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Mental Health (Expert Forum)
Drug Interactions
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Drug Interactions
by Kathy__0__0, Apr 07, 1999 12:00AM
I am on the following medications, Lipitor 10mg, Corgard 20mg,
Lactulose syrup at 2 tlb per day, Premarin .625 mg and norpramin at 25mg per day for panic attacks ( for the last 15 years)
In the last year the doctor reduced dose of norpramin from 50 to
25 mg because I complain of 30 pound weight gain over the years. I am doing well with the panic even on this smaller dose.
The doctor would like to take me off the norpramin and try the drug Celexa. He wants me to start taking Celexa at 20mg per day
and continue the norpramin for 2 weeks while the celexa kicks in.
My concern is can you take these two drugs together for 2 weeks?
And is there any problems taking Corgard ( a beta-blocker) with the Celexa? I've think I read about Celexa and Metoprolol (beta- blocker) having a problem. Thank-you for your answer.
Doctor's Answer
by HFHS M.D.-HG, Apr 07, 1999 12:00AM
_
Dear Kathy,
Celexa (Citalopram) is the newest antidepressant among the SSRI's ( Serotonin Specific Reuptake Inhibitors).It is indicated for the treatment of depression. It may have efficacy for panic attacks and obsessive compulsive disorder like the other SSRI"s. It is usually started at a dose of 20mg per day and the dose will be increased depending upon the symptoms. The most frequent side effects reported with celexa are nausea, dry mouth, insomnia and diarrhea.
Combination of imipramine , a tricyclic antidepressant ( TCA) with celexa has shown that the concentration of imipramine's metabolite( Desipramine, marketed as Norpramin) was increased by approximately 50%. The clinical significance of this is unknown. Neverthless, caution is indicated in the co-administration of TCA's with celexa as the serum levels of the TCA often increase . You are on a low dose of Norpramin (25 mg ). You and your physician can decide if a serum level of Norpramin should be taken. Eventhough co-administration of celexa and metoprolol has increased plasma levels of metoprolol, it had no clinically significant effects on blood pressure or heart rate. There are no known studies done with a combination of celexa and corgard.
I would recommend you to discuss with your physician in detail about your concern regarding the medications. I hope this information is helpful to you. This information is provided for general educational purposes only and should not be replaced by evaluation with a physician.
Sincerely,
HFHS M.D.
Key words: celexa, norpramin.
