). The lower limit of quantification was 0.10 microg x L(-1). The intra- and inter-day relative standard deviation (RSD) over the entire concentration range was less than 5.2%. Accuracy determined at three concentrations (0.25, 8.00 and 90.0 microg x L(-1) for citalopram) ranged from -4.7% to 1.3%. Each plasma sample was chromatographed within 3.0 min. The method was successfully used in bioequivalence study of citalopram in human plasma after oral administration of 20 mg citalopram. Calculated with AUC(0-120 h), the bioavailability of two formulations was (102.1 +/- 10.9)%. The method is rapid, selective, robust and is proved to be suitable for bioequivalence evaluation of different formulations containing citalopram.
Administration, Oral ; Antidepressive Agents, Second-Generation ; administration & dosage ; blood ; pharmacokinetics ; Area Under Curve ; Chromatography, Liquid ; Citalopram ; administration & dosage ; blood ; pharmacokinetics ; Humans ; Male ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry ; Therapeutic Equivalency

The neuroprotective effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion (2-VO) model was prepared and given escitalopram oxalate (experimental group) or PBS (control group) after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor (VEGF) were detected to explore the possible mechanisms. (1) Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experimental group was significantly longer than the control group (both P<0.01). (2) Cerebrovascular confocal detection results showed that the inside diameter of capillaries was significantly less in the experimental group than in the control group; the vascular density was significantly increased in the experimental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. (3) There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group (P=0.003<0.01). (4) VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group (P<0.05). It was concluded that escitalopram oxalate could significantly improve the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.
Animals ; Citalopram ; administration & dosage ; pharmacology ; Disease Models, Animal ; Hypoxia-Ischemia, Brain ; blood ; pathology ; prevention & control ; Male ; Maze Learning ; drug effects ; Memory ; drug effects ; Neuroprotective Agents ; administration & dosage ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; blood ; metabolism

Citalopram and paroxetine are selective serotonin reuptake inhibitors and also have antinociceptive effects. We investigated the antiallodynic and antihyperalgesic effects of intrathecally administered morphine, citalopram, paroxetine, and combinations thereof, in a rat model in which peripheral inflammation was induced by complete Freund's adjuvant (CFA). Drugs were intrathecally administered via direct lumbar puncture. Mechanical allodynia was measured using a Dynamic Plantar Aesthesiometer. Thermal hyperalgesia and cold allodynia were determined by measuring latency of paw withdrawal in response to radiant heat and cold water. Behavioral tests were run before and 15, 30, 45, and 60 min after intrathecal injection. Intraplantar injection of CFA produced mechanical allodynia, thermal hyperalgesia, and cold allodynia. Intrathecally administered morphine (0.3 or 1 microg) had antiallodynic or antihyperalgesic effects (24.0%-71.9% elevation). The effects of morphine were significantly increased when a combination of citalopram (100 microg) and paroxetine (100 microg) was added (35.2%-95.1% elevation). This rise was reversed by naloxone and methysergide. The effects of citalopram and paroxetine were also reversed by naloxone and methysergide. We suggest that the mu opioid receptor and serotonin receptors play major roles in production of the antiallodynic and antihyperalgesic effects of morphine, citalopram, paroxetine, and combinations thereof, in animals experiencing inflammatory pain.
Analgesics, Opioid/administration & dosage/*pharmacology ; Animals ; Behavior, Animal/drug effects ; Citalopram/administration & dosage/pharmacology ; Disease Models, Animal ; Hyperalgesia/etiology ; Inflammation/*chemically induced/pathology ; Injections, Spinal ; Male ; Morphine/administration & dosage/*pharmacology ; Pain/*prevention & control ; Pain Measurement ; Pain Threshold/drug effects ; Paroxetine/administration & dosage/pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Serotonin/*chemistry/metabolism ; Serotonin Uptake Inhibitors/administration & dosage/*pharmacology ; Temperature ; Time Factors