Drug General Information (ID: DDI4KUVIR6)
Drug Name			Citalopram		Drug Info		Dexmethylphenidate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidepressants				Norepinephrine-Dopamine Reuptake Inhibitor
Structure

Mechanism of Citalopram-Dexmethylphenidate Interaction (Severity Level: Moderate)
Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Citalopram				Dexmethylphenidate
Mechanism		SSRIs				Inhibit the metabolism of SSRIs
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased metabolism of Citalopram caused by Dexmethylphenidate

Recommended Action
Management		Pharmacologic response to SSRIs should be monitored more closely whenever methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) is added to or withdrawn from therapy, and the dosage of one or both drugs adjusted as necessary.

References
1	Gammon GD, Brown TE "Fluoxetine and methylphenidate in combination for treatment of attention deficit disorder and comorbid depressive disorder." J Child Adolesc Psychopharmacol 3 (1993): 1-10. [PMID: 19630593]
2	Ishii M, Tatsuzawa Y, Yoshino A, Nomura S "Serotonin syndrome induced by augmentation of SSRI with methylphenidate." Psychiatry Clin Neurosci 62 (2008): 246. [PMID: 18412855]
3	Lavretsky H, Kumar A "Methylphenidate augmentation of citalopram in elderly depressed patients." Am J Geriatr Psychiatry 9 (2001): 298-303. [PMID: 11481139]
4	Lavretsky H, Park S, Siddarth P, Kumar A, Reynolds CF 3rd "Methylphenidate-enhanced antidepressant response to citalopram in the elderly: a double-blind, placebo-controlled pilot trial." Am J Geriatr Psychiatry 14 (2006): 181-5. [PMID: 16473984]
5	Product Information. Concerta (methylphenidate). Alza, Palo Alto, CA.
6	Product Information. Focalin (dexmethylphenidate). Mikart Inc, Atlanta, GA.
7	Stoll AL, Pillay SS, Diamond L, Workum SB, Cole JO "Methylphenidate augmentation of serotonin selective reuptake inhibitors: a case series." J Clin Psychiatry 57 (1996): 72-6. [PMID: 8591972]
8	Findling RL "Open-label treatment of comorbid depression and attentional disorders with co-administration of serotonin reuptake inhibitors and psychostimulants in children, adolescents, and adults: a case series." J Child Adolesc Psychopharmacol 6 (1996): 165-75. [PMID: 9231310]