course material

1. Citalopram for Lactating Mothers with Postpartum Depression (PPD).
Citalopram for Lactating Mothers with Postpartum Depression (PPD). DNP 664 Assignment
Session 2Session 2 Assignment (25 points): For session assignments, each student is to
choose one of the topic options below and write a 300-word evidence-based summary to
include topic specific pharmacodynamics and pharmacokinetics, special considerations, and
precautions. Include a minimum of 2 resources (i.e. research, EBP, clinical guidelines). Post
to the session discussion (faculty will evaluate assignments directly from the session
discussion). The summary is due to be posted to the session discussion by midnight the first
Sunday of the session. Refer to Session Assignment Rubric and Guidelines.Citalopram for
Lactating Mothers with Postpartum Depression (PPD).ORDER A PLAGIARISM-FREE PAPER
HERE Choose 1 of the following topic option and post summaryAn agent utilized for
treatment of a disorder for the one of the following populations: pediatric,
pregnancy/lactating, or geriatric; orExplore immunization agents, pros and cons, and/or
controversial aspects with focus on pediatric population; orA topical agent utilized for an
ear, eye, nose, or mouth disorder.A dermatologic agent for treatment of a skin disorder with
focus on a special population.Citalopram for Lactating Mothers with Postpartum Depression
(PPD)Postpartum depression is a psychiatric condition that affects women after giving
birth. It is a serious pathological manifestation of the so-called ‘baby blues’ and is estimated
to affect about 14% of postpartum mothers (Kim et al., 2014; McIntosh, 2014).
Pharmacotherapy includes the use of atypical antidepressants known as selective serotonin
reuptake inhibitors or SSRIs. One of these that has been tried in several randomized
controlled trials (RCTs) and found to be effective is citalopram (Celexa), despite the fact that
SSRIs enter breast milk and cross the blood-brain barrier (Katzung, 2018; Stahl,
2017).Citalopram for Lactating Mothers with Postpartum Depression (PPD).Pharmacology
of Citalopram (Celexa)PharmacokineticsCitalopram is taken orally and quickly absorbed
reaching peak plasma concentrations after 1-4 hours. It is lipophilic and therefore gets to be
widely distributed (high bioavailability) in the body. Its metabolism is by the cytochrome
P450 isoenzymes in the liver through first pass effect. Up to 23% of the drug is excreted
unchanged in the urine, while another estimated 10% is excreted by the fecal route
(Sangkuhl et al., 2011).PharmacodynamicsCitalopram works by blocking the reuptake
pump of the neurotransmitter serotonin (also known as serotonin transporter). It also
boosts serotonin and increases its neurotransmission while desensitizing its receptors
(Katzung, 2018; Stahl, 2017).Special ConsiderationsCitalopram should not be given at doses
higher than 40 mg per day due to the risk of abnormal conductivity of the heart

2. (arrhythmias). It should also be given only once a day. Although tapering is wise, it is not
necessary to taper citalopram for fear of withdrawal symptoms (Stahl, 2017).Citalopram for
Lactating Mothers with Postpartum Depression (PPD).PrecautionsThe behavior of the child
should be noted before treatment commencement to act as a baseline. If a change occurs,
the drug can be changed to sertraline (another SSRI with proven efficacy and good safety
profile in PPD). Concurrent use of tramadol may cause seizures, and the drug should never
be used together with monoamine oxidase inhibitors or MAOIs (Katzung, 2018; Stahl,
2017). Citalopram for Lactating Mothers with Postpartum Depression (PPD).