Celexa: Side effects, appropriate dosage, applications, and additional details
What is Citalopram?
Celexa: Side effects, appropriate dosage, applications, and additional details
Citalopram is a widely-used prescription drug, marketed under the brand name Celexa. It's primarily employed to combat mood disorders in adults. These disorders often manifest as feelings of extreme sadness and a loss of interest in activities once enjoyed.
Citalopram falls under the category of antidepressants. More specifically, it belongs to the class of selective serotonin reuptake inhibitors (SSRIs). This classification signifies a group of medications that work in a similar manner.
Citalopram is administered in the form of a daily tablet.
The use of Citalopram is not endorsed for individuals below the age of adulthood. Not enough studies have been conducted to recommend its use in this age group.
Efficacy
Research conducted over a period of 4 to 6 weeks showed that depression symptoms lessened more significantly in participants taking Citalopram, compared to those given a placebo.
Long-term studies also revealed that individuals who showed improvement in their depression symptoms while on Citalopram were less likely to experience a relapse, compared to those on a placebo.
Generic Citalopram
Citalopram is commercially available as a branded drug under the name Celexa. It's also available in its generic form, known as citalopram. A generic drug is an exact replica of its branded counterpart, often offering lower prices.
Citalopram consists of a single active ingredient: citalopram. This component is responsible for the drug's therapeutic effects.
In addition to its tablet form, citalopram is also available as an oral liquid solution and as a dissolvable tablet.
Citalopram Side Effects
Citalopram can induce mild or serious adverse effects. The following descriptions provide some of the most common side effects that may develop while using Citalopram. These lists do not encompass all potential side effects.
For additional information on Citalopram's potential side effects, consult your doctor or pharmacist. They can offer advice on managing bothersome side effects.
Note: The Food and Drug Administration (FDA) monitors the side effects of approved drugs. If you wish to report an adverse effect you've experienced with Citalopram, you can do so through MedWatch.
More frequent side effects
More common side effects of Citalopram may include:
- Sweating, including hot flashes
- Tremors
- Gastrointestinal issues, such as nausea, vomiting, diarrhea, stomach upset, and constipation
- Fatigue or drowsiness
- Muscle or joint aches
- Insomnia (difficulty sleeping)
- Anxiety or restlessness
- Appetite changes
- Weight gain or weight loss
- Dysmenorrhea (painful menstrual periods)
- Sexual issues, such as decreased interest in sex, ejaculatory disorder, and erectile dysfunction
- Upper respiratory infection (infection of the nose or throat)
Most of these side effects typically subside within a few days or a couple of weeks. If they worsen or persist, speak with your doctor or pharmacist.
Serious side effects
Serious side effects from Citalopram are relatively uncommon, but they can occur. Contact your doctor immediately if you experience serious side effects. Dial 911 if your symptoms appear life-threatening or if you think you're experiencing a medical emergency.
Serious side effects and their symptoms can include the following:
- Suicidal thoughts and behaviors.* Symptoms can include:
- thoughts of harming oneself
- worsening depression or anxiety
- feelings of agitation or irritability
- aggressive behaviors
- abnormal changes in behavior or feelings
- Withdrawal symptoms when you stop using the drug. For more details, see the “Citalopram withdrawal” section below.
- Hyponatremia (low sodium levels). Symptoms can include:
- headache
- confusion
- weakness or unsteadiness
- fainting
- Mania or hypomania (excessive energy or period of high energy). Symptoms can include:
- increased energy
- restlessness
- trouble sleeping
- racing thoughts
- Bleeding. Symptoms can include:
- easy bruising
- nosebleeds
- blood in urine or stool
- QT prolongation and torsades de pointes (types of heart rhythm problems). Symptoms can include:
- heart palpitations
- dizziness
- fainting
- Serotonin syndrome (high levels of serotonin). Symptoms can include:
- sweating or fever
- tremor
- blood pressure changes
- racing heart
- agitation
- dizziness
- Seizures (changes in brain electrical activity). Symptoms can include:
- dizziness
- sudden muscle movements
- changes in vision
- sudden feelings of anxiety
Contact your local emergency services or dial their designated number.
Maintain your presence with the individual until professional assistance arrives.
Eliminate any firearms, medications, or other potentially hazardous items.
