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Wellbutrin XL/Bupropion XL

What the medicinal ingredient is:

Bupropion hydrochloride.

What the medication is used for:

• relieve your symptoms of depression (feeling sad, a change in appetite or weight, difficulty concentrating or sleeping, feeling tired, headaches, unexplained aches and pain) OR
• prevent autumn-winter seasonal depression in patients with a history of seasonal depression

What it does:

WELLBUTRIN XL is one of a group of drugs called antidepressants. WELLBUTRIN XL is thought to block reuptake of chemicals in the brain called noradrenaline and dopamine, which are linked with depression.

What dosage forms it comes in:

150 mg and 300 mg once daily tablets.

When it should not be used:

Do not take WELLBUTRIN XL if you:

• know that you are allergic to WELLBUTRIN SR, bupropion, or any of the other ingredients in WELLBUTRIN XL tablets
• are taking any other medicines which contain bupropion such as WELLBUTRIN SR or ZYBAN
• have been diagnosed with epilepsy or have a history of seizures
• have or have had an eating disorder, for example binge eating (bulimia) or anorexia
• are usually a heavy drinker who has just stopped or are about to stop drinking
• are taking Monoamine oxidase (MAO) inhibitor antidepressants (e.g. phenelzine sulphate, moclobemide)
• are taking the antipsychotic thioridazine
• have liver or kidney problems
• are pregnant or trying to become pregnant, or if you think that you might be pregnant
• are breast-feeding

BEFORE you use WELLBUTRIN XL tell your doctor or pharmacist if you:

• have ever had any fits or seizures in the past
• take other medications that may increase your chance of a seizure, including drugs for depression and some antibiotics
• are taking any prescription or over-the-counter medications, or are planning on taking any prescription or over-the-counter medications during your therapy
• have, or have had an eating disorder, for example binge eating (bulimia) or anorexia nervosa
• have liver problems
• have kidney problems
• take more than the recommended amount of WELLBUTRIN XL tablets. WELLBUTRIN XL tablets should NOT be used if you are taking the smoking cessation aid ZYBAN or any other medications containing bupropion hydrochloride such as WELLBUTRIN SR
• have diabetes which is treated with insulin or other medications
• have use over-the-counter diet aids
• have had a serious head injury
• drink alcohol. It is best not to drink alcohol at all or to drink very little while taking WELLBUTRIN XL. If you drink a lot of alcohol and suddenly stop, you may increase your chance of having a seizure. Be sure to discuss your use of alcohol with your doctor before you begin taking WELLBUTRIN XL
• are pregnant, or thinking about becoming pregnant, or are breast-feeding

Interactions with This Medication:

If you are taking or have recently been taking other medicines for depression called monoamine oxidase inhibitors (MAOIs) tell your doctor before taking WELLBUTRIN XL.

You should tell your doctor if you are taking or have recently taken any medications (prescription, non-prescription or natural herbal) especially:

• other antidepressants such as citalopram, paroxetine, venlafaxine
• the antipsychotic thioridazine
• other medications for mental illness such as haloperidol and risperidone
• medicines for Parkinson's disease such as levodopa, amantadine or orphenadrine
• medicines used for epilepsy (such as carbamazepine, phenytoin, or phenobarbitone)
• cyclophosphamide or ifosfamide, drugs mainly used to treat cancer
• drugs called beta blockers to treat heart conditions
• medicines to regulate heart rhythm
• clopidogrel or ticlopidine, drugs used to reduce blood clots
• nicotine patches to help you stop smoking
• digoxin, used to treat congestive heart failure and a fast heart rate or irregular heart rhythm such as atrial fibrillation (sometimes called “a-fib”)
• tamoxifen, a drug to treat breast cancer
• ritonavir or efavirenz, drugs to treat HIV infection
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely while taking WELLBUTRIN XL.

 

Proper Use of This Medication:

Usual dose:

How to take WELLBUTRIN XL:

• WELLBUTRIN XL is formulated to be taken as a single tablet, once-daily.

