Bendrofluozide causes depletion of folate and since you were having folate deficiency, it was stopped. Your blood pressure would have also been controlled.

Citrpram contains the drug citalopram which is an antidepressant drug used to treat major depression, panic disorder and anxiety. Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs).

Citalopram is generally considered safe and well-tolerated in the therapeutic dose range of 10 to 60 mg/day. It's good that you are on it and feeling much better.

It does have side effects but it is generally well tolerated as I said earlier. Over 10% of patients report one or more of the following side effects: fatigue, drowsiness, dry mouth, increased sweating, trembling, headache, dizziness, sleep disturbances, insomnia, cardiac arrhythmia, hallucinations, blood pressure changes, nausea and/or vomiting, diarrhea e.t.c. Since, you are tolerating it well, you should continue with it. Thanks.



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Edited by Dr. Shariq Riaz on 9/13/2009 at 11:48 AM

Do you have any more questions?


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Edited by Dr. Shariq Riaz on 9/13/2009 at 11:55 AM

Bendrofluazide is a thiazide diuretic which works by inhibiting sodium absorption at the beginning of the distal convoluted tubule. It does cause folate deficiency and since you used it for so many years, it would definitely be responsible for your symptoms. B12 problems are not related to this drug. The deficiency most commonly occurs due to lack of intrinsic factor which is responsible for it's absorption from the intestine. If you were given potassium supplements that too can cause deficiency of vit. B12. Thanks.

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Edited by Dr. Shariq Riaz on 9/13/2009 at 12:09 PM

Any more questions?

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Edited by Dr. Shariq Riaz on 9/13/2009 at 12:19 PM

O.K. I will try to explain it to you in simple terms. Bendrofluazide is a diuretic. It causes folate deficiency but it does not cause deficiency of vit. B12. Since, bendrofluazide also causes deficiency of potassium, some times potassium supplements may be given. That is why I asked about it as potassium can cause vit. B12 deficiency.

Intrinsic factor is present in the intestines of human beings which causes absorption of vit. B12 from the intestine into the blood. So, it's deficiency will also cause vit. B12 deficiency.

Folate deficiency does cause behavioral disorders but panic attacks in your case are not likely to be due to that.

Bendrofluazide can be given for long if the patient is tolerating it well and symptoms like raised uric acid in blood, folate deficiency e.t.c. are not there.

Your panic attacks do not seem to be related to the drugs that you have taken or due to folate deficiency as well. Thanks.

Follow-up questions are welcome.

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Edited by Dr. Shariq Riaz on 9/13/2009 at 1:42 PM

Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is necessary for the absorption of vitamin B12 later on in the terminal ileum(small intestine). In pernicious anemia, an autoimmune disease, autoantibodies directed against intrinsic factor or parietal cells themselves lead to an intrinsic factor deficiency, malabsorption of vitamin B12 which leads to megaloblastic anemia. Atrophic gastritis can also cause intrinsic factor deficiency and anemia through damage to the parietal cells of the stomach wall.

Your panic attacks seems to be well controlled on Citalopram. So, you should continue with that. No body can say whether panic attacks would come again or not but atleast they are well controlled and you should continue the medications as advised by your doctor.

Behavioral problems caused by folate deficiency include forgetfullness, irritability e.t.c. Thanks.


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Edited by Dr. Shariq Riaz on 9/13/2009 at 3:03 PM

Follow-up questions are welcome but you have not accepted any of my answers so far.


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Edited by Dr. Shariq Riaz on 9/13/2009 at 3:47 PM

<p>Thanks and you are most welcome.</p>