Listen attentively to the person without passing judgment.
For those grappling with suicidal thoughts, a 24/7 crisis hotline can provide assistance. The National Suicide Prevention Lifeline is reachable at 1-800-273-8255. For individuals with hearing impairments, call 1-800-799-4889.
Adverse reactions in children
Celexa isn’t authorized for juvenile use and could exacerbate suicidal tendencies in children.* For more details, refer to "Suicidal thoughts and behaviors" under "Side effect details" below.
Side effect details
You might be curious about the frequency of certain side effects associated with this medication.* Here are some details on several potential side effects caused by Celexa.
Hypersensitivity reaction
Like most drugs, some users may experience a hypersensitivity reaction after ingesting Celexa. However, there are no studies providing data on the prevalence of hypersensitivity reactions in Celexa users. Symptoms of a mild hypersensitivity reaction can include:
- skin rash
- itching
- flushing (warmth and reddening of the skin)
A severe hypersensitivity reaction is rare but possible. Symptoms of a severe hypersensitivity reaction can include:
- swelling beneath the skin, typically around the eyes, lips, hands, or feet
- swelling of the tongue, mouth, or throat
- difficulty breathing or speaking
Contact your doctor promptly if you experience a severe hypersensitivity reaction to Celexa. Contact emergency services if your symptoms appear life-threatening or if you believe you are experiencing a medical emergency.
Weight fluctuation
Changes in appetite might be observed with Celexa use, which could lead to weight gain or weight loss. In clinical trials, weight changes were minimal and affected at least 1% of people who took Celexa. In some studies, individuals who took Celexa lost around 1 lb. In contrast, people who took a placebo (treatment with no active drug) did not lose weight.
The number of people who gained weight while using Celexa or the extent of the weight gain is not known. Additionally, the trials did not include a placebo comparison for weight gain.
Remember that depression itself might cause alterations in appetite and weight. If you are taking Celexa and experience excessive weight loss or weight gain of more than a few pounds, it's essential to discuss this with your doctor. They can examine the underlying causes and offer helpful treatment options.
Sexual side effects
Sexual issues might emerge during Celexa usage. Both males and females who take the drug could experience a decline in libido. Men who take Celexa might also encounter erectile dysfunction or changes in ejaculation (mainly a delay in ejaculation).
In clinical studies, 6% of males who took Celexa reported changes in ejaculation, compared to 1% of males who took a placebo. Erectile dysfunction occurred in 3% of males who took Celexa, compared to less than 1% of males who took a placebo.
You may not experience sexual side effects while taking Celexa. However, if you do, it's crucial to share this information with your doctor if they are bothersome. Your doctor may be able to adjust your Celexa dose to alleviate symptoms or recommend an alternative medication.
Insomnia
Sleep difficulties might arise while using Celexa. Nonetheless, clinical studies revealed similar rates of insomnia in users who took Celexa or a placebo. In the Celexa group, 15% of individuals had insomnia, compared with 14% of the placebo group. Depression might also cause sleep disturbances.
Sleep is vital to your overall well-being. If you experience sleep issues while using Celexa, inform your doctor. They can suggest treatments to help you achieve a restful night's sleep.
Diarrhea
Diarrhea is a possible side effect of Celexa, but it might improve over time. Studies found that roughly 8% of people who took Celexa had diarrhea, compared with 5% of people who took a placebo.
You might also experience diarrhea if you discontinue Celexa too abruptly. See the “Celexa withdrawal” section below for further details.
Should your diarrhea persist or prove bothersome while using Celexa, discuss this issue with your doctor. They can offer suitable treatment options.
Hot flashes
Hot flashes are a possibility with Celexa use, although they are unlikely to occur frequently. In early studies, fewer than 1% of people who took Celexa reported hot flashes. The studies did not include a placebo comparison.
If you experience hot flashes during your Celexa treatment and they are bothersome, communicate this information to your doctor. They can suggest ways to help you feel more comfortable.
Constipation
Constipation is not likely to occur during Celexa use. In studies, more people who took a placebo experienced constipation compared to those who took Celexa. Exact statistics are not available, but clinical studies found that at least 2% of people who took Celexa reported constipation.
However, if you experience constipation while using Celexa, communicate with your doctor about potential treatment options.
