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Re: lost eye contact after SSRI - Paxil then Celexa

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What does the PDR say about adverse reactions to those SSRIs?

A while back on another list, a parent posted some PDR sections, not by

typing them in but from a website. Apparently, the PDR is on the web.

buddychance2002 wrote:

>I am writing about my friends son who is 12 and started paxil later

>celexa. He lost all eye contact .It is very sad and disturbing to

>see the change in him. He is less anxious now but his appearance is

>very different.

>I feel like I am forgeting something that may be helpful that I have

>learned here on the list about eye contact and supplements. He is on

>CLO daily.

>Does anyone have any ideas about why this may have caused this awful

>reaction?

>Thanks ,

>mom to

>

>

>

>

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I didn't mean to imply that the PDR will state " loses eye contact " as a

side effect. Instead, the PDR will list bunches and flocks of adverse

possibilities, and among them some clues may arise.

Binstock wrote:

>What does the PDR say about adverse reactions to those SSRIs?

>

>A while back on another list, a parent posted some PDR sections, not by

>typing them in but from a website. Apparently, the PDR is on the web.

>

>

>

>buddychance2002 wrote:

>

>

>

>>I am writing about my friends son who is 12 and started paxil later

>>celexa. He lost all eye contact .It is very sad and disturbing to

>>see the change in him. He is less anxious now but his appearance is

>>very different.

>>I feel like I am forgeting something that may be helpful that I have

>>learned here on the list about eye contact and supplements. He is on

>>CLO daily.

>>Does anyone have any ideas about why this may have caused this awful

>>reaction?

>>Thanks ,

>>mom to

>>

>>

>

>

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Share on other sites

Guest guest

I could not find the PDR online but found medscape , a

long list including blurred vision and much more.

I dont really have a clue to make of it. I am going to

look this list over and wonder about vitamin A .

Mom to

From Medscape:

CELEXA ORAL

Adverse Effects List & Discussion

Adverse Effects List from First Databank

More Frequent

ABNORMAL EJACULATION severe

DECREASED LIBIDO severe

DROWSINESS

DRY MOUTH

IMPOTENCE severe

INSOMNIA

NAUSEA

SEXUAL DYSFUNCTION severe

Less Frequent

ABDOMINAL PAIN

AGITATION severe

AMNESIA, DRUG INDUCED severe

ANOREXIA

ANXIETY

ARTHRALGIA

ASTHENIA

BLURRED VISION severe

BRUXISM

CONFUSION severe

DIARRHEA

DYSPEPSIA

DYSPNEA severe

FATIGUE

FEVER severe

FLATULENCE

INCREASED SALIVATION

INCREASED SWEATING

INCREASED YAWNING

ITCHING severe

MENSTRUAL DISORDERS severe

MYALGIA

ORTHOSTATIC HYPOTENSION

PARESTHESIA

POLYURIA severe

RHINITIS

SINUSITIS

SKIN RASH severe

TASTE PERVERSION

TREMORS

VOMITING

WEIGHT GAIN

WEIGHT LOSS

Rare or Very Rare

AGGRESSIVE BEHAVIOR severe

BLEEDING severe

BREAST ENLARGEMENT severe

BREAST TENDERNESS severe

CARDIAC ARRHYTHMIAS severe

DELUSIONS severe

DEPERSONALIZATION severe

EMOTIONAL LABILITY severe

EPIDERMAL NECROLYSIS severe

EUPHORIA severe

EXTRAPYRAMIDAL EFFECTS severe

GALACTORRHEA (IN FEMALES) severe

HALLUCINATIONS severe

HYPOMANIA/MANIA(BIPOLAR DISORDER) severe

HYPONATREMIA severe

MENTAL CHANGES severe

MICTURITION DISTURBANCES(DYSURIA) severe

MOOD CHANGES severe

PANIC REACTION severe

PARANOIA severe

PSYCHOSIS severe

SEROTONIN SYNDROME severe

SUICIDAL IDEATION severe

THROMBOCYTOPENIA severe

Binstock wrote:

---------------------------------

I didn't mean to imply that the PDR will state " loses

eye contact " as a

side effect. Instead, the PDR will list bunches and

flocks of adverse

possibilities, and among them some clues may arise.

