Amitriptyline and Citalopram ( A Complete Guide)

Amitriptyline and Citalopram both are well known antidepressants. As the technology advances, psychological problems are becoming more prevalent. Most of the people around us are suffering from one type of a psychological problem or another. This is due to the fact that stress is causing us to be more anxious. Moreover, with ever growing competition, pressure to be perfect and trying to raise standard of living has us chasing unrealistic expectations. In this scenario, we have to deal with neurosis and other psychological disturbances. According to an estimate, patients in mental asylums had the same level of anxiety as that of today’s high school students. Hence it is not difficult to understand the surge in the demand of antidepressants and anti-anxiety drugs. In this article we will discuss the uses of Amitriptyline and Citalopram

 Amitriptyline and citalopram are also antidepressants and these are given to patients if he or she is suffering from major depressive disorder or other depressive disorders. This article will throw light on everything related to amitriptyline and citalopram including uses, contraindications and common side effects. Let’s take a look at amitriptyline and citalopram uses and importance in combating depressions. 

Amitriptyline

First medicine under discussion is amitriptyline which is an antidepressant and it is very popular among physicians. Amitriptyline is a scientific name and this medicine is found with different brand names in the market.


Brand names

  • Elavil
  • Amitid
  • Endep
  • Amitril

Brand names of combination products

  • Etrafon (contains Amitriptyline, Perphenazine)
  • Duo-Vil (contains Amitriptyline, Perphenazine)
  • Triavil (contains Amitriptyline, Perphenazine)
  • Limbitrol (contains Amitriptyline, Chlordiazepoxide)

At times, this branded product is no longer on the market but generic alternatives may be found available.

Why is amitriptyline prescribed?

It is used to treat symptoms of depression. Amitriptyline belongs to a class of medications which is called tricyclic antidepressants. It increases some of the natural substances found in the brain which are needed to lower depression and create mental balance. 

How to use

The intake of amitriptyline is generally oral and it is taken by mouth and it is commonly taken one to four times a day. The patient needs to take it around the same time every day. Moreover, you need to follow the directions of your doctor or follow the direction written on prescription by the pharmacist. You can also ask your doctor or pharmacist to explain any part of the prescription you don’t understand. The medicine should be taken as directed and should not be taken in more or less amount than described by your doctor. 

Most of the time, the doctor starts with lower dosage and then increases the dose with the passage of time. Amitriptyline takes time to show its effects and it might take a few weeks before it shows complete effects. You need to be patient and keep taking the dose according to your doctor’s advice. The withdrawal symptoms will be severe if you stop taking amitriptyline at once because your doctor will decrease the dose with time systematically. 

other uses of Amitriptyline

It is also used to treat psychological disorders like post-herpetic neuralgia (which is stabbing pains, burning or aches which can last after the months and years of shingles infection), eating disorder and for the prevention of headaches due to migraine. You should discuss to your doctor about the use of medication for your particular condition. It can be used for other purposes too but you need to consult your doctor first. 

Side Effects of Amitriptyline

This medicine has some side effects and one should consult the doctor if one faces one of the symptoms given below while using the Amitriptyline.

  • nightmares
  • unsteadiness
  • nausea
  • dry mouth
  • vomiting
  • weakness or tiredness
  • excessive sweating
  • drowsiness
  • constipation
  • blurred vision
  • difficulty urinating
  • pain
  • headaches
  • changes in sex drive or ability
  • changes in appetite or weight
  • burning, or tingling in the hands or feet
  • confusion

There are some more serious side effects which should be dealt with utmost care. If you have any symptoms from the list mentioned below or you have noticed anything from the ‘important warning’ section, you should immediately call your doctor.

  • slow or difficult speech
  • hallucinating (seeing things or hearing voices that do not exist)
  • dizziness or faintness
  • seizures
  • weakness or numbness of an arm or a leg
  • unusual bleeding or bruising
  • crushing chest pain
  • yellowing of the skin or eyes
  • fainting
  • rapid, pounding, or irregular heartbeat
  • uncontrollable shaking of a part of the body
  • severe skin rash or hives
  • jaw, neck, and back muscle spasms
  • jaw, neck, and back muscle spasms
  • swelling of the face and tongue

In case of overdose

A case of overdose should be immediately reported to the emergency helpline and taken to hospital. You can also call an emergency service available in your area. If the victim has collapsed, suffering from seizure, suffering from shortage of breath or can’t be awakened he should be taken directly to the emergency room. Other symptoms of overdose are given below; consult the doctor if any one of these happens to you. 

  • seizures
  • irregular heartbeat
  • coma (loss of consciousness for a period of time)
  • cold body temperature
  • confusion
  • fever
  • problems concentrating
  • vomiting
  • drowsiness
  • hallucinating (seeing things or hearing voices that do not exist)
  • rigid muscles
  • agitation

Precautions before taking amitriptyline

Following things should be kept in mind and should be discussed with your doctors before taking amitriptyline as a regular dose. If you are using any of the below mentioned medicine then should tell your doctor and he will prescribe the dose accordingly.

  • You need to tell your doctor if you are currently on any other medication before taking amitriptyline and citalopram like cisapride, phenelzine, monoamine oxidase, selegiline or any MAO inhibitors have ingested during past 2 weeks. 
  • Also, you need to tell your doctor if you recently had any other problem like a heart attack or hypertension, or pregnancy, breastfeeding, or if you lately had surgery. 
  • The medicine makes you drowsy so take care while taking the medicine and do not drive or operate heavy machinery. 
  • No special dietary restriction is advised unless your doctor tells you to avoid something. 