Sweating can Occur if you abruptly stop using the medication Celexa or due to certain drug interactions. For further information, refer to the "Celexa withdrawal" and "Celexa interactions" sections.
If you're utilizing Celexa and find the sweating bothersome, communicate this to your medical practitioner. They might suggest treatments to improve your comfort.
Suicidal ideations
The likelihood of intensified depression or suicidal thoughts and behaviors can increase when using Celexa. This is more prevalent in individuals under the age of 25, fresh users, or those whose dosage of Celexa has recently been altered.
Research has been conducted on suicide instances in individuals younger than 18 who consumed either an antidepressant or a placebo. The outcomes showed 14 more instances of suicide per 1,000 individuals in the antidepressant group, relative to the placebo group. In the age group of 18 to 24, studies reported 5 more instances of suicide per 1,000 individuals in the antidepressant group, compared to the placebo group. However, in individuals aged 25 and above, fewer instances of suicide were reported per 1,000 individuals in the antidepressant group, versus the placebo group.
It's crucial to monitor any changes in thoughts and behaviors during your Celexa treatment. Encourage family and friends to do the same. It may take several weeks to identify if Celexa is helping alleviate your depression symptoms, so it's important to have support during this time. If you experience thoughts of self-harm while using Celexa, inform your doctor immediately or contact emergency services.
Celexa Dosage
The dosage of Celexa your doctor prescribes will depend on various factors. These include:
- the severity and type of condition Celexa is used to treat
- your age
- other medical conditions you may have
Typically, your doctor will commence treatment with a low dosage. Then, they will adjust it gradually to reach the optimal dose for you. Your doctor will ultimately prescribe the smallest dose required to produce the desired effects.
The following information provides common and recommended dosages. However, always adhere to the dosage prescribed by your doctor. They will determine the best dose for your needs.
Drug forms and strengths
Celexa is available as 10-mg, 20-mg, and 40-mg tablets to be swallowed.
Depression Dosage
The initial dose of Celexa is 20 mg per day. Your doctor may increase your dose to 40 mg per day after at least a week of treatment with the starting dose.
A maximum dose of 40 mg per day is recommended due to increased risks of heart-related side effects, such as a heart rhythm disorder known as QT prolongation.
In certain scenarios, your doctor may want you to continue taking 20 mg of Celexa per day:
- You experience side effects that bother you while taking 40 mg of Celexa per day.
- You're older than 60.
- You take specific medications like cimetidine (Tagamet), clopidogrel (Plavix), or omeprazole (Prilosec).
- Your body metabolizes the medication differently. This may occur if genetic testing has revealed how your body processes or responds to certain medications.
What if I miss a dose?
If you miss a dose of Celexa, take it as soon as possible. If it's nearly time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not double up on doses.
Consider setting reminders on your phone to avoid missing a dose. A medication timer may also be helpful.
Will I need to use this drug long term?
Celexa is intended for long-term use. If you and your doctor establish that Celexa is safe and effective for you, you'll likely continue taking it long term.
Celexa Uses
The Food and Drug Administration (FDA) approves prescription drugs like Celexa to treat certain conditions. Celexa may also be used off-label for other conditions. Off-label use refers to a drug that's approved to treat one condition being used to treat another.
Celexa for depression
Celexa is FDA-approved for the treatment of depression in adults. Initial studies of the medication focused on individuals with major depressive disorder (MDD). MDD involves symptoms that interfere with daily life for at least 2 weeks. Examples of these symptoms include:
- a depressed mood
- reduced interest in usual activities
- appetite changes
- weight gain or weight loss
- sleeping more than usual or having trouble falling asleep
- fatigue (lack of energy)
- guilt feelings
- low self-worth
- difficulty thinking or concentrating
In clinical studies that lasted 4 to 6 weeks, depression symptoms improved more in individuals who took Celexa. This was compared with individuals who took a placebo (treatment with no active drug).
Researchers then focused on the individuals who took Celexa and saw an improvement in their depression symptoms to examine how the drug functioned long term. These individuals were compared with individuals who took a placebo. Individuals in the Celexa group were less likely to experience a relapse of their depression.
Outside of its approved uses, Celexa may be utilized in an unconventional manner. Unapproved drug use refers to employing a medication that's been authorized for one purpose, but is used for another that hasn't been endorsed. You might ponder if Celexa is utilized for particular other conditions.