Yahoo!

______________________________________________________________________

Post your free ad now! http://personals.yahoo.ca

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Thnx for the list. Amazing list -- prompting concern that people taking

Celexa ought be paid so to do, and paid well!

I wonder what prompted the summary word " DEPERSONALIZATION " . Lack of eye contact

(etc) in the people who so reacted?

The search

celexa OR citalopram

today generated 1800+ citations, here's a small smattering therefrom:

The search

(celexa[ti] OR citalopram[ti]) AND adverse

generated 212 citations, an additional sampling follows after the ##########

1: Neuropsychopharmacology. 2004 May 19 [Epub ahead of print]

Inhibition of G Protein-Activated Inwardly Rectifying K(+) Channels by Various

Antidepressant Drugs.

Kobayashi T, Washiyama K, Ikeda K.

1Department of Molecular Neuropathology, Brain Research Institute, Niigata,

University, Niigata, Japan.

G protein-activated inwardly rectifying K(+) channels (GIRK, also known as Kir3)

are activated by various G protein-coupled receptors. GIRK channels play an

important role in the inhibitory regulation of neuronal excitability in most

brain regions and the heart rate. Modulation of GIRK channel activity may affect

many brain functions. Here, we report the inhibitory effects of various

antidepressants: imipramine, desipramine, amitriptyline, nortriptyline,

clomipramine, maprotiline, and citalopram, on GIRK channels. In Xenopus oocytes

injected with mRNAs for GIRK1/GIRK2, GIRK2 or GIRK1/GIRK4 subunits, the various

antidepressants tested, except fluvoxamine, zimelidine, and bupropion,

reversibly reduced inward currents through the basal GIRK activity at micromolar

concentrations. The inhibitions were concentration-dependent with various

degrees of potency and effectiveness, but voltage- and time-independent. In

contrast, Kir1.1 and Kir2.1 channels in other Kir channel subfamilies were

insensitive to all of the drugs. Furthermore, GIRK current responses activated

by the cloned A(1) adenosine receptor were similarly inhibited by the tricyclic

antidepressant desipramine. The inhibitory effects of desipramine were not

observed when desipramine was applied intracellularly, and were not affected by

extracellular pH, which changed the proportion of the uncharged to protonated

desipramine, suggesting its action from the extracellular side. The GIRK

currents induced by ethanol were also attenuated in the presence of desipramine.

Our results suggest that inhibition of GIRK channels by the tricyclic

antidepressants and maprotiline may contribute to some of the therapeutic

effects and adverse side effects, especially seizures and atrial arrhythmias in

overdose, observed in clinical practice.Neuropsychopharmacology advance online

publication, 19 May 2004; doi:10.1038/sj.npp.1300484

PMID: 15150531 [PubMed - as supplied by publisher]

1: Eur J Clin Pharmacol. 2004 May 28 [Epub ahead of print]

Impact of polymorphisms of cytochrome-P450 isoenzymes 2C9, 2C19 and 2D6 on

plasma concentrations and clinical effects of antidepressants in a naturalistic

clinical setting.

Grasmader K, Verwohlt PL, Rietschel M, Dragicevic A, Muller M, Hiemke C,

Freymann N, Zobel A, Maier W, Rao ML.

Department of Psychiatry, University of Bonn, Sigmund-Freud-Strasse 25, 53105,

Bonn, Germany.

OBJECTIVE. This evaluation focuses on polymorphisms of the cytochrome-P450 (CYP)

isoenzymes 2C9, 2C19 and 2D6 and their association with plasma concentrations

within a typical clinical setting. Side effects and treatment response were

analysed in an exploratory approach in poor and ultra-rapid metabolisers.

