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Celexa (citalopram)

Profile and Side Effects of Celexa (citalopram)

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Updated October 27, 2008

General Information

Celexa (citalopram) is an SSRI antidepressant manufactured by Forest Laboratories, Inc. Celexa is FDA approved for the treatment of major depressive disorder but is effective and commonly prescribed for the treatment of panic disorder and social anxiety disorder.

Dosage Information

Celexa and its generic equivalent, citalopram, are manufactured in tablets of 10, 20 and 40 mg. It is also available in a liquid oral solution. Your doctor may begin therapy with a low dose that may be increased if your symptoms do not improve. Starting at a low dose can also minimize some of these side effects because it gives your body time to adjust to the medication. Celexa (citalopram) is usually taken once each day and may be taken with or without food.

Side Effects

Some of the common side effects associated with Celexa (citalopram) therapy include:

  • drowsiness
  • Dry mouth
  • Dizziness
  • Nausea
  • Agitation
  • Diarrhea
  • Fatigue
  • Impaired sexual functioning

Some people experience a reduction in some of these side effects after being on the medication for a while. If they remain bothersome, though, you should consult with your doctor.

If you experience any of the following less common side effects, you should call your doctor right away:

  • Agitation or irritability
  • Restlessness
  • Impulsiveness
  • Hyperactivity
  • Tremors
  • Memory problems

You should get emergency medical attention if you experience any of the following rare, but serious, side effects:

  • Allergic Reaction - difficulty breathing; swelling of your face, lips or tongue or difficulty swallowing.
  • Seizures
  • Problems with balance or coordination
  • Confusion
  • Hallucinations
  • Racing or abnormal heart rate
  • Fainting
  • Suicidal thoughts

These are not the only side effects that may be experienced with citalopram. You should report any bothersome side effects to your doctor or other health care professional.

How Long Does Celexa Take to Work?

Some people experience some improvement of symptoms within one or two weeks of starting citalopram. Full therapeutic effect, however, may not be achieved for about eight weeks.

Is Celexa Addictive?

Celexa is not believed to be addictive or habit-forming.

What if I Miss a Dose?

Take the missed dose as soon as you remember unless it’s nearly time to take your next dose. Do not take extra Celexa to make up the missed dose.

Precautions and Contraindications

Pregnancy. Some studies suggest that exposure to SSRIs, including Celexa, during late pregnancy may increase the risk of persistent pulmonary hypertension, a serious lung disorder, in a newborn.

If you are nursing or are pregnant, it is best to discuss the risks and benefits of SSRI therapy with your doctor.

NSAIDs or Aspirin. Use of Celexa with NSAIDs or aspirin may be associated with an increased risk of bleeding.

Liver Disease. Before taking Celexa, tell your doctor if you have impaired liver function. Depending on your condition, your doctor may need to adjust your dose and perform certain tests while on Celexa therapy.

Alcohol. Drinking alcohol with Celexa should be avoided.

This list is not all-inclusive. There are other drug interactions that should be avoided and medical issues your doctor may need to consider. Be sure to tell your doctor about all medications, including over-the-counter drugs and supplements, you are taking before beginning citalopram.

Serotonin Syndrome

Any SSRI antidepressant has a risk of producing a potentially life-threatening condition called "serotonin syndrome." This rare condition is usually the result of an interaction of two or more drugs that affect brain serotonin levels. Even some over-the-counter supplements, such as St. John’s Wort, can result in serotonin syndrome if mixed with SSRIs.

A particularly troublesome interaction is mixing SSRIs with a class of antidepressants called "monoamine oxidase inhibitors" (MAOIs), which should not be taken with SSRIs. It is recommended that Celexa be avoided for 2 weeks before or after using an MAOI.

SSRI Discontinuation Syndrome

Before discontinuing Celexa, talk with your doctor. Some people have reported withdrawal-like symptoms when decreasing or stopping SSRI therapy. It is believed that these symptoms are the result of the brain trying to stabilize serotonin levels after an abrupt change.

Symptoms that may occur during discontinuation of any SSRI therapy include:

  • Nausea
  • Headache
  • Muscle aches
  • Dizziness
  • Electric shock-like sensations in the neck and head

While all of these symptoms are not believed to be dangerous, they can be quite upsetting. When discontinuing an SSRI, your doctor may give you a gradual reduction schedule to avoid these withdrawal-like symptoms.

FDA Black Box Warning

The association of increased suicidal thoughts, especially among adolescents, with SSRI treatment has been a center of attention and controversy in recent years. In response to the concerns suggested in case studies and some research, the U.S. Food and Drug Administration (FDA) issued a statement in 2007. The FDA proposed that makers of all antidepressant medications indicate a warning on their products about a possible increased risk of suicidal thinking and behavior in young adults, ages 18 to 24, during initial treatment.

Sources:

Antidepressant Use in Children, Adolescents, and Adults. Revisions to Product Labeling. U.S. Food and Drug Administration. May 2, 2007.

RxList. Zoloft. 09 Oct 2008.

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