Celexa for anxiety (unapproved use)
Though Celexa doesn't have FDA approval for treating anxiety, some research suggests that selective serotonin reuptake inhibitors (SSRIs) like Celexa might be beneficial as treatment options for anxiety. These medications could be an alternative for people struggling with anxiety who might benefit from medication.
Celexa for OCD (unapproved use)
SSRIs, including Celexa, are sometimes utilized off-label for managing obsessive-compulsive disorder (OCD). This is a behavioral health issue characterized by unwanted thoughts or behaviors that recur or repeat persistently.
A review of studies has scrutinized individuals with OCD who were administered Celexa, other SSRIs, or a placebo. Individuals who received Celexa or another SSRI exhibited improvements in their symptoms to a greater extent than those who received a placebo.
Handling OCD often requires doses of Celexa that are higher than those prescribed for depression. Additionally, it might take longer for people with OCD to recognize the effects of Celexa.
Though the maximum recommended dose of Celexa for depression is 40 mg, doses of 60 mg have been employed to manage OCD. Increasing your Celexa dose to 60 mg may augment your risk of experiencing heart-related side effects such as dizziness and heart palpitations (sensation of skipped or extra heartbeats).
Celexa for bipolar depression (unapproved use)
Though Celexa isn't FDA-approved for the treatment of bipolar depression, it might be employed off-label in specific cases. Bipolar depression constitutes a mental health condition defined by extreme fluctuations in energy and mood.
Celexa and other SSRIs are seldom the primary choice of treatment for bipolar depression, but these medications may be used with other drugs.
If you have bipolar depression, you might experience mania or hypomania (dramatic thoughts or periods of elevated energy) while taking Celexa or other antidepressants. For further details, refer to the “Celexa precautions” section below.
Celexa for PMDD (unapproved use)
Celexa might be employed off-label to manage premenstrual dysphoric disorder (PMDD), which is a more acute manifestation of premenstrual syndrome (PMS). PMS encompasses a spectrum of physical and psychological symptoms women experience approximately a week or two prior to their period.
A number of studies have revealed that Celexa and other SSRIs showed superior efficacy in alleviating symptoms of PMDD compared to a placebo. Treating PMDD might entail doses of Celexa (10 mg to 30 mg) that are lower than those used to manage depression.
Celexa for menopausal symptoms (unapproved use)
Celexa might be prescribed off-label to alleviate symptoms associated with menopause, often at doses lower than those used for depression. Your doctor might prescribe 10 mg to 30 mg of Celexa to help manage menopausal symptoms.
Celexa for IBS (unapproved use)
Celexa might be used off-label to manage irritable bowel syndrome (IBS), a condition that impacts your digestive system. Celexa studies of people with IBS have yielded mixed results. IBS symptoms might subside in some people when taking Celexa. Your doctor might prescribe Celexa as part of your treatment plan.
Celexa for PTSD (unapproved use)
Post-traumatic stress disorder (PTSD) is a mental health condition that can materialize following exposure to or witnessing a traumatic event. Celexa might be employed off-label for the treatment of PTSD, although other antidepressants and medications are often preferred over Celexa.
Due to the absence of substantial evidence, guidelines from The Management of Posttraumatic Stress Disorder Work Group advise against utilizing Celexa as the sole medication for PTSD. The drug may not fully alleviate your symptoms. Non-drug treatments such as counseling are typically attempted before medication.
More studies are required to ascertain the role Celexa might play in managing PTSD.
Celexa for pediatrics (unapproved use)
Celexa might be used off-label to manage depression in children.* Nevertheless, research has not demonstrated that Celexa alleviates depression in children significantly better than a placebo.
Different antidepressant medications have FDA-approval for the treatment of major depressive disorder in children and are usually preferred over Celexa. Examples of these medications include fluoxetine (Prozac) and escitalopram (Lexapro).
Celexa for agitation associated with dementia (unapproved use)
Celexa might be used off-label to manage agitation resulting from dementia. Dementia signifies a range of symptoms that signal a decline in communication, thought, and memory. Some individuals with dementia might feel agitated, meaning that they're anxious or restless.
A study examined individuals suspected of having Alzheimer's disease, which constitutes a type of dementia. The individuals were administered counseling and either citalopram (the active drug in Celexa) or a placebo.