PATIENTS AND METHODS. We analysed 136 Caucasian depressed inpatients treated

with amitriptyline, citalopram, clomipramine, doxepin, fluvoxamine, mirtazapine,

paroxetine, sertraline and venlafaxine, who underwent weekly plasma

concentration measurements, assessment of the severity of illness and side

effects during their stay in the hospital. Patients were genotyped with respect

to CYP2C9 alleles *1 and *2, the CYP2C19 alleles *1, *2 and *3 and the CYP2D6

alleles *1 to *9 and CYP2D6 gene duplication. RESULTS. CYP2D6 poor metaboliser

genotype and co-medication with inhibitors of CYP2D6 were associated with higher

plasma concentrations than the drug-specific median plasma concentration when

normalised to dose; plasma concentrations of CYP2C19 extensive metabolisers and

smokers were significantly lower than the drug-specific median. Five of the six

CYP2D6 poor metabolisers experienced side effects. Response was not associated

with plasma concentrations above or below the lower limit of a presumed

therapeutic range. CONCLUSION. These data indicate a significant influence of

the CYP2D6 genotype, minor influence of the CYP2C19 genotype and no influence of

the CYP2C9 genotype on plasma concentrations of patients taking mainly

second-generation antidepressants. Because of the good tolerability of the

latter and the flat dose-response relationship, genotyping should only be

considered in cases of suspected side effects.

2: J Dev Behav Pediatr. 2003 Apr;24(2):104-8.

Use of citalopram in pervasive developmental disorders.

Namerow LB, P, Bostic JQ, Prince J, Monuteaux MC.

Department of Psychiatry, Hartford Hospital, University of Connecticut School of

Medicine, Hartford, Connecticut 06106, USA.

This study assessed the effectiveness and tolerability of the selective

serotonin reuptake inhibitor citalopram in the treatment of patients with

pervasive developmental disorders (PDDs). The medical charts of 15 children and

adolescents (aged 6-16 yr) with Asperger syndrome, autism, or PDD not otherwise

specified treated with citalopram were retrospectively reviewed. The final dose

of citalopram was 16.9 +/- 12.1 mg/day with a treatment duration of 218.8 +/-

167.2 days. Independent ratings of the Clinical Global Impression (CGI) Severity

and Improvement scales allowed comparison between baseline and PDD symptoms at

the last visit. Eleven adolescents (73%) exhibited significant improvement in

PDD, anxiety, or mood CGI score (z = 2.95; p =.003). Anxiety symptoms associated

with PDDs improved significantly in 66% of patients (z = 2.83, p =.005), and

mood symptoms improved significantly in 47% of patients (z = 2.78, p =.005).

Mild side effects were reported by five patients (33%). These data suggest

citalopram may be effective, safe, and well tolerated as part of the treatment

of PDDs.

Publication Types:

Evaluation Studies

PMID: 12692455 [PubMed - indexed for MEDLINE]

3: J Child Adolesc Psychopharmacol. 2002 Fall;12(3):243-8.

A retrospective assessment of citalopram in children and adolescents with

pervasive developmental disorders.

Couturier JL, Nicolson R.

Department of Psychiatry, University of Western Ontario, London, Ontario,

Canada.

Although selective serotonin reuptake inhibitors have been used to treat

symptoms of aggression and anxiety in children and adolescents with pervasive

developmental disorders (PDDs), there are no published reports of the use of

citalopram in this population. The purpose of this study was to examine the

benefits and adverse effects of citalopram in a group of children and

adolescents with PDDs. Target behaviors included aggression, anxiety,

stereotypies, and preoccupations. Seventeen patients with PDDs (14 with autistic

disorder, three with Asperger's disorder) (mean age = 9.4 +/- 2.9 years; range

4-15 years) were treated with citalopram for at least 2 months (mean duration of

treatment = 7.4 +/- 5.3 months; range 1-15 months). Treatment was initiated at a

low dose (5 mg daily) and was increased by 5 mg weekly as tolerated and as

necessary. The mean final dose was 19.7 +/- 7.8 mg (range 5-40 mg). Outcome was

based on a consensus between clinician and parents, using the Improvement item

of the Clinical Global Impressions Scale as a guide. Ten (59%) children were

judged to be much improved or very much improved regarding target behaviors.

