citalopram escitalopram Lexapro
Postmortem citalopram concentrations: alone or along with other compounds.

Segura LJ, Bravo B.

Toxicology Laboratory, Instituto Anatomico Forense of Madrid, Ciudad Universitaria, Madrid, Spain. lseguraa meditex.es

Citalopram, an antidepressant whose use has become more widespread in Spain in recent years participates directly and indirectly in the lethal mechanism in voluntary and involuntary poisonings. There were 30 cases of autopsies in the Madrid region where citalopram and other psychoactive substances (psychotropic drugs, alcohol, opiates) were detected in the corpses. The postmortem citalopram levels in relation to the manner and mechanism of death were evaluated, and a significant difference between the toxic and nontoxic cases (p < 0.01) was found. We studied the citalopram blood levels alone and along with other psychoactive products, and these cases were then further divided into those where the compounds were at deadly levels and those which were not. We found a range of citalopram levels between 0.37 and 0.83 microg/mL in which some cases were associated with citalopram toxicity and others were not. Citalopram blood levels of less than 0.35 microg/mL did not lead to fatal poisoning when it was the sole substance detected.

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citalopram escitalopram Lexapro
The intensity dependence of the auditory evoked N1 component as a predictor of response to Citalopram treatment in patients with major depression.

Linka T, Muller BW, Bender S, Sartory G.

Clinic for Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchowstrasse 174, 45147 Essen, Germany. thomas.linka uni-essen.de

The intensity dependence of the auditory evoked N1 ERP component (IDAP) has been suggested as an indicator of central serotonergic neurotransmission with relevance to pharmacological treatment. We report the results of a study evaluating the IDAP in 16 in-patients fulfilling DSM-IV criteria for major depressive episode in the course of treatment with the SSRI Citalopram. Our data revealed a significant correlation between the intensity slopes of the N1 amplitude prior to Citalopram treatment and treatment response: patients with higher intensity slopes of N1 amplitude showed a significantly stronger decrease of HDRS-Score after Citalopram treatment than patients within the lower intensity slope ranges. Our results indicate an association of N1 amplitude intensity dependence with response to antidepressant treatment with Citalopram.

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citalopram escitalopram Lexapro
Predosing with the unlabeled "inactive" enantiomer as a tool for improvement of the PET signal.

Elfving B, Bjornholm B, Knudsen GM.

Neurobiology Research Unit N9201, University Hospital Rigshospitalet, DK-2500 Copenhagen, Denmark. belfving pet.rh.dk

In this study we investigated whether the PET signal of labeled (S)-citalopram could be improved by predosing with the unlabeled distomer (R)-citalopram. Ten minutes before intravenous injection of 1.5 MBq [(3)H]-(S)-citalopram, rats were given i.v. 0.9% saline, 16 or 24 microg (R)-citalopram. Sixty minutes after injection of [(3)H]-(S)-citalopram, the brains were dissected into eight regions. The binding obtained in each brain region was compared to cerebellum as a reference region. Predosing with saline, 16 and 24 microg (R)-citalopram yielded thalamus/cerebellum ratios of 1.6 +/- 0.12, 1.6 +/- 0.12, and 1.1 +/- 0.26 (means +/- SD), respectively. It is concluded that the nonspecific binding of radiolabeled (S)-citalopram cannot be reduced by predosing with the 150 times less active enantiomer (R)-citalopram, possibly due to the pool of nonspecific sites being too large for blocking. Copyright 2002 Wiley-Liss, Inc.

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citalopram escitalopram Lexapro
[18F]altanserin binding to human 5HT2A receptors is unaltered after citalopram and pindolol challenge.

Pinborg LH, Adams KH, Yndgaard S, Hasselbalch SG, Holm S, Kristiansen H, Paulson OB, Knudsen GM.

Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark. pinborg nru.dk

The aim of the present study was to develop an experimental paradigm for the study of serotonergic neurotransmission in humans using positron emission tomography and the 5-HT2A selective radioligand [18F]altanserin. [18F]altanserin studies were conducted in seven subjects using the bolus/infusion approach designed for attaining steady state in blood and brain 2 hours after the initial [18F]altanserin administration. Three hours after commencement of radiotracer administration, 0.25 mg/kg of the selective serotonin reuptake inhibitor, citalopram (Lundbeck, Valby, Denmark), was administered to all subjects as a constant infusion for 20 minutes. To reduce 5-HT1A-mediated autoinhibition of cortical 5-HT release, four of the seven subjects were pretreated with the partial 5-HT1A agonist pindolol for 3 days at an increasing oral dose (25 mg on the day of scanning). In each subject, the baseline condition (120 to 180 minutes) was compared with the stimulated condition (195 to 300 minutes). Despite a pronounced increase in plasma prolactin and two subjects reporting hot flushes compatible with an 5-HT-induced adverse effect, cortical [18F]altanserin binding was insensitive to the citalopram challenge, even after pindolol pretreatment. The biochemical and cellular events possibly affecting the unsuccessful translation of the citalopram/pindolol challenge into a change in 5-HT2A receptor binding of [18F]altanserin are discussed.