Scientific research showed that people experiencing symptoms saw more improvement while taking citalopram compared to those given a placebo. One of the evaluation tools used in the study was the modified Alzheimer Disease Cooperative Study — Clinical Global Impression of Change. According to this measure, 40% of those on citalopram noticed an improvement in symptoms compared to 26% of those on the placebo.
Celexa for insomnia (not its intended purpose)
Celexa is not recommended for addressing sleep issues. Sleep disorders often impact a person's regular sleep pattern. Discuss sleep difficulties with your doctor for potential treatment options.
Celexa and minors
Celexa is not approved for use in children, potentially increasing the risk of suicidal thoughts and actions in young individuals. Please review "Suicidal thoughts and behaviors" under the "Celexa side effects" section above for further details.
Alternatives to Celexa
Various drugs are available that can be beneficial for depression treatment. Your doctor may suggest alternatives depending on your specific needs.
The Food and Drug Administration (FDA) has authorized other medications to manage depression, such as:
- Selective serotonin reuptake inhibitors (SSRIs), including:
- escitalopram (Lexapro)
- sertraline (Zoloft)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- vortioxetine (Trintellix)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as:
- duloxetine (Cymbalta)
- venlafaxine (Effexor)
- Tricyclic antidepressants (TCAs), like:
- amitriptyline
- desipramine (Norpramin)
Celexa vs. Lexapro
You might wonder how Celexa compares to other medications used for similar purposes. Below, we discuss their similarities and differences.
Components
Celexa contains the active ingredient citalopram, while Lexapro includes escitalopram.
Uses
The FDA has approved Celexa only for the treatment of depression in adults. On the other hand, Lexapro is approved for depression treatment in adults and children aged 12 to 17 years. Lexapro is also authorized to treat generalized anxiety disorder in adults.
Form and administration
Both Celexa and Lexapro are available in tablet form, which you swallow. Lexapro is also available as an oral liquid solution. Generally, both Celexa and Lexapro are administered once daily.
Side effects and risks
Celexa and Lexapro belong to the same drug class. Consequently, they share similar side effects. Below are examples of these side effects.
More common side effects
The following lists contain examples of more common side effects that can occur with Celexa, with Lexapro, or with both drugs (administered individually).
- May occur with Celexa:
- painful menstrual periods
- May occur with Lexapro:
- limited common side effects
- May occur with both Celexa and Lexapro:
- tremors
- fatigue or sleepiness
- muscle or joint pain
- trouble sleeping (insomnia)
- anxiety or restlessness
- appetite changes
- weight gain or loss
- digestive system issues, like nausea, vomiting, diarrhea, upset stomach, or constipation
- sexual problems, such as loss of sexual desire, ejaculation disorder, impotence (difficulty maintaining or achieving an erection)
- upper respiratory infection
- sweating, including hot flashes
Serious side effects
The lists below explain serious side effects that may occur with Celexa, with Lexapro, or with both drugs (when used independently).
- May occur with Celexa:
- QT prolongation and torsades de points (heart rhythm issues)
- May occur with Lexapro:
- limited serious side effects
- May occur with both Celexa and Lexapro:
- serotonin syndrome (elevated levels of the chemical serotonin)
- allergic reaction
- suicidal thoughts and behaviors*
- withdrawal symptoms upon stopping the drug
- low sodium levels (hyponatremia)
- mania or hypomania (excited or hyperactive states)
- bleeding
- seizures
Effectiveness
Both medications are used solely for depression management.
Comparative analyses of both medications based on various studies revealed that individuals taking Lexapro were more likely to experience symptom improvement compared to those using Celexa.
Brand-name Celexa and Lexapro are both medicinal substances, also obtainable in their generic versions. The generic variation of Celexa is referred to as citalopram, while the generic version of Lexapro is named escitalopram. Generally, brand-name medications tend to be more expensive than their generic counterparts.
Brand-name Celexa tablets often cost less than brand-name Lexapro tablets. Meanwhile, the cost of both generic Celexa and Lexapro tablets is typically similar, although the exact price can vary based on factors like insurance coverage, location, and chosen pharmacy.
