Citalopram (Celexa)

Celexa

What is citalopram (Celexa) and how does it work?

Citalopram is an antidepressant medication that affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Citalopram was approved by the FDA in July 1998.

Citalopram is approved for treating depression. It is also used off-label for treating:

Do I need a prescription for citalopram (Celexa)?

Yes

What are the side effects of citalopram (Celexa)?

The most common side effects associated with citalopram are

Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Citalopram is also associated with sexual dysfunction. Some patients may experience withdrawal reactions upon stopping citalopram. Symptoms of withdrawal include:

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

What is the dosage for citalopram (Celexa)?

The usual starting dose is 20 mg in the morning or evening. The dose may be increased to 40 mg daily after one week. A dose of 60 mg has not been shown to be more effective than 40 mg. As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often slowly adjusted upwards to find the most effective dose.

Which drugs or supplements interact with citalopram (Celexa)?

All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane). Such combinations may lead to confusionhigh blood pressuretremor, and hyperactivity. If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started. Tryptophan, a common dietary supplement, can cause headachesnauseasweating, and dizziness when taken with any SSRI. Linezolid and intravenous methylene blue are also MAO inhibitors and should not be combined with citalopram.

Use of an SSRI with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.

Celexa side effects

Get emergency medical help if you have signs of an allergic reaction to Celexa: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
  • severe nervous system reaction – very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
  • high levels of serotonin in the body – agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or
  • low levels of sodium in the body – headache, confusion, slurred speech, severe weakness, vomiting, feeling unsteady.

Common Celexa side effects may include:

  • problems with memory or concentration;
  • headache, drowsiness;
  • dry mouth, increased sweating;
  • numbness or tingling;
  • increased appetite, nausea, diarrhea, gas;
  • fast heartbeats, feeling shaky;
  • sleep problems (insomnia), feeling tired;
  • cold symptoms such as stuffy nose, sneezing, sore throat;
  • changes in weight; or
  • difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Celexa?

Taking Celexa with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with citalopram. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cimetidine;
  • lithium;
  • St. John’s wort;
  • tryptophan (sometimes called L-tryptophan);
  • a blood thinner (warfarin, Coumadin, Jantoven);
  • any other antidepressant;
  • heart medication;
  • medicine to treat a psychiatric disorder; or
  • “triptan” migraine headache medicine.

This list is not complete and many other drugs can interact with citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Celexa only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

How should I take Celexa?

Take Celexa exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using Celexa suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Celexa?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Celexa may cause you to bruise or bleed easily.

Drinking alcohol can increase certain side effects of Celexa.

Citalopram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Celexa Generic Name: citalopram (si TAL o pram)

What is Celexa?

Celexa (citalopram) is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Celexa is used to treat depression.

Celexa may also be used for purposes not listed in this medication guide.

Important information

You should not use Celexa if you also take pimozide, as the combination can cause problems with your heart rhythm.

Do not use Celexa if you have used a MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine) or have received a methylene blue injection. A fatal reaction may occur.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give Celexa to anyone younger than 18 years old without the advice of a doctor. Citalopram is not approved for use in children.

Before taking this medicine

You should not use Celexa if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide.

Do not use Celexa if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, or methylene blue injection.

To make sure Celexa is safe for you, tell your doctor if you have:

  • a bleeding or blood clotting disorder;
  • liver or kidney disease;
  • narrow-angle glaucoma;
  • seizures or epilepsy;
  • heart disease, heart failure, a heart rhythm disorder, slow heartbeats, or recent history of heart attack;
  • personal or family history of Long QT syndrome;
  • an electrolyte imbalance (such as low levels of sodium, potassium or magnesium in your blood);
  • bipolar disorder (manic depression); or
  • a history of drug abuse or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine during pregnancy without your doctor’s advice.

Citalopram can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Celexa.

Do not give Celexa to anyone under 18 years old without medical advice. Citalopram is not approved for use in children.

Celexa

Uses

Citalopram is used to treat depression. It may improve your energy level and feelings of well-being. 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.

How to use Celexa

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking citalopram and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication with or without food as directed by your doctor, usually once daily in the morning or evening. The dosage is based on your medical condition, response to treatment, age, laboratory tests, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). The maximum dosage for citalopram is 40 milligrams per day.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

To reduce your risk of side effects, your doctor may direct you to start taking this drug at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

It may take 1 to 4 weeks to feel a benefit from this drug and up to several weeks before you get the full benefit.

Tell your doctor if your condition does not improve or if it worsens.