Core symptoms of PDDs (social interactions, communication) did not show

clinically significant improvement. Citalopram was generally well tolerated,

although four patients developed treatment-limiting adverse effects: two with

increased agitation, one with insomnia, and one with possible tics. The results

of this case series suggest that citalopram has beneficial effects on some

interfering behaviors associated with PDDs with few adverse effects. Controlled

trials are warranted.

PMID: 15168101 [PubMed - as supplied by publisher]

#############################

2: [Wow! This study appears to be a " let's endorse citalopram " by using small

samples that blur statistical artifacts when comparing the three groups. Note

the 10% adverse reaction rate in group 1 -- who cares! Let's promote

citalopram.]

Am J Obstet Gynecol. 2004 Jan;190(1):218-21.

Frequency of infant adverse events that are associated with citalopram use

during breast-feeding.

Lee A, Woo J, Ito S.

Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children,

and the Department of Pharmacology, University of Toronto, Toronto, Ontario,

Canada.

OBJECTIVE: The purpose of this study was to determine the frequency of infantile

adverse events from exposure through breast-feeding to maternal citalopram

therapy. STUDY DESIGN: This was a prospective, observational cohort study. Women

who were breast-feeding were placed in three groups on the basis of citalopram

use: group 1 consisted of 31 women who were depressed and were undergoing

citalopram therapy, group 2 consisted of 12 women who were depressed but were

not undergoing citalopram therapy, and group 3 consisted of 31 healthy women who

were matched to group 1 by maternal age and parity. Data collection included

infant feeding method, medication use, and adverse events. RESULTS: There was no

statistically significant difference in the rate of adverse events in the three

groups (3/31 events, 0/12 events, and 1/31 events in groups 1, 2, and 3,

respectively). The average dose of citalopram that was used in group 1 was

25.3+/-11.4 mg per day (range, 10-60 mg/d). CONCLUSION: To our knowledge, this

is the first prospective, controlled study to examine the safety of citalopram

during breast-feeding, which should be continued during maternal citalopram

therapy.

PMID: 14749663 [PubMed - indexed for MEDLINE]

3: Psychopharmacol Bull. 2003 Winter;37(1):96-121.

Overview of the safety of citalopram.

Nemeroff CB.

Department of Psychiatry and Behavioral Sciences, Emory University School of

Medicine, Atlanta, Georgia, USA. LXK18@...

Citalopram is a highly selective serotonin reuptake inhibitor (SSRI) that has

been prescribed to >30 million patients in >70 countries. The purpose of this

focused overview is to summarize the data from well-controlled clinical trials

and published literature relative to the safety of citalopram in patients with

depression and depressive symptoms. This overview is based mainly on 3 sources:

(1) data from clinical trials sponsored by Forest Laboratories, (2) published

clinical studies, and (3) case reports. Both pharmacokinetic and pharmacodynamic

interactions were scrutinized, as were data on special populations and safety

concerns. The available data suggest that citalopram 20-60 mg once daily is safe

for patients with depression. Few drugs appear to interact with citalopram in a

clinically meaningful way. Well-designed short- and long-term trials demonstrate

an overall safety/side effect profile consistent with other SSRIs. The more

frequent adverse events (nausea, somnolence, dry mouth, increased sweating) are

mainly transient, mostly mild to moderate in severity, and observed consistently

across studies at rates similar to other SSRIs. Analysis of laboratory values,

ECG, and vital signs revealed no unusual findings. Only a small, clinically

unimportant reduction in heart rate was observed, similar to that seen with

other SSRIs. Citalopram treatment did not increase risk of suicide, overdose,

seizure, or arrhythmia. Thus, the pharmacodynamic, pharmacokinetic, and safety

profiles of citalopram demonstrate that it is safe for use in adults with

depression and depressive symptoms, including the elderly and patients with mild

to moderate renal and hepatic disease.

PMID: 14561952 [PubMed - in process]

4: J Clin Psychiatry. 2003 May;64(5):562-7.

