Citanew Tablet 10mg

About Citanew Tablet 10mg

Citanew Tablet Uses

• Major depressive disorder (MDD) including persistent low mood, loss of interest, and sleep disturbance.
• Generalized anxiety disorder (GAD) causing excessive, uncontrollable worry and tension.
• Panic disorder with or without agoraphobia, including recurrent unexpected panic attacks.
• Social anxiety disorder (social phobia) causing significant distress in social situations.
• Obsessive-compulsive disorder (OCD) involving intrusive thoughts and compulsive behaviors.
• Post-traumatic stress disorder (PTSD) under psychiatric supervision.
• Premenstrual dysphoric disorder (PMDD) causing severe mood changes before menstruation.

Citanew Tablet Benefits

• Escitalopram is the most selective SSRI currently available, targeting the serotonin reuptake transporter with greater precision than older SSRIs, which reduces off-target side effects.
• Effective for both depression and anxiety in a single medicine, avoiding the need for separate antidepressant and anxiolytic prescriptions.
• Better tolerability profile compared to older antidepressants such as tricyclics and MAO inhibitors, with fewer anticholinergic, sedative, and cardiovascular side effects.
• Once-daily dosing improves adherence in patients who require long-term maintenance treatment.
• Non-habit forming with no dependence or addiction potential, unlike benzodiazepine alternatives for anxiety.
• Generally well tolerated in elderly patients at reduced starting doses.

What Experts Say

Citanew contains Escitalopram, the S-enantiomer of Citalopram and the most pharmacologically selective SSRI in clinical use.

How It Works

Escitalopram works by selectively inhibiting the serotonin reuptake transporter (SERT) on presynaptic neurons.

Normally, after serotonin is released into the synaptic cleft, SERT pumps it back into the releasing neuron, terminating its effect. Escitalopram blocks this reuptake process, allowing serotonin to remain in the synapse longer and enhancing its signaling effect on postsynaptic receptors.

The result is a gradual normalization of serotonergic transmission in the limbic system and prefrontal cortex, which regulates mood, anxiety, and emotional processing. Therapeutic effects typically become apparent after 1 to 2 weeks, with full antidepressant benefit emerging at 4 to 6 weeks.

Why Escitalopram Stands Apart

Among all SSRIs, Escitalopram binds to SERT with the highest affinity and selectivity. It also binds to a secondary allosteric site on the SERT protein, which prolongs its inhibitory effect even after it dissociates from the primary binding site.

This dual-binding mechanism is unique to Escitalopram among commercially available SSRIs and contributes to its clinical efficacy at lower doses compared to Citalopram, its racemic parent compound.

The R-enantiomer of Citalopram actually interferes with the SERT binding of the S-enantiomer. By removing it, Escitalopram achieves superior receptor occupancy and a cleaner pharmacological profile.

Clinical Note

The FDA requires a black box warning on all antidepressants regarding increased risk of suicidal thinking and behavior in patients under 25 years of age, particularly in the early weeks of treatment.

All patients starting Citanew should be monitored closely for mood changes, agitation, and suicidal ideation during the first 4 to 8 weeks.

Citanew must never be stopped abruptly due to the risk of discontinuation syndrome. The dose should always be tapered gradually under medical supervision.

Drug Class

• Selective Serotonin Reuptake Inhibitor (SSRI).

Packaging and Quantity

• 1 pack contains 14 tablets.
• Available in 5mg, 10mg, and 20mg strengths.

When Not to Use Citanew

• Concurrent use of MAO inhibitors or within 14 days of stopping one, due to the risk of life-threatening serotonin syndrome.
• Concurrent use of Pimozide or Linezolid.
• Known allergy or hypersensitivity to Escitalopram or Citalopram.
• QT interval prolongation or concurrent use of medicines known to prolong the QT interval.
• Children and adolescents under 12 years of age.

How to Use

• Citanew may be taken with or without food.
• The tablet should be swallowed whole with a full glass of water.
• Alcohol must be avoided throughout treatment as it significantly increases side effects and worsens depressive symptoms.
• Citanew must not be stopped suddenly. The dose must always be reduced gradually under doctor supervision to prevent discontinuation symptoms including dizziness, irritability, and electric shock sensations.
• The standard adult starting dose is 10mg once daily, increased to 20mg once daily after a minimum of 1 week if required. The maximum dose is 20mg daily.

The dose should not be changed or stopped without explicit medical advice. Full therapeutic benefit may take 4 to 6 weeks to appear.

Citanew Tablet 10mg formula

• Escitalopram

Available forms

• Tablets
• Oral Drops

How to use Citanew Tablet 10mg?

