citalopram + imipramine

Citalopram + imipramine is a combination of two antidepressant medications, each with distinct mechanisms of action. Citalopram is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain by inhibiting its reuptake into presynaptic cells, thereby enhancing serotonergic neurotransmission[4][5][6]. Imipramine is a tricyclic antidepressant (TCA) that works primarily by inhibiting the reuptake of both norepinephrine and serotonin, while also blocking certain adrenergic, histaminergic, and cholinergic receptors[3][7]. This combination may be considered in treatment-resistant depression or when monotherapy has proven insufficient. However, combining these drugs can increase the risk of adverse effects such as serotonin syndrome and cardiac arrhythmias due to additive serotonergic activity and potential for QT prolongation[1][9].