Abstract
While reviewing a batch of repeat medication scripts, you come across a request for a month's supply of 40 mg citalopram tablets. It is for a woman who you saw last week and it strikes you as odd as you recall issuing her with a month's supply of citalopram at this appointment. You also recall thinking she seemed more depressed.
What are your next steps?
You call the patient to discuss her request. During the discussion, she becomes tearful and admits that she has been hoarding citalopram and was intending to overdose.
How would you handle this situation?
What are the risks of citalopram in overdose? How does this compare with risks of other antidepressants?
Outline the important aspects of reviewing repeat prescriptions.
Helpful links
National Institute for Health and Clinical Excellence. Depression: updated Edition (2009). Retrieved from www.nice.org.uk/nicemedia/live/12329/45896/45896.pdf
National Prescribing Centre. Repeat prescribing. Retrieved from www.npc.nhs.uk/repeat_medication/repeat_prescribing
National Prescribing Centre. Saving time, helping patients—a good practice guide to quality repeat prescribing (2004). Retrieved from www.npc.nhs.uk/repeat_medication/repeat_prescribing/resources/library_good_practice_guide_repeatprescribingguide_2004.pdf
Newcastle, North Tyneside and Northumberland Mental Health NHS Trust. Suicide risk: a guide for primary care and mental health staff (2001). Retrieved from www.gp-training.net/training/tutorials/clinical/psychiatry/suicide.pdf
National Poisons Information Centre. Toxbase. Retrieved from www.toxbase.org
MHRA Drug Safety Update. Citalopram and escitalopram: QT interval prolongation - new maximum daily dose restrictions (including elderly patients), contraindications, and warnings (2011). www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON137769