Drug Content

Citalopram- Half Life: 35 hours; Schedule IV Drug

Celexa (Citalopram) is a prescription antidepressant drug used to treat depression associated with mood disorders.  In certain cases citalopram is used in the treatment of anxiety if other medications do not work.  Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs).  This drug may need to be taken for up to 4 weeks or longer before it starts to work as it differs person to person.

Citalopram is generally well-tolerated in patients taking therapeutic doses ranging from 20 to 60 mg a day.  Regardless of how strong a SSRI is, patients should always be monitored when taking them.  While Citalopram is taken by people of all ages, it is one of the main SSRIs that is given to elderly patients who need them.  Citalopram works by increasing the amount of serotonin (a natural substance in the brain) that helps maintain mental balance.

Investigational studies have found that citalopram significantly reduces the symptoms of diabetic neuropathy and premature ejaculation.  There is also evidence that it may even treat post-stroke pathological crying.  There are other medications that treat these conditions- however, if those medications do not work, a doctor may simply prescribe a low dosage to see if citalopram has any effect.

As stated earlier, citalopram is generally well-tolerated by patients taking it, so side effects shouldn’t be too much of a nuisance.  Medications work differently on every person, so there are no guarantees that citalopram will agree with you or not, so contact your doctor if there are any concerns when taking the medication.

Citalopram is listed as a Schedule IV drug of the United States’ Controlled Substances Act which means that even though it has a low potential for abuse, it can be still abused.  Do not stop taking citalopram without consulting your doctor first as the potential for withdrawal symptoms may occur if too much of the drug is taken or if the drug is taken for too long.

Side effects of citalopram cannot be anticipated, but if any develop or change in intensity, be sure to inform your doctor as soon as possible.  Only your doctor can determine whether or not it is safe to continue taking citalopram.  Side effects are as followed:

Nausea; dry mouth, gas; loss of appetite; diarrhea; insomnia; drowsiness; dizziness; trouble concentrating; feeling nervous, restless, or unable to sit still; weight changes; frequent urination; decreased sex drive; impotence; difficulty having an orgasm; dry or watery mouth; yawning; ringing in your ears

If any of these more serious side effects are experienced, be sure to contact your doctor as soon as possible:

Seizures; tremors; muscle stiffness; twitching; shivering; problems with balance and/or coordination; feeling agitated; confusion; excessive sweating; increased heartbeat

Citalopram, just like any other drug can cause withdrawal symptoms.  Citalopram withdrawal symptoms tend to begin within eight hours of the last dose taken and can last anywhere from one to eight weeks.  This highly depends on how much was taken and differs from person to person.  If you or someone you know has stopped using citalopram, the best advice would be to taper slowly rather than stop suddenly.  Antidepressant withdrawal happens to be one of the more uncomfortable types of withdrawal- not that any type of withdrawal is comfortable, but with citalopram, there are many different symptoms that include but are not limited to:

Anxiety; dizziness; headache; fatigue; insomnia; tremors; hallucinations; nausea; vomiting; diarrhea; restlessness; blurred vision; muscle/joint pain; tingling sensations; fever; abdominal discomfort; anorexia; agitation; vertigo; excessive sweating; irritability; aggression; insomnia; confusion; nightmares; chills; hot flashes; trouble concentrating; crying spells; thoughts of suicide; lethargy; weakness; flu symptoms

Now a doctor prescribes these types of medications to patients who need them, but there are times where a patient might not quite listen to a doctor when he/she tells them to take it as prescribed.  If one goes overboard, they are going to feel the effects of withdrawal, but even a person that has been taking an antidepressant like citalopram for a period over a couple of years, they will even need to taper off of the drug because they have built up a natural tolerance to the drug.

CNS depressants (anti-anxiety medications and sleep aids) act on the Central Nervous System by slowing down brain function.  By doing this, these types of medications can treat anxiety, muscle tension, and insomnia to name a few, but if used in higher doses, CNS depressants may successfully be used as general anesthetics.  Tranquilizers and sedatives are two examples of CNS depressants.  Based on their pharmacology and chemistry- CNS depressants can be divided into two groups:

Barbiturates- were first introduced for medical use in the early 1900s, and there have been more than 2,500 barbiturates synthesized.  Barbiturates produce a broad spectrum of central nervous system depression- from mild depression to coma.  In short, barbiturates are sedatives that slow down the mind and body.  The four different classes of barbiturates are ultrashort, short, intermediate, and long-acting.
Benzodiazepines- are in a class of psychoactive drugs, and are the more popular drug for treating anxiety, muscle spasms, and inducing sleep.  Benzodiazepines act as hypnotics in high doses, anxiolytics in moderate doses, and sedatives in low doses.  Three of the more popular benzodiazepines on the market include Xanax (alprazolam), Valium (diazepam), and Klonopin (clonazepam).  Estazolam (ProSom) is usually prescribed for short-term treatment of sleep disorders- this is due to its sedating effects.

Most CNS Depressants act on the brain similarly and affect the neurotransmitter ‘gamma-aminobutyric acid’ (GABA).  Neurotransmitters are chemicals that are used to relay, amplify and modulate signals between a neuron and another cell.  GABA however, works by decreasing brain activity.  It is the CNS depressant’s job to increase GABA activity that produces a drowsy and/or calming effect.  These effects can be completely beneficial to those who require these effects for whatever ailments they are suffering from (anxiety problems, sleep disorders, etc), but for those who don’t need these medications for the above symptoms, barbiturates and benzodiazepines should not be taken- and people who do need them should only take them as prescribed.

