Sepram
Sepram is an antidepressant (SSRI) used to treat depression, prevent its return, and help with panic disorder and fear of public places.
How to Use
Dosage
The usual starting dose for adults is 20 mg once a day. For panic disorder, start with 10 mg daily for the first week, then increase to 20-30 mg daily.
Method
Take Sepram once a day with water. You can take it at any time of day, with or without food. Do not chew the tablets, as they taste bitter.
For most adults, the maximum daily dose is 40 mg. For elderly patients and those with liver problems, the maximum daily dose is 20 mg.
Possible Side Effects
- •Drowsiness
- •Insomnia
- •Headache
- •Increased sweating
- •Dry mouth
- •Nausea
- •Agitation
- •Decreased sexual desire
- •Loss of appetite
- •Anxiety
- •Nervousness
- •Confusion
- •Abnormal dreams
- •Tremor (shaking)
- •Tingling sensation
- •Dizziness
- •Concentration difficulties
- •Tinnitus (ringing in the ears)
- •Yawning
- •Diarrhea
- •Vomiting
- •Constipation
- •Itching
- •Muscle and joint pain
- •Fatigue
- •Ejaculation and erection problems in men
- •Difficulty achieving orgasm in women
- •Skin tingling (prickling sensation)
- •Weight loss
- •Increased appetite
- •Weight gain
- •Aggression
- •Depersonalization (feeling detached from oneself)
- •Hallucinations
- •Mania (periods of extreme high mood)
- •Fainting
- •Dilated pupils
- •Fast heart rate
- •Slow heart rate
- •Hives (itchy rash)
- •Hair loss
- •Rash
- •Bleeding under the skin
- •Photosensitivity reaction (abnormal skin reaction to sunlight)
- •Difficulty urinating
- •Difficulty starting urination, reduced urination
- •Vaginal bleeding
- •Swelling in arms or legs
- •Grand mal seizures (severe fits)
- •Involuntary movements
- •Taste disturbances
- •General bleeding
- •Liver inflammation
- •Fever
- •Self-harm or suicidal thoughts
- •Bleeding from skin and mucous membranes, low platelet count
- •Hypersensitivity (skin rash)
- •Anaphylactic reaction (severe allergic reaction)
- •Abnormal secretion of antidiuretic hormone (SIADH)
- •Low potassium in blood
- •Panic attack
- •Teeth grinding
- •Restlessness
- •Abnormal muscle movements or stiffness
- •Extrapyramidal symptoms (movement disorders)
- •Akathisia (involuntary need to move)
- •Movement disorder
- •Vision disturbance
- •Prolonged QT interval on ECG (heart tracing)
- •Dizziness when standing up due to low blood pressure (orthostatic hypotension)
- •Nosebleed
- •Intestinal bleeding (including rectal bleeding)
- •Very heavy vaginal bleeding soon after childbirth
- •Sudden swelling of skin or mucous membranes
- •Irregular or continuous uterine bleeding between periods (in women)
- •Painful erections
- •Increased prolactin levels in blood
- •Milk secretion in men and non-breastfeeding women
- •Abnormal liver function test results
- •Increased risk of bone fractures
- •Serotonin syndrome (high fever, restlessness, confusion, muscle twitching, muscle spasms)
- •Hyponatremia (nausea, vomiting, muscle twitching, confusion due to abnormally low sodium in the blood)
- •Torsades de Pointes (rapid, irregular heartbeat, fainting - a life-threatening heart condition)
Important Warnings
- Do not take Sepram if you are allergic to citalopram or any of its ingredients, or if you are taking MAO inhibitors or certain heart rhythm medications.
- Talk to your doctor if you have a history of mania, panic disorder, liver/kidney problems, diabetes, epilepsy, bleeding disorders, low sodium, heart conditions, or glaucoma.
- If you experience thoughts of self-harm or suicide, contact a doctor or go to the nearest hospital immediately.
- Sepram is generally not recommended for children or adolescents under 18 years of age.
- Avoid Sepram during pregnancy and breastfeeding. It can cause problems for the baby.
Show 2 more warnings
- Do not drive or operate machinery if you feel dizzy or drowsy until these symptoms go away.
- If you have sugar intolerance, discuss it with your doctor before taking this medicine.
Use in Elderly Patients
Suitable for older adults, with specific precautions. Serotonergic. Risk of QT prolongation. A significant adverse effect is low serum sodium level. Increases risk of falls. Consider potential interactions especially with preparations that increase risk of bleeding. (updated 12.2.2024)