Celexa versus Zoloft
Zoloft, like Lexapro, is a drug that shares several similarities with Celexa. Here's a breakdown of how the two medications are alike and differ:
Composition
Celexa contains citalopram as its active ingredient. In contrast, Zoloft contains sertraline as its active ingredient.
Uses
The Food and Drug Administration (FDA) has approved both Celexa and Zoloft for treating depression. Additionally, Zoloft is FDA-approved for the following conditions:
- obsessive-compulsive disorder (OCD)
- panic disorder
- post-traumatic stress disorder (PTSD)
- social anxiety disorder
- premenstrual dysphoric disorder (PMDD)
While Celexa is often used off-label for these conditions, see the "Celexa uses" section above for more information.
Forms and administration
Both Celexa and Zoloft are available as tablets, which are taken orally. Zoloft is also available in the form of an oral liquid solution. Both medication types are usually taken daily.
Side effects and safety concerns
Since Celexa and Zoloft belong to the same class of drugs, they can both cause similar side effects. Below are examples of such side effects:
More common side effects
These lists contain examples of more common side effects that can occur with Celexa, with Zoloft, or with both medications (when taken separately).
- Those associated with Celexa include:
- painful menstrual periods
- upper respiratory infection
- Those associated with Zoloft include:
- unique common side effects not listed here
- Those associated with both Celexa and Zoloft include:
- sweating
- digestive problems, such as nausea, vomiting, diarrhea, upset stomach, or constipation
- sexual problems, such as decreased interest in sex, ejaculation disorder, or impotence (difficulty getting or maintaining an erection)
- appetite changes
- weight gain or loss
- tremors
- fatigue or drowsiness
- muscle or joint aches
- insomnia
- anxiety or agitation
Serious side effects
These lists contain examples of serious side effects that can occur with Celexa, with Zoloft, or with both medications (when taken separately).
- Those associated with Celexa include:
- unique serious side effects not listed here
- Those associated with Zoloft include:
- specific side effects not listed here when the drug is taken with disulfiram (Antabuse)
- Those associated with both Celexa and Zoloft include:
- serotonin syndrome (high levels of serotonin)
- allergic reactions
- suicidal thoughts or behaviors*
- mania or hypomania (exaggerated happiness)
- bleeding
- QT prolongation and torsades de pointes (heart rhythm disorders)
- withdrawal symptoms when the drug is stopped
- hyponatremia (low sodium levels)
- seizures
Effectiveness
Only depression is a condition both Celexa and Zoloft are used to treat. The effectiveness of these medications in treating depression has been demonstrated in various studies, but they have not been directly compared in clinical trials.
Costs
Like Celexa, Zoloft is a brand-name drug with a generic alternative. The generic form of Zoloft is called sertraline, which is often less expensive than the brand-name option.
Brand-name and generic Celexa tablets tend to cost about the same, while brand-name and generic Zoloft tablets also tend to cost about the same. However, the actual cost can vary based on factors such as insurance coverage, location, and chosen pharmacy.
Celexa withdrawal symptoms
Rapidly discontinuing Celexa can lead to withdrawal symptoms. These can extend for several days to weeks, a condition known as discontinuation syndrome. Withdrawal symptoms can include:
- dizziness
- headache
- insomnia
- anxiety
- restlessness
- irritability (easily upset or frustrated)
- bad mood or mood swings
- lethargy (lack of energy) or sluggishness
- electric shock-like sensations
- difficulty concentrating or clouded thinking
Memory loss isn't typically a side effect of Celexa withdrawal.
If you need to stop taking Celexa, your doctor will help you taper your dose gradually to minimize these symptoms. It's crucial not to abruptly stop taking the medication or alter your dosage without consulting your doctor first.
Celexa and Alcohol
It's advisable to abstain from alcohol while on Celexa. The drug affects the brain and nervous system, which may lead to impaired judgment and drowsiness. Alcohol also impacts the brain and can cause drowsiness, while also clouding your thoughts and potentially impairing your ability to operate machinery safely. Combining Celexa with alcohol might increase the risk of harm.
If you consume alcohol, discuss the potential risks with your doctor and determine if Celexa is suitable for you.
Celexa Interactions
Celexa can interact with various medications and supplements, as well as certain foods. These interactions can cause varying effects, such as reducing a drug's efficacy or increasing side effects or severity.
