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BOF: 2.49

A 36-year-old female is on citalopram for treatment of depression. She presents with a history of shivering, anxiety, dizziness, headache and nausea.

These symptoms are the result of:

a)      Overdose of citalopram

b)      Withdrawal of citalopram

c)      Combination of citalopram and St. John’s Wort

d)      Concomitant alcohol abuse

e)      Excessive consumption of cigarettes in combination with citalopram

Answer:

b)

Citalopram is a SSRI (selective serotonin reuptake inhibitor). These drugs may be associated with a specific withdrawal syndrome known as the discontinuity syndrome, which is characterised by shivering, dizziness, anxiety, nausea and headaches.

SSRIs should be gradually reduced and patients should be counselled that they should not leave out doses.

St. John’s wort is an herbal antidepressant, which interacts with serotoninergic drugs in particular

 

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