CNS depressants can cause dangerous side effects if combined with other medications/substances that produce similar effects such as prescription pain medications, certain OTC cold/allergy medications, and alcohol.  These medications/substances slow down breathing and decrease one’s heartbeat and respiration, so combining them can be potentially fatal.

If one suddenly decides to discontinue high doses of CNS depressants, it can lead to withdrawal- which can be severely uncomfortable.  Since CNS depressants slow down the brain, discontinuing them can cause the brain to search for the substance, and if it can’t find it than seizures can occur, which can be potentially fatal.  One who is looking to end their use of a CNS depressant, or has suddenly stopped and is going through withdrawal, should speak to a doctor- who can taper one off of the substance.

In addition to medical care, one can look into counseling in an in-patient or out-patient environment that can help people overcome their addiction to CNS depressants.  Cognitive-behavioral therapy is an example of in-patient/out-patient therapy, and has been successfully used to help people take care of their abuse of benzodiazepines.  This type of therapy helps a patient focus on their thinking, expectations, and behaviors while increasing their skills of handling the stress of life off of medication(s).

CNS depressants can be used effectively to treat people’s anxiety and sleep disorders, but it’s the ones who become out of control that ruin it for the people that actually need the medications.  It’s not as easy as it used to be to get a doctor to prescribe these medications, but with the proper symptoms that are shown, a doctor will know who is lying and who is fabricating.

Diazepam- Half Life: 20-100 hours; Schedule IV Drug

Valium (Diazepam) is a prescription medication used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety.  Diazepam is in a class of drugs known as benzodiazepines.  It works by slowing down the central nervous system.  Diazepam affects the chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms.  Diazepam is also used to relieve the symptoms of acute alcohol withdrawal, as well as act as a muscle relaxant.

Diazepam was the second benzodiazepine to be invented by Sternbach of Hoffman-La Roche, and was approved for use in 1963.  Diazepam is two and a half times more potent than its predecessor “chlordiazepoxide”, which it also surpassed in sales.  Diazepam is classified as a “classical” benzodiazepine similar to; clonazepam, lorazepam, oxazepam, nitrazepam, flurazepam, bromazepam and clorazepate.

Diazepam can be administered orally, intravenously, intramuscularly, or via suppository.  When Diazepam is taken orally, it has a fast onset of action– which is around 30 minutes, but can range up to 2 hours.  When Diazepam is administered via IV (intravenously), the onset of action is 1-5 minutes, and IM (intramuscularly) is at 15-30 minutes.  The duration of Diazepam’s peak pharmacological effects is in between 15 minutes and 1 hour for both IV and IM.  As a matter of fact– when Diazepam is administered as an intramuscular injection, the absorbtion is slow, erratic and imcomplete, so Diazepam is mainly used via IV or orally.

Like all drugs, Diazepam is potentially habit-forming and is listed as a Schedule IV drug of the United States’ Controlled Substances Act.  Do not stop taking Diazepam without consulting your doctor first as the potential for withdrawal symptoms can occur if too much of the drug is taken, or if the drug is taken for too long.

Side effects of Diazepam cannot be anticipated, but if any develop or change in intensity, be sure to inform your doctor as soon as possible.  Only your doctor can determine whether or not it is safe to continue taking Diazepam.  Side effects are as followed:

Drowsiness; tiredness; blurred vision; insomnia; muscle weakness; lack of balance or coordination; slurred speech; nausea; vomiting; constipation; headache; drooling; skin rash; loss interest in sex

If any of these more serious side effects are experienced, be sure to contact your doctor as soon as possible:

Confusion; unusual thoughts or behavior; unusual risk-taking behavior; decreased inhibitions; no fear of danger; depression; thoughts of suicide or harming yourself; agitation; hyperactivity; hostility; hallucinations; lightheadesness; fainting; tremor; muscle twitching; fever; chills; body aches; flu symptoms; jaundice (yellowing of the skin or eyes); urinary retention

Since Diazepam depresses the Central Nervous System much like alcohol does, your body can develop a tolerance to the drug based on how much of the drug you take and\or how long it has been taken.  Diazepam is both physically and psychologically addicting and is considered one of the toughest addictions to break, as with most benzodiazepines.  With chronic use, abuse potential is high and withdrawal symptoms can develop after only 2 or 3 days of repeated use.  Be sure to talk to your doctor when stopping Diazepam, as you’ll need to be slowly tapered off of the drug.  Abruptly discontinuing Diazepam after an extended period of use is extremely dangerous and can cause seizures and possible death.

If one begins to experience withdrawal symptoms, contact a doctor immediately.  Symptoms of withdrawal are as followed:

Severe anxiety; rapid heartbeat; tremor; insomnia; irritability; sweating; anxiety; blurred vision; decreased concentration; decreased mental clarity; severe diarrhea; heightened awareness of noise or bright lights; impaired sense of smell; loss of appetite; weight loss; muscle cramps; seizures; tingling sensation; agitation; convulsions

The severity of withdrawal from Diazepam depends on how much of the drug was taken and for how long it was taken for.  Diazepam withdrawal can last between one week up to six weeks, depending on how much in is your system.  It has been proven that for every year a person is on Diazepam, they will experience one week of acute withdrawal symptoms.  Of course this depends on the person’s health, their state of mind, etc.  Even though acute withdrawal might be over with, there have been people who have still felt minor discomfort at random times months, and even years later.  The symptoms won’t be nearly as bad as the acute symptoms, but it can take a while before one has control of their entire life again.

Overall, Diazepam is an excellent drug to take for the symptoms of anxiety– it’s just important that the dosage is monitored by a doctor, and that it isn’t abused.