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    Treatment of depressive illness in the initial phase and as maintenance against potential relapse/recurrence. Citalopram is also indicated in the treatment of panic disorder with or without agoraphobia. Citalopram should be administered as a single oral dose of 20 mg daily. Dependent on individual patient response, the dose may be increased to a maximum of 40 mg daily. In general, improvement in patients starts after one week, but may only become evident from the second week of therapy. As with all antidepressant medicinal products, dosage should be reviewed and adjusted, if necessary, within 3 to 4 weeks of initiation of therapy and thereafter as judged clinically appropriate. Although there may be an increased potential for undesirable effects at higher doses, if after some weeks on the recommended dose insufficient response is seen, some patients may benefit from having their dose increased up to a maximum of 40 mg a day (see section 5.1). Citalopram should be administered as a single oral dose, either in the morning or in the evening. The tablets can be taken with or without food, but with fluid. Following treatment initiation, an antidepressant effect should not be expected for at least two weeks. Treatment should continue until the patient has been free of symptoms for 4-6 months. Citalopram should be withdrawn slowly, it is advised that the dose is gradually reduced over 1-2 week periods. Children and adolescents under the age of 18: Dosage adjustment is not required if the patient has mild to moderate renal impairment. No information is available on treatment of patients with severe renal impairment (creatinine clearance less than 30ml/min).

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    Horses & Ponies for Sale News Training/Showing Program Trophy Room 2017 Show Schedule Lesson Program Summer Camp Rehabilitation Services Staff Hippotherapy Boarding Facility Tour History Directions & Map Contact Us Old Friends Links The Patchwork Farm feeding program is tailored to the individual horse, featuring high quality feeds. Our horses are turned out daily on lush grass pastures weather permitting and on wet days they are turned out on all weather paddocks. In the barn, the horses always have hay in front of them. We stock a Kentucky orchard/alfalfa mix hay and a local grass hay for the “fatties”. We like our horses to be able to munch all day, like nature intended. We rely on the expert work of our team’s professionals to keep our horses healthy and happy. Each horse is an individual and is treated as such. It couldn’t be easier for our owners- we handle all scheduling. Payment is made from the owner’s Equine Care Account. Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). It may improve your energy level and feelings of well-being. Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed. Citalopram is known as a selective serotonin reuptake inhibitor (SSRI). This medication works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

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