Celexa and Other Medications
Below is a list of medications known to interact with Celexa. This list is not exhaustive.
Before beginning Celexa treatment, inform your doctor and pharmacist about all prescriptions, over-the-counter medications, and supplements you take. Additionally, discuss any vitamins, herbal remedies, and supplements you use. Sharing this information can help prevent potential interactions.
If you have concerns about drug interactions, consult your doctor or pharmacist.
Celexa and Tramadol
Taking Celexa alongside tramadol, a pain medication, might increase the risk of serotonin syndrome (elevated levels of serotonin). For symptoms of serotonin syndrome, see the "Celexa side effects" section above.
If you're taking tramadol, inform your doctor before initiating Celexa use. They may monitor your side effects or suggest alternative medications.
Celexa and Medications Impacting the Central Nervous System
Considering Celexa's influence on the central nervous system (CNS), exercise caution when combining it with other medications affecting the CNS. The CNS includes the brain and spinal cord.
Medications that can affect the CNS include:
- Opioid pain relievers
- Barbiturates, such as phenobarbital
- Benzodiazepines, like alprazolam, clonazepam, and lorazepam
If you're taking a drug acting on your CNS or if you're unsure, consult your doctor before using Celexa. They may need to monitor your side effects or suggest an alternative medication combination.
Celexa and Certain Depression Medications
Combining Celexa with certain other antidepressants might increase your risk of serotonin syndrome. For symptoms of serotonin syndrome, see the "Celexa side effects" section above.
Monoamine oxidase inhibitors (MAOIs) are one type of antidepressants to avoid using within 14 days after ceasing Celexa therapy. Other antidepressant types include serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants.
- Examples of MAOIs include:
- phenelzine (Nardil)
- selegiline (Eldepryl)
- Examples of SNRIs include:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
- Examples of SSRIs include:
- sertraline (Zoloft)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- Examples of tricyclic antidepressants include:
- imipramine (Tofranil)
- amitriptyline
- desipramine (Norpramin)
Taking multiple antidepressants concurrently can increase your risk of bleeding. Learn more about this by reading "Celexa and drugs that increase the risk of bleeding" below.
If you're taking an antidepressant, inform your doctor before starting Celexa. They can evaluate your medications and suggest the most appropriate treatment for you.
Celexa and Drugs that Increase the Risk of Bleeding
Celexa might enhance the risk of bleeding, especially when taken with other medications also increasing the bleed risk.
Examples of these medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- ibuprofen (Advil, Motrin)
- naproxen (Aleve)
- aspirin (Bayer)
- SSRI antidepressants, such as:
- sertraline (Zoloft)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- SNRI antidepressants, such as:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
- warfarin (Coumadin)
If you've any questions about drug interactions that may affect you, consult your doctor or pharmacist.
Celexa and Compatible and Incompatible Drugs
Celexa, a medication used to treat major depressive disorder, may interact with certain drugs, leading to potentially severe side effects. Here's a paraphrased list of drugs to consider when taking Celexa:
- Triptans and Celexa: Triptans, often utilized for migraines, can increase the risk of serotonin syndrome when taken alongside Celexa. Symptoms of serotonin syndrome include agitation, diarrhea, hallucinations, and coma (for a complete list, refer to the "Celexa side effects" section). Examples of triptans are sumatriptan (Imitrex), frovatriptan (Frova), almotriptan, and eletriptan (Relpax). If you need to take a triptan while using Celexa, your doctor will closely monitor you for symptoms of serotonin syndrome.
- Carbamazepine and Celexa: Although the interaction between carbamazepine (Tegretol) and Celexa isn't conclusively proven, carbamazepine may accelerate Celexa's breakdown in the body, resulting in Celexa's ineffectiveness. If you're taking carbamazepine, consult your doctor before starting Celexa. They may monitor you for Celexa side effects and the medication's efficacy.
- Lithium and Celexa: The use of Celexa and lithium (Lithobid) may increase the risk of serotonin syndrome. Symptoms of serotonin syndrome are similar to those for triptan use with Celexa. If you're taking lithium, inform your doctor before starting Celexa treatment. They may monitor you more closely or suggest alternative medications.
- Pimozide and Celexa: A study showed that the concurrent use of Celexa and pimozide might heighten the risk of QT prolongation, a type of heart rhythm problem. Your doctor should monitor your heart rhythm if you need to use both drugs jointly. Inform them of any dizziness or heart palpitations.