Citalopram treatment of fluoxetine-intolerant depressed patients.

Calabrese JR, Londborg PD, Shelton MD, Thase ME.

Mood Disorders Program, Case Western Reserve University School of Medicine,

Cleveland, Ohio 44106, USA. jrc8@...

BACKGROUND: We assessed the tolerability of and response to citalopram in

depressed patients who had discontinued fluoxetine treatment due to adverse

events. METHOD: Fifty-five outpatients with DSM-IV major depressive disorder and

a confirmed history of intolerance to fluoxetine (mean final dose = 24.6 mg/day)

were switched to citalopram (20 mg/day) after a 2- to 4-week single-blind

placebo washout period. During a 6-week, open-label treatment protocol,

citalopram could be titrated up to 40 mg/day. Safety and tolerability, including

reemergence of symptoms that previously had been associated with fluoxetine,

were assessed by recording all spontaneously reported or observed adverse

events. Efficacy was evaluated using the Hamilton Rating Scale for Depression

(HAM-D), the Clinical Global Impressions (CGI) scale, and several other

measures. Response was defined as a CGI-Improvement score at endpoint of 1 or 2

(i.e., very much or much improved). RESULTS: Ninety-five percent of patients (N

= 52) completed the citalopram trial. The only adverse events reported by more

than 5 patients (>or= 10%) were pharyngitis (15%) and constipation (11%), and

none of the 3 early terminations were attributed to adverse events. The rate of

recurrence of the fluoxetine-associated adverse events was low, with headache (3

[27%] of 11 cases), nausea (2 [22%] of 9 cases), and decreased libido (5 [18%]

of 28 cases) being the most common. Significant improvement from baseline HAM-D

(p <.001) was observed by the first week of citalopram therapy and continued

until study end. The intent-to-treat CGI response rate was 65% (36 of 55

patients) at study endpoint; 69% (36 of 52 patients) of the completers

responded. CONCLUSION: These data suggest that fluoxetine-intolerant patients

can be treated effectively with citalopram.

Publication Types:

Clinical Trial

PMID: 12755660 [PubMed - indexed for MEDLINE]

5: Epilepsy Behav. 2000 Dec;1(6):444-447.

Treatment of Interictal Depression with Citalopram in Patients with Epilepsy.

Hovorka J, Herman E, Nemcova I I.

Neurology and Neuropsychiatry Department, The Na Frantisku Hospital, Prague 1,

Czech Republic

The purpose of this study is to assess the efficacy and safety of the selective

serotonin-reuptake inhibitor (SSRI) citalopram in depressed epileptic patients.

We evaluated 43 epileptic patients who suffered from depression and whose total

score on the 21 items of the Hamilton Scale for Depression (HAMD 21) exceeded 15

points. These patients were examined by the psychiatrist and scaled before

treatment and after 4 and 8 weeks of treatment with citalopram. The dose of

citalopram was flexible, related to the actual condition of the patient. In each

patient and in the whole group of patients we compared the monthly seizure

frequency (total, partial seizures, generalized tonic-clonic seizures) recorded

during treatment with citalopram with that recorded during the 2 months

preceding the start of citalopram. During treatment we observed a decrease in

the total score on the HAMD 21 from a mean initial value of 21.5 +/- 2.9 (range,

17-26) prior to therapy 14.5 +/- 2.9 (range, 10-19) (P < 0.001) after 4 weeks of

treatment and to 9.9 +/- 3.1 (range, 4-19) (P < 0.001) after 8 weeks of

treatment. There were 9 (20.9%) responders after 4 weeks of treatment and 28

responders (65.1%) after 8 weeks, all of them with decrease on the HAMD 21

greater than 50%. Nausea was the most common adverse event in 7 patients (16.3%)

during the first month of treatment and in 3 patients (6.9%) during the second

month of treatment. Sexual dysfunction (decrease of libido) was reported in 2

(4.7%) male patients during the entire course of treatment. No seizure worsening

was observed in our patients. Monthly seizure frequency did not change

significantly: 2.24 (+/-0.76) seizures before treatment with citalopram, 2.29

(+/-0.81) seizures in the first month of treatment, 2.21 (+/-1.00) seizures in

the second month of treatment. No occurrence of de novo generalized tonic-clonic

seizures was recorded in individual patients. Citalopram is a safe and effective

antidepressant in the treatment of depressed epileptic patients.