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citalopram escitalopram Lexapro
Neuroendocrine response to intravenous citalopram in healthy control subjects: pharmacokinetic influences.

Lotrich FE, Bies R, Muldoon MF, Manuck SB, Smith GS, Pollock BG.

Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, USA, lotrichfe msx.upmc.edu.

RATIONALE: The neuroendocrine response to intravenous citalopram may provide an acute, functional, in vivo measure of the neural serotonin (5-HT) system.OBJECTIVE: To refine the quantification of acute neuroendocrine responses following intravenous citalopram in studies of 5-HT function.METHODS: In 75 adult healthy subjects taking part in four similar protocols, we measured plasma prolactin and cortisol, as well as serial citalopram concentrations following intravenous citalopram (10 mg, 20 mg, 40 mg, 0.33 mg/kg) and placebo. The relationship between the AUC for intravenous citalopram during the first 150 min (AUC(150)) and the magnitude of the neuroendocrine response was determined. The role of pharmacokinetic (PK) parameters, as well as sensitivity to placebo injections, in influencing the neuroendocrine response to citalopram was then evaluated.RESULTS: Citalopram produced a dose-dependent increase in cortisol and prolactin. The maximal increase from baseline correlated significantly but modestly with citalopram's AUC(150) (prolactin r(2)=0.23, P<0.0001; cortisol r(2)=0.3, P<0.0001). Additionally, citalopram's AUC(150) was affected by between-subject differences in both the peripheral and central volume of distribution. However, the neuroendocrine responses to citalopram did not correlate with the responses to placebo.CONCLUSIONS: The parenteral citalopram challenge test is characterized by a modest concentration-response relationship, with concentration influenced by variable PK factors. Accounting for individual differences in drug distribution may improve the power of the citalopram challenge test, when used as an in vivo measure of central 5-HT function.

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citalopram escitalopram Lexapro
Liquid chromatography-positive ion electrospray mass spectrometry method for the quantification of citalopram in human plasma.

Pistos C, Panderi I, Atta-Politou J.

Department of Pharmaceutical Chemistry, School of Pharmacy, University of Athens, Panepistimioupolis Zografou, GR 15771 Athens, Greece. kpistos pharm.uoa.gr

A rapid, sensitive and novel narrow-bore liquid chromatography-mass spectrometric method was developed and fully validated for the quantification of citalopram in human plasma. The analyte and internal standard (imipramine) were extracted by liquid-liquid extraction with a mixture of hexane-heptane-isopropanol (88:10:2, v/v/v). The use of a Hypersil BDS C(8) micro-bore column (250 mm x 2.1 mm i.d.; 3.5 microm particle size), results in substantial reduction in solvent consumption. The mobile phase consisted of 10 mM ammonium formate-formic acid (pH 4.5) and acetonitrile (30:70, v/v), pumped at a flow rate of 0.15 ml min(-1). The analytes were detected after positive electrospray ionization using the selected ion-monitoring mode of the species at m/z 325 for citalopram and m/z 281 for imipramine. The method had a chromatographic run time of 10.0 min and a linear calibration curve over the range 0.50-250 ng ml(-1) (r(2) > 0.996). The limit of quantitation was 0.50 ng ml(-1). Accuracy and precision were below the acceptance limits of 15%.

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citalopram escitalopram Lexapro
Combined chronic treatment with citalopram and lithium does not modify the regional neurochemistry of nitric oxide in rat brain.

Wegener G, Bandpey Z, Heiberg IL, Volke V, Trabace L, Rosenberg R, Harvey BH.

Centre for Basic Psychiatric Research, University of Aarhus, Risskov, Denmark. wegener dadlnet.dk

A substantial number of patients do not respond sufficiently to antidepressant drugs and are therefore often co-medicated with lithium as an augmentation strategy. Also inhibitors of nitric oxide synthase (NOS) have been used as an augmentation strategy, while inhibitors of NOS exhibit antidepressant-like properties in various animal models. Therefore, we hypothesized that modulation of NOS may be involved in the long-term effects of antidepressants and lithium, and studied the influence of acute and chronic administration of citalopram, alone or in combination with lithium, on NOS activity in hippocampus, cerebellum, and frontal cortex, by determination of L-citrulline being formed. We found that administration of acute or chronic citalopram (5 mg/kg and 20 mg/kg/24h, respectively) alone or in combination with subchronic lithium (60 mmol/kg chow pellet) did not influence the activity of NOS ex vivo in all regions compared to control. In contrast, high doses of lithium caused a significant decrease in NOS activity in vitro. We conclude that basal conditions are unsuitable for the study of antidepressant effects on NOS, and that the neurochemistry of nitric oxide remains unaltered following chronic citalopram or subchronic lithium under normal physiological conditions.

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