- Ketoconazole and Celexa: If you take Celexa and ketoconazole together, the amount of ketoconazole in your body may decrease. It's essential to share your use of ketoconazole when you initiate Celexa treatment. Medical professionals may monitor your ketoconazole levels or suggest another medication for you.
- CYP2C19 inhibitors and Celexa: Using Celexa in combination with CYP2C19 inhibitors might boost the concentration of Celexa in your system, leading to increased risks for side effects, such as an irregular heart rhythm. Examples of CYP2C19 inhibitors include cimetidine (Tagamet), omeprazole (Prilosec), and clopidogrel (Plavix). Inform your doctor if you're taking a CYP2C19 inhibitor before starting Celexa. They may decrease your Celexa dose or recommend a different medication.
- Herbal and supplement products and Celexa: You should consult your doctor or pharmacist before merging Celexa with any herbal or supplement products. St. John's wort and tryptophan might raise your risk for serotonin syndrome, although studies have been inconclusive.
Celexa and Pregnancy
There exists uncertainty regarding the safety of Celexa during pregnancy. While some studies conduct Celexa use in pregnant women, the drug hasn't been extensively researched.
- Studies on Celexa and Birth Defects: Research on infants born to mothers who used Celexa during their last trimester (third quarter) indicated a higher likelihood of hospitalization, tube feeding, and respiratory support. However, it's unclear if these issues were due to Celexa or withdrawal syndrome.
- Studies on Persistent Pulmonary Hypertension and Selective Serotonin Reuptake Inhibitors (SSRIs): Some studies suggest that Celexa and other SSRIs might elevate the risk of persistent pulmonary hypertension of the newborn (PPHN). PPHN is a rare and severe lung disorder in which infants struggle to expand their lungs after birth. Nonetheless, other studies found no link between SSRIs and PPHN.
- Studies on Antidepressant Discontinuation and Depression: Research stated that women who ceased antidepressant use during pregnancy were more probable to relapse from their depression when compared to those who remained on them.
- Animal Studies on Celexa: Studies in animals revealed that Celexa didn't produce toxic effects in the offspring when mothers received high doses of the medication, although it's uncertain whether these results can be applied to humans.
If you're expecting or planning to conceive, it's essential to consult your doctor before using Celexa. They can discuss the advantages and potential side effects of Celexa with you, helping you decide if it's the best choice. Some individuals find the benefits overwhelming, while others might benefit more from an alternative medication.
Celexa and family planning
The safety of Celexa during pregnancy is unclear. If you or your sexual partner can become pregnant, discuss your family planning options with your doctor while using Celexa.
Celexa and breastfeeding
The safety of Celexa for breastfeeding mothers is not definitively known. Celexa has been detected in the breast milk of lactating women, leading to reports of drowsiness, reduced appetite, and weight loss in their infants.
If you intend to breastfeed whilst taking Celexa, meet with your doctor to discuss the pros and cons of using Celexa, explore alternative treatment options, and consider any potential side effects in your baby.
Celexa cost
Medication costs can vary based on factors such as your insurance, location, and pharmacy.
Your insurance plan might require prior authorization before covering Celexa. This means your doctor must request approval from your insurance company, who will then decide if your plan will cover the medication.
To learn if prior authorization is necessary for Celexa, contact your insurance provider.
Financial support and insurance assistance
Assistance may be available through your local pharmacy to help you pay for Celexa or understand your insurance coverage. Speak to your pharmacist to explore ways to reduce the cost of your prescription.
How to use Celexa
Follow your doctor's or healthcare provider's instructions when using Celexa.
Celexa comes in tablet form, to be swallowed once a day.
Timing
It's crucial to take Celexa at roughly the same time every day. You can take it in the morning or evening.
To prevent missing a dose, consider setting reminders on your phone and using a medication timer.
Consuming Celexa with food
You can take Celexa with or without food.
Can Celexa be crushed, split, or chewed?
In some circumstances, your doctor might adjust your dose, requiring you to split tablets. A pill cutter can make this process easier. Celexa tablets of 20 mg and 40 mg have scored lines to facilitate even splitting.
If swallowing tablets is challenging, speak to