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Cymbalta dosage 120 mg once or twice daily 160 mg daily), and citalopram dosage 120 mg once or twice daily. The following is provided as a brief summary of specific pharmacological effects the drugs discussed herein: -Citalopram is a competitive monoamine oxidase inhibitor (MAO-I inhibitor). This drug, with its higher affinity for the noradrenergic than serotonergic systems, may exert some direct therapeutic effects over these systems. -Citalopram causes a rapid decrease in plasma volume [9, 20]. the animal study, maximum drop in plasma volume caused by citalopram in the range of 12- 24 hours was similar to those reported by other MAO-I inhibitors such as atorvastatin  or alandrolone . -Citalopram dose-dependently lowers the plasma concentration of noradrenaline from 25-100% for up to 8 hours, depending on the dose. Some studies also show that citalopram significantly (approximately by 25%) lowers plasma concentrations of noradrenaline and dopamine compared with placebo. -Citalopram, because it also binds to the serotonin 1-5-HT 2 receptor, may potentiate the effects of serotonin reuptake inhibitors (SNRIs) such as sertraline , an increase in plasma concentration of serotonin (5HT) is thought to be a common mechanism of action . It is likely that citalopram acts to enhance the effect of SNRIs by binding to and lowering the plasma concentration of serotonin itself. -Citalopram has weak, but substantial, anti-oxidant potential . There is evidence, however, that, in patients with significant atherosclerotic cardiovascular risk such as myocardial infarction, citalopram may increase blood glucose concentrations [29, 30], and that citalopram may produce significant weight gain . -Citalopram has no significant effect on appetite. -Citalopram may have very potent cardiovascular effects, as mentioned above, in patients with myocardial infarction, coronary artery disease, and/or ischemic stroke. -The mechanism responsible for citalopram, at least acute effects, is thought to be that of an MAO-I inhibitor effect . For additional comments related to potential drug buy viagra pfizer ireland interactions, please see also the drug interaction section of prescribing information. Please see the following citations if pertinent to the topic at hand: 1. G. W. S. Shulman. Pharmacopharmacotherapy. 5th Ed. New York: Wiley; 2005. p. 567. 2. J. S. Wahl. Eur Respir 6:23 (1992). 3. M. A. Fries. Pharmacol Ther. 21:1103-1120 (1992). 4. S. Schoenbaum. Pharmacotherapy of Drug-Induced Amnesia. p. 48. 5. R. S. Lappe. Ann Emerg Med. 34:1071-1066 (1989). 6. B. D. Lappe. Clin Pharmacol Ther. 19(Suppl. 5) (1989). 7. R. S. Lappe, et al.. J Clin Pharmacol. 33:2 (1989). 8. R. S. Lappe. Am J Psychiatry. 157(Suppl. 2-3), (1990). 9. C. D. Vetter. Anesthesia. 10(Suppl. 2):35 (1978). 10. J. R. Clements. Anesth Analg. 67(Suppl. 1):15 (1978). 11. S. E. Stolz & J. D. Rachlin. Clin Pharmacol Ther. 30:119 (1984). 12. W. Schoenbaum, et al. Int J Neuropsychopharmacol. 12(Suppl. 1):2 (1992). 13. A. J. Maiti. Ann Neurol. 46(Suppl. 1):14 (1991). 14. E. M. Dreyer. Arch Gen Psychiatry. 43(Suppl. 1):15 (1992). 15. R. S. Linville & A. L. Schoenbaum. JAMA. 269:2251-2254 (1991). 16. L. J. R. De Visser & B. Stirling. Lancet. 1:9 (1987). 17. L. U. Schoenbaum. Biol Psychiatry. 17(Suppl. 5):2 (1991).
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