Citalopram

 Amitriptyline and citalopram both are antidepressants. Citalopram belongs to the class of selective serotonin reuptake inhibitors (SSRI). SSRIs were first introduced in U.S. markets in the 1980s and have gained a lot of popularity from the masses. It is mostly used in the treatment for depression and also at times for panic attacks. It is more popular than other antidepressants because of its better effectiveness and lesser side effects.

Brand Name: Celexa 

It is also goes by the brand name cipramil

Generic Name: Citalopram

How Citalopram Works:

  • Citalopram commonly takes four to six weeks to work so you will have to be patient with its effects.
  • It works by balancing the level of serotonin in your brains, serotonin is a chemical substance found in your brains which helps you sleep, mood and other important functions. 
  • Serotonin balance is achieved by citalopram because it stops serotonin absorption in nerve cells and your brain chemistry is changed which helps you relax and changes your mood. 
  • Citalopram can help in reducing the panic attacks severity and symptoms and other coexisting conditions like depression.

How is it taken?

In initial stages, citalopram is suggested for morning and evening in a 20mg tablet and this dose can be increased to 40 mg after one week. However, it takes a few weeks before it starts showing its effects and dosage is increased gradually to find the optimal amount of dose. 

Common Side Effects:

Both amitriptyline and citalopram has a few common side effects but citalopram has few side effects:

  • Nausea
  • Lethargy 
  • Sleep disturbances
  • Lightheadedness
  • Problems with memory or concentration
  • Drowsiness
  • Headache
  • Fast heartbeats, feeling shaky
  • Changes in weight
  • Tiredness
  • Sexual side effects
  • Dry mouth
  • Increased sweating
  • Blurred vision

Many of the side effects of citalopram become less intense or more controllable over time. By means of any medication, there is a risk of having an allergic drug response to citalopram.

These side effects can also increase if Citalopram and Diazepam are taken together.

Precautions

Every precautionary measure informed by your doctor should be followed carefully as amitriptyline and citalopram have similar precautions. Particularly people who are taking any other medications or about to undergo surgery should be careful while taking citalopram. Moreover, if you are pregnant or planning to get pregnant you should also tell your doctor about this before getting citalopram. Ladies who are breastfeeding should also be careful while taking this medicine. Alcohol usage should also be limited while taking this medication.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

FAQs about amitriptyline and citalopram?

  1. What is the difference between amitriptyline and citalopram?

A few differences of amitriptyline and citalopram are given below. 

Amitriptyline Citalopram
Amitriptyline is an antidepressant and has side effects of drowsiness and causes withdrawal symptoms if discontinued suddenly.It is mainly prescribed for anxiety and stress, chronic myofascial pain, fibromyalgia, urinary incontinence, depression, post traumatic stress disorder, pain, burning mouth syndrome, neuropathic pain, vulvodynia, depression, insomnia, neurotic depressionIt might also be prescribed for disorders like cyclic vomiting syndrome, cough, depressive psychosis, somatoform pain disorder, pudendal neuralgia, reflex sympathetic dystrophy syndrome, irritable bowel syndrome, interstitial cystitis, migraine prevention, hyperhidrosis dysautonomia
Citalopram is also antidepressants with rather less side effectsIt is mainly prescribed for depression, anxiety and stress, postpartum depressionIt can also be prescribed off label for disorders like, premenstrual dysphoric disorder, body dysmorphic disorder, agitation, bipolar disorder, persistent depressive disorder, hot flashes, panic disorder, neuralgia, excoriation disorder, borderline personality disorder, generalized anxiety disorder, vulvodynia, dissociative identity disorder, trichotillomania, severe mood dysregulation, obsessive compulsive disorder, somatoform pain disorder, occipital neuralgia
  1. Which is more effective in amitriptyline and citalopram?

According to a study published in Indian Journal of psychiatry on amitriptyline and citalopram, “in several double-blind clinical trials citalopram has demonstrated efficacy equivalent to that of the commonly prescribed TCA amitriptyline”. However the same study reported citalopram ‘slightly more efficient’ than amitriptyline.

  1. Which of these two amitriptyline and citalopram have lesser side effects?

According to a study published in Cambridge University on amitriptyline and citalopram “the response of patients with major depressive illness to amitriptyline and citalopram was compared in a double-blind multi-centre trial. No differences in efficacy were observed, but citalopram had less hypnotic effect and a remarkably lower profile of side-effects”.

What we recommend for depression

Professional counselling

If you are suffering from depression then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.


References

ncbi.nlm.nih.gov/pmc/articles/PMC2918306/

medlineplus.gov/druginfo/meds/a682388.html

medicinenet.com/citalopram/article.htm

medicinenet.com/citalopram/article.htm#which_drugs_or_supplements_interact_with_citalopram_celexa

nhs.uk/medicines/citalopram/

verywellmind.com/faqs-about-celexa-for-panic-disorder-2584294

drugs.com/citalopram.html

cambridge.org/core/journals/the-british-journal-of-psychiatry/article/comparison-of-the-antidepressant-action-of-citalopram-and-amitriptyline/66C39E5F56BF3168819A21D6E74195DE

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