PMID: 12737834 [PubMed - as supplied by publisher]

6: Clin Infect Dis. 2003 May 1;36(9):1197. Epub 2003 Apr 21.

Comment in:

Clin Infect Dis. 2003 Nov 1;37(9):1274-5.

Serotonin syndrome after concomitant treatment with linezolid and citalopram.

Bernard L, Stern R, Lew D, Hoffmeyer P.

Division of Orthopaedic Surgery, Geneva University Hospital, Geneva,

Switzerland. louis.bernard@...

Linezolid, a new synthetic antimicrobial, is an important weapon against

methicillin-resistant Staphylococcus aureus (MRSA). Although there are reports

of serotonin syndrome developing after concomitant use of linezolid and the

selective serotonin reuptake inhibitor paroxitene, this report concerns a

patient receiving citalopram who developed thrombocytopenia, serotonin syndrome,

and lactic acidosis and died following long-term linezolid therapy.

PMID: 12715317 [PubMed - indexed for MEDLINE]

7: Hum Psychopharmacol. 2002 Dec;17(8):401-5.

Efficacy of citalopram and moclobemide in patients with social phobia: some

preliminary findings.

Atmaca M, Kuloglu M, Tezcan E, Unal A.

Firat (Euphrates) University, School of Medicine, Department of Psychiatry,

23119 Elazig, Turkey. matmaca_p@...

The efficacy of irreversible and reversible monoamine oxidase inhibitors (MAOIs)

in the treatment of social phobia (SP) is well established. Recently, selective

serotonin reuptake inhibitors (SSRIs) have been used more frequently. In the

present study, the efficacy and side-effect profile of citalopram, an SSRI, and

moclobemide, the only MAOI used in Turkey, were compared. The 71 patients

diagnosed with SP according to DSM-III-R were randomly assigned to two

subgroups; citalopram (n = 36) or moclobemide (n = 35). The study was an 8-week,

randomized, open-label, rater-blinded, parallel-group trial. All patients were

assessed by Hamilton anxiety rating (HAM-A), Liebowitz social anxiety (LSAS),

clinical global impression-severity of illness (CGI-SI) and clinical global

impression-improvement (CGI-I) scales. There was a similar percentage of

responders (citalopram 75%, n = 27 and moclobemide 74.3%, n = 26), with a >50%

or greater reduction in LSAS total score and ratings of " very much " or " much

improved " on the CGI-I. None of the patients withdrew from the study. The

results of the present study suggest that citalopram has shown promising results

in patients with SP. Copyright 2002 Wiley & Sons, Ltd.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 12457375 [PubMed - indexed for MEDLINE]

8: Depress Anxiety. 2002;16(3):128-33.

Citalopram treatment of paroxetine-intolerant depressed patients.

Thase ME, Ferguson JM, Lydiard RB, Wilcox CS.

Department of Psychiatry, University of Pittsburgh School of Medicine, Western

Psychiatric Institute Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213-2593,

USA. thaseme@...

We assessed the tolerability and antidepressant response to citalopram in a

group of patients who could not tolerate a recent trial of paroxetine therapy.

Sixty-one outpatients with major depressive disorder and a confirmed history of

intolerance to paroxetine (mean final dose: 26.7 mg/day) were switched after at

least a 1 week washout to citalopram therapy (20 mg/day). During the 6-week,

open label treatment protocol, citalopram could be titrated up to a maximum dose

of 40 mg/day. Response was evaluated using the Clinical Global Impressions CGI

scale, the 24-item Hamilton Rating Scale for Depression, and several other

measures of symptoms and quality of life. Fifty-three patients (87%) completed 6

weeks of citalopram therapy (mean intent-to-treat dose: 23.9 mg/day). The

specific side effects that were reported to be intolerable during the earlier

paroxetine trial typically recurred only less than 30% of the time during

citalopram therapy; only 6 patients (10%) dropped out because of adverse events.

