Does Citalopram affect norepinephrine levels? (3+ facts)
By
Dr Drielli Vital-Fujii (PhD)
Author bio
Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.
Dr Drielli Vital-Fujii’s Highlights:
- Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.
- PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)
- Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil
Professional Experience:
2012 – 2018 Project manager at University of São Paulo – Pharmacy Department
Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.
2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.
She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).
2018 – 2019 Faculdades Oswaldo Cruz
Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.
2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department
She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.
2023-2023 UniPiaget – University Center.
Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.
Education:
2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo
2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo
2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo
2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes
The leading publications of Dr Drielli Vital-Fujii are:
Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.
Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.
Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.
Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.
Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.
Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.
Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.
Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.
Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.
You can view some of Dr Drielli’s work below and links to her professional profile.
Orcid: https://orcid.org/0000-0001-9270-0466
Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii
Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000
Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR
Linkedin: linkedin.com/in/driellivital
Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital
CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists
In this article, we will discuss whether citalopram affects norepinephrine levels, what is the function of norepinephrine, what research suggests, what are the symptoms of increased and decreased norepinephrine levels, and what to do if you are concerned about this effect of citalopram.
Does citalopram affect norepinephrine levels?
Yes, citalopram can affect the norepinephrine levels in the brain. The impact of citalopram on norepinephrine levels is the subject of ongoing research and debate. While citalopram is primarily designed to target serotonin reuptake, it may indirectly affect norepinephrine levels in some individuals. (1,2)
However, these effects can vary greatly from person to person. It is essential for individuals considering or currently taking citalopram to have open discussions with their healthcare providers regarding their concerns.
What is the function of norepinephrine?
Norepinephrine, or noradrenaline (NA), is a neurotransmitter and hormone produced by the adrenal glands and some neurons in the central nervous system. It is involved in several functions in the body, including:
- Stress response: Norepinephrine is a key component of the body’s “fight or flight” response. When faced with a stressor, norepinephrine is released, increasing heart rate and blood pressure, sharpening focus and awareness, and preparing the body to respond to the perceived threat.
- Mood regulation: Norepinephrine aids in mood control in addition to its function in the stress response. Norepinephrine regulates alertness and arousal, and imbalances in this hormone are associated with mood disorders such as depression.
- Cognitive function: Norepinephrine plays a role in cognitive processes such as attention, memory, and learning. Optimal norepinephrine levels are necessary for these functions to work properly. (3,5)
What does research suggest?
Research into the specific effects of citalopram on norepinephrine levels has yielded mixed results. Some studies suggest that citalopram minimally impacts norepinephrine as it primarily targets serotonin reuptake.
It is important to note that the relationship between neurotransmitters in the brain is complicated, and an alteration in one system can sometimes indirectly affect others. Some people may experience a decrease in the norepinephrine levels in the brain while taking citalopram in the long term. The anti-panic effect of citalopram may occur due to decreased norepinephrine levels in the brain. (2,4)
Another study suggests that citalopram produces a dose-dependent increase in norepinephrine levels in the brain. This study is especially important because several clinical studies suggest that a drug that can inhibit serotonin and norepinephrine uptake is a more potent antidepressant treatment. (5)
What are the symptoms of norepinephrine imbalance?
Symptoms of increased norepinephrine levels:
- Anxiety
- Irritability
- Rapid heartbeat
- Severe headache
- Excessive sweating (3)
Symptoms of decreased norepinephrine levels:
- Depression
- Low blood sugar
- Low blood pressure
- Memory problems
- Irregular heartbeat (3)
What to do if citalopram is affecting norepinephrine levels?
If you are concerned about citalopram affecting your norepinephrine levels, you should openly communicate your fears to your healthcare provider. Individual responses to citalopram can vary. Some may experience an increase in their norepinephrine levels due to their unique neurochemistry, while others may not.
You should communicate all your symptoms to your doctor so they can monitor your condition. If you are experiencing any symptoms related to an increase or decrease in norepinephrine, they may adjust your dose of citalopram because these symptoms can be dose-dependent.
Your doctor can also try to manage your symptoms before considering an alternative. If you have increased anxiety due to increased norepinephrine, they might prescribe a benzodiazepine along with citalopram, such as Xanax or Valium, to manage your anxiety.
If you are experiencing a rapid heartbeat due to increased norepinephrine, they might prescribe you a beta-blocker, such as Inderal, to manage your symptoms. If that does not make you feel better, they may consider prescribing a different antidepressant that does not affect norepinephrine.
You should never discontinue your antidepressant without consulting your doctor, as it can cause severe withdrawal effects.
Conclusion
Drawing from my knowledge and research studies, it is clear that the effect of citalopram on norepinephrine levels is a debated topic, and individual experience can vary. So consult your healthcare provider and make an informed decision before starting your treatment, and if you are already taking citalopram, report your symptoms for appropriate management.
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References
1.-
P David, D. J., Bourin, M., Jego, G., Przybylski, C., Jolliet, P., & Gardier, A. M. (2003). Effects of acute treatment with paroxetine, citalopram and venlafaxine in vivo on noradrenaline and serotonin outflow: A microdialysis study in Swiss mice. British Journal of Pharmacology, 140(6), 1128-1136. https://doi.org/10.1038/sj.bjp.0705538
2.-
Kawahara Y, Kawahara H, Kaneko F, Tanaka M. Long-term administration of citalopram reduces basal and stress-induced extracellular noradrenaline levels in rat brain. Psychopharmacology (Berl). 2007 Sep;194(1):73-81. doi: 10.1007/s00213-007-0826-8. Epub 2007 May 30. PMID: 17534604. https://pubmed.ncbi.nlm.nih.gov/17534604/#:~:text=Conclusion%3A%20The%20present%20results%20indicate,of%20noradrenaline%20in%20the%20brain.
3.-
Bylund, D., & Bylund, K. (2013). Norepinephrine. Encyclopedia of the Neurological Sciences (Second Edition), 614-616. https://doi.org/10.1016/B978-0-12-385157-4.00047-6
4.-
Kaneko F, Kawahara Y, Kishikawa Y, Hanada Y, Yamada M, Kakuma T, Kawahara H, Nishi A. Long-Term Citalopram Treatment Alters the Stress Responses of the Cortical Dopamine and Noradrenaline Systems: the Role of Cortical 5-HT1A Receptors. Int J Neuropsychopharmacol. 2016 Aug 12;19(8):pyw026. doi: 10.1093/ijnp/pyw026. PMID: 27029212; PMCID: PMC5006198. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006198/
5.-
P David, D. J., Bourin, M., Jego, G., Przybylski, C., Jolliet, P., & Gardier, A. M. (2003). Effects of acute treatment with paroxetine, citalopram and venlafaxine in vivo on noradrenaline and serotonin outflow: A microdialysis study in Swiss mice. British Journal of Pharmacology, 140(6), 1128-1136. https://doi.org/10.1038/sj.bjp.0705538
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