• Take the tablet by mouth with a glass of water
• You can take it with food or without
• It's better to take it in the morning or evening
• The recommended dosage is usually 1 tablet per day or as prescribed by your physician
• Do not stop taking the medicine without your doctor’s approval

Drug Interactions

Citanew has several clinically significant interactions. All current medicines, supplements, and herbal products must be disclosed before starting treatment. Key interactions include:

• MAO inhibitors such as phenelzine, tranylcypromine, and isocarboxazid: Concurrent or recent use causes life-threatening serotonin syndrome. A minimum 14-day washout period is required before starting Citanew after stopping an MAO inhibitor.
• Linezolid and methylene blue: Both have MAO inhibitory properties and must not be used with Citanew.
• Pimozide: Concurrent use is contraindicated due to the risk of QT interval prolongation and serious cardiac arrhythmia.
• Serotonergic medicines including tramadol, triptans, fentanyl, lithium, and St. John's Wort: Concurrent use increases the risk of serotonin syndrome.
• Anticoagulants such as warfarin and NSAIDs such as aspirin and ibuprofen: Escitalopram inhibits platelet aggregation, significantly increasing bleeding risk when combined with anticoagulants or NSAIDs.
• Medicines that prolong QT interval including antipsychotics, certain antibiotics, and antiarrhythmics: Concurrent use increases the risk of serious cardiac arrhythmia.
• CYP2C19 inhibitors such as omeprazole, esomeprazole, and cimetidine: These raise Escitalopram blood levels, increasing the risk of side effects and QT prolongation.
• Alcohol: Concurrent use worsens CNS depression and mood instability. Strictly contraindicated during treatment.

Risks and warnings

• Serotonin syndrome: Combining Citanew with other serotonergic medicines can cause a life-threatening reaction. Symptoms include high fever, agitation, tremor, and rapid heartbeat. Emergency medical care must be sought immediately.
• QT prolongation: Escitalopram prolongs the cardiac QT interval in a dose-dependent manner, increasing the risk of serious arrhythmia. The maximum dose must not exceed 20mg daily. Baseline ECG is recommended in patients with cardiac risk factors.
• Discontinuation syndrome: Citanew must never be stopped abruptly. Dose tapering under medical supervision is essential to avoid withdrawal symptoms.
• Pregnancy: Escitalopram use in the third trimester has been associated with neonatal withdrawal syndrome. The prescribing doctor must assess the risk-benefit ratio carefully. Citanew should not be stopped during pregnancy without psychiatric supervision.
• Breastfeeding: Escitalopram passes into breast milk. A doctor should be consulted before use during breastfeeding.
• Bleeding risk: Escitalopram inhibits platelet aggregation and increases bleeding risk, particularly when combined with NSAIDs, warfarin, or aspirin.
• Hyponatremia: Escitalopram can cause abnormally low blood sodium, particularly in elderly patients and those on diuretics. Symptoms include headache, confusion, and seizures.
• Driving and machinery: Citanew may cause dizziness and fatigue, particularly in the early weeks of treatment. Caution is advised when driving or operating heavy machinery.

Citanew Tablet Side Effects

Most patients tolerate Citanew well, particularly after the first 1 to 2 weeks when initial side effects tend to settle. Side effects are dose-dependent.

• Nausea, particularly in the first few days of treatment.
• Dry mouth.
• Insomnia or drowsiness.
• Increased sweating.
• Diarrhea or constipation.
• Sexual dysfunction including reduced libido, delayed ejaculation, and difficulty reaching orgasm.
• Dizziness or lightheadedness.
• Weight changes with prolonged use.

Serious side effects require immediate medical attention:

• Signs of serotonin syndrome including agitation, confusion, rapid heartbeat, high fever, muscle twitching, and loss of coordination.
• Suicidal thoughts or worsening depression, particularly in patients under 25 in the early weeks of treatment.
• Unusual bruising or bleeding, including nosebleeds or prolonged bleeding after cuts.
• Irregular heartbeat or palpitations.
• Severe allergic reaction including facial swelling, difficulty breathing, or widespread rash.
• Hyponatremia (low sodium) presenting as headache, weakness, confusion, or seizures, particularly in elderly patients.

Discontinuation symptoms when stopping suddenly, including electric shock sensations, dizziness, irritability, and flu-like symptoms.

Storage Conditions

• Store at room temperature, between 20°C and 25°C.
• Keep away from direct sunlight, heat, and moisture.
• Store in the original packaging to protect from humidity.
• Keep out of reach and sight of children.
• Do not use after the expiry date printed on the packaging.
• Do not store in the bathroom or near a kitchen sink.