The intent-to-treat CGI response rate was 56% at study endpoint; 62% of the

completers responded. Significant improvement from pretreatment was observed on

various symptom measures after two weeks of citalopram therapy. Citalopram

therapy was well tolerated, and more than one half of the patients who began

treatment improved significantly. Although further work is necessary to assess

the relative merits of this within-class switching strategy (as compared to

other options), these data provide further evidence that the various selective

serotonin reuptake inhibitors do not have interchangeable tolerability profiles.

Copyright 2002 Wiley-Liss, Inc.

Publication Types:

Clinical Trial

Multicenter Study

PMID: 12415538 [PubMed - indexed for MEDLINE]

S F wrote:

>I could not find the PDR online but found medscape , a

>long list including blurred vision and much more.

>

>I dont really have a clue to make of it. I am going to

>look this list over and wonder about vitamin A .

>

>Mom to

>

>

>>From Medscape:

>

>

>CELEXA ORAL

>Adverse Effects List & Discussion

> Adverse Effects List from First Databank

>

>

>

>

>

>

>More Frequent

>ABNORMAL EJACULATION severe

>DECREASED LIBIDO severe

>DROWSINESS

>DRY MOUTH

>IMPOTENCE severe

>INSOMNIA

>NAUSEA

>SEXUAL DYSFUNCTION severe

>Less Frequent

>ABDOMINAL PAIN

>AGITATION severe

>AMNESIA, DRUG INDUCED severe

>ANOREXIA

>ANXIETY

>ARTHRALGIA

>ASTHENIA

>BLURRED VISION severe

>BRUXISM

>CONFUSION severe

>DIARRHEA

>DYSPEPSIA

>DYSPNEA severe

>FATIGUE

>FEVER severe

>FLATULENCE

>INCREASED SALIVATION

>INCREASED SWEATING

>INCREASED YAWNING

>ITCHING severe

>MENSTRUAL DISORDERS severe

>MYALGIA

>ORTHOSTATIC HYPOTENSION

>PARESTHESIA

>POLYURIA severe

>RHINITIS

>SINUSITIS

>SKIN RASH severe

>TASTE PERVERSION

>TREMORS

>VOMITING

>WEIGHT GAIN

>WEIGHT LOSS

>Rare or Very Rare

>AGGRESSIVE BEHAVIOR severe

>BLEEDING severe

>BREAST ENLARGEMENT severe

>BREAST TENDERNESS severe

>CARDIAC ARRHYTHMIAS severe

>DELUSIONS severe

>DEPERSONALIZATION severe

>EMOTIONAL LABILITY severe

>EPIDERMAL NECROLYSIS severe

>EUPHORIA severe

>EXTRAPYRAMIDAL EFFECTS severe

>GALACTORRHEA (IN FEMALES) severe

>HALLUCINATIONS severe

>HYPOMANIA/MANIA(BIPOLAR DISORDER) severe

>HYPONATREMIA severe

>MENTAL CHANGES severe

>MICTURITION DISTURBANCES(DYSURIA) severe

>MOOD CHANGES severe

>PANIC REACTION severe

>PARANOIA severe

>PSYCHOSIS severe

>SEROTONIN SYNDROME severe

>SUICIDAL IDEATION severe

>THROMBOCYTOPENIA severe

>

>

>

>

>

>Binstock wrote:

>---------------------------------

>I didn't mean to imply that the PDR will state " loses

>eye contact " as a

>side effect. Instead, the PDR will list bunches and

>flocks of adverse

>possibilities, and among them some clues may arise.

>Yahoo!

>

>______________________________________________________________________

>Post your free ad now! http://personals.yahoo.ca

>

>

>

>Many frequently asked questions and answers can be found at

<http://forums.autism-rxguidebook.com>

>

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