Major Depressive Disorder:

Dosing with WELLBUTRIN XL Tablets should begin at 150 mg/day given as a single daily dose in the morning. The dose of WELLBUTRIN XL may be increased to the 300 mg/day maximum dose after 1 week. The usual adult target dose for WELLBUTRIN XL Tablets is 300 mg/day, given once daily in the morning.

Prevention of Seasonal Depression:

Dosing with WELLBUTRIN XL Tablets should begin at 150 mg/day given as a single daily dose in the morning. The dose of WELLBUTRIN XL may be increased to the 300 mg/day maximum dose after 1 week. The usual adult target dose for WELLBUTRIN XL Tablets is 300 mg/day, given once daily in the morning. For patients taking 300 mg/day during the autumn-winter season, the dose should be reduced to 150 mg/day for 2 weeks prior to discontinuation.

• Take your WELLBUTRIN XL tablet at the same time each day. If you have any problems with your dosing routine, contact your doctor or pharmacist.
• Swallow your WELLBUTRIN XL tablet whole, with fluids. Do not divide, chew or crush tablets.
• Take only the recommended dose prescribed by your doctor. Never increase the dose of WELLBUTRIN XL you or those in your care are taking, unless your doctor tells you to.
• The effects of your medication may not be noticeable in the first few days of treatment, and significant improvement may take several weeks. If you are concerned that your medicine is not working, discuss this with your doctor.
• You should talk to your doctor before you stop taking your medication on your own.

Side Effects and What to Do About Them:

Like all medications, WELLBUTRIN XL can cause some side effects. You may not experience any of them. For most patients these side effects are likely to be minor and temporary. However, some may be serious. Some of these side effects may be dose related. Consult your doctor if you experience these or other side effects, as the dose may have to be adjusted.

The most common side effects of WELLBUTRIN XL are:

• dry mouth
• nausea
• constipation
• insomnia
• dizziness
• anxiety
• decreased appetite

 

Celexa/Citalopram

What the medicinal ingredient is:

Citalopram hydrobromide

What the medication is used for:

CITALOPRAM has been prescribed to you by your doctor to relieve your symptoms of depression. Treatment with these types of medications is most safe and effective when you and your doctor have good communication about how you are feeling.

What it does:

CITALOPRAM belongs to a group of medicines known as antidepressants, more specifically to the family of medicines called SSRIs (Selective Serotonin Reuptake Inhibitors). CITALOPRAM is thought to work by increasing the levels of a chemical in the brain called serotonin (5-hydroxytryptamine).

What dosage forms it comes in:

Tablets: 10 mg, 20 mg and 40 mg

When it should not be used:

• Do not use CITALOPRAM at the same time as pimozide.
• Do not use CITALOPRAM if you are currently or have recently taken monoamine oxidase antidepressants (e.g. selegiline, moclobemide).
• Do not take CITALOPRAM if you are allergic to it, or to any of the components of its formulation (for list of ingredients see below).
• Stop taking CITALOPRAM and contact your doctor immediately if you experience an allergic reaction or any severe side effect.
• Do not use CITALOPRAM if you have been diagnosed with a congenital long QT syndrome

 

Before you use CITALOPRAM tell your doctor or pharmacist:

• All your medical conditions, including heart problems, history of seizures, manic-depressive illness, liver or kidney disease or diabetes.
• You have a bleeding disorder or have been told that you have low platelets.
• If you have QT/QTc prolongation or a family history of QT/QTc prolongation.
• If you have a personal history of fainting spells.
• If you have a family history of sudden cardiac death at <50 years.
• If you have electrolyte disturbances (e.g., low blood potassium, magnesium, or calcium levels) or conditions that could lead to electrolyte disturbances (e.g., vomiting, diarrhea, dehydration).
• If you have an eating disorder or are following a strict diet.
• If you had a recent bone fracture or were told you have osteoporosis or risk factors for osteoporosis.
• If you are pregnant or thinking about becoming pregnant, or if you are breast feeding.
• Any medications (prescription or non-prescription) which you are taking or have taken within the last 14 days, especially monoamine oxidase inhibitors, pimozide, any other antidepressants, triptans used to treat migraines, lithium, tramadol or drugs containing tryptophan.
• Your habits of alcohol and /or street drug consumption.
• Any natural or herbal products you are taking (e.g. St. John’s Wort).
• If you drive a vehicle or perform hazardous tasks during your work.

 

INTERACTIONS WITH THIS MEDICATION:

Do not use CITALOPRAM if you are taking or have recently taken:

• Monoamine oxidase inhibitor (e.g., phenelzine, tranylcypromine, moclobemide or selegiline)
• Pimozide
• Linezolid (an antibiotic)
• Methylene blue (intravenous)

 

The following list includes some, but not all, of the drugs that may increase the risk of side-effects while receiving CITALOPRAM. You should check with your doctor or pharmacist before taking any other medication (prescription, non-prescription or natural/herbal) with CITALOPRAM.

• drugs to treat heart rhythm disturbances (antiarrhythmics)
• antipsychotics
• opioid painkillers
• drugs to treat infections
• drugs to treat nausea and vomiting
• cancer drugs
• asthma drugs
• diuretics (water pills)
• Carbamezepine
• Other SSRIs e.g., escitalopram or any other antidepressant (e.g., imipramine, desipramine)
• Lithium
• Tryptophan
• Cimetidine
• Triptans (e.g., sumatriptan, zolmitriptan, naratriptan)
• Fluconazole, Ketoconazole, Itraconazole
• Erythromycin
• Warfarin
• Omeprazole
• Any herbal product such as St. John’s Wort
• Certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g.warfarin, dabigatran), acetylsalicylic acid (e.g. Aspirin) and other non-steroidal anti-inflammatory drugs (ibuprofen)·
• Certain medicines used to treat pain, such as fentanyl (used in anaesthesia or to treat chronic pain), tramadol, tapentadol, meperidine, methadone, pentazocine.
• Certain medicines used to treat cough, such as dextromethorphan.

Avoid drinking alcohol while taking CITALOPRAM

PROPER USE OF THIS MEDICATION:

Usual dose:

• It is important that you take CITALOPRAM exactly as your doctor has instructed.
  • Usually your doctor will prescribe 20 mg per day, which you will take once daily preferably at the same time each day. If you are elderly, your doctor may prescribe a lower dose. This dose may be increased. Never change the dose of CITALOPRAM you are taking, or that someone in your care is taking unless your doctor tells you to. Dosage directions should be followed carefully. Never exceed the prescribed dose.
• Swallow the tablets whole with a drink of water. Do not chew them. CITALOPRAM can be taken with or without food.
• You should continue to take CITALOPRAM even if you do not feel better, as it may take several weeks for your medication to work. Improvement may be gradual.
• Continue to take CITALOPRAM for as long as your doctor recommends it. Do not stop taking your tablets abruptly even if you begin to feel better, unless you are told to do so by your doctor. Your doctor may tell you to continue to take CITALOPRAM for several months. Continue to follow your doctor’s instructions.

SIDE EFFECTS AND WHAT TO DO ABOUT THEM:

• CITALOPRAM may cause unwanted effects (side-effects). These may include:
  • Fatigue
  • dry mouth
  • increased sweating
  • tremor (shakiness)
  • nausea
  • diarrhea
  • somnolence (sleepiness)
  • ejaculation disorder
  • upper respiratory tract infection.
• Contact your doctor before stopping or reducing your dosage of citalopram. Symptoms such as dizziness, abnormal dreams, electric shock sensations, agitation, anxiety, emotional indifference, difficulty concentrating, headache, migraine, tremor (shakiness), nausea, vomiting, sweating or other symptoms may occur after stopping or reducing the dosage of citalopram. Such symptoms may also occur if a dose is missed. These symptoms usually disappear without needing treatment. Tell your doctor immediately if you have these or any other symptoms. Your doctor may adjust the dosage of citalopram to reduce the symptoms.
• Side-effects are often mild and may disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side-effects while taking CITALOPRAM, please consult your doctor.
• Usually CITALOPRAM does not affect your ability to carry out normal daily activities. However, you should not drive a car or operate machinery until you are reasonably certain that CITALOPRAM does not affect you adversely.
• If you experience any symptoms of a possible heart rhythm disturbance, such as dizziness, palpitations, fainting or seizures, you should seek immediate medical attention.

   

Cipralex/ Escitalopram

 

What is fluoxetine?

Fluoxetine is an antidepressant, notably the first SSRI (selective serotonin reuptake inhibitor) approved for use in the United States. It has been approved by the FDA and marketed under the brand name Prozac® for over three decades.

Fluoxetine uses

• Currently, fluoxetine is FDA-approved for acute and maintenance treatment of major depressive disorder (MDD), as well as obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. Not all mental health conditions can be treated by a provider through our platform.
• Fluoxetine should be taken exactly as directed by your healthcare provider. Generally, it is taken once a day at the same time, earlier in the day if trouble sleeping is a concern. Abruptly stopping fluoxetine is generally not recommended, even if you feel better, because serious withdrawal symptoms can occur.

What is Paroxetine?

Paroxetine is an FDA-approved medication predominantly used to treat depression, anxiety disorders, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD). It belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

How Paroxetine Works?

Paroxetine works by increasing the levels of serotonin in the brain, a neurotransmitter linked to mood regulation. By stabilizing serotonin levels, the medication helps to enhance mood, reduce anxiety, and improve symptoms of other mental disorders. The exact mechanism is not fully understood, but it's believed that enhancing serotonin's action in the brain helps improve mood and reduces symptoms of mental health conditions.

What is sertraline?

Sertraline is a prescription drug and was one of the first SSRI (selective serotonin reuptake inhibitor) antidepressants on the US market. Sertraline is marketed under the brand name Zoloft®, which was first approved by the Food and Drug Administration in 1992 as a treatment of major depressive disorder.

Sertraline uses

Currently, sertraline is approved by the FDA to treat major depressive disorder (MDD), as well as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder. Not all mental health conditions can be treated by a provider through our platform.

What is Trazodone?

Trazodone is an FDA-approved medication primarily used for the treatment of major depressive disorder. It can also be prescribed off-label for sleep disorders due to its sedative effects. It's classified as a serotonin antagonist and reuptake inhibitor (SARI).

How Trazodone Works

Trazodone operates by modulating the activity of neurotransmitters in the brain, particularly serotonin, which plays a vital role in mood regulation and emotional state. It blocks the reabsorption (reuptake) of serotonin and affects the availability of certain other neurotransmitters, ensuring more serotonin is available in the brain. This action helps to alleviate symptoms of depression and improve mood stability. The medication’s sedative effect, which contributes to its effectiveness in treating insomnia and anxiety-related sleep issues, is linked to its impact on other neurotransmitter systems in the brain.

What is venlafaxine?

Venlafaxine is a prescription drug, notably the first of a newer type called SNRIs (serotonin-norepinephrine reuptake inhibitors) that offer an alternative to SSRIs (selective serotonin reuptake inhibitors). The Food and Drug Administration first approved the drug in 1993 to treat depression in adults and later in 1997 as an extended-release (XR) version. It is marketed under the brand name Effexor®.

Venlafaxine uses

Venlafaxine (generic for Effexor XR®) is approved by the FDA to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety order (SAD), and panic disorder (PD). Not all mental health conditions can be treated by a provider through our platform. Those who are not candidates for treatment through our platform should consider seeking care from a medical provider in person to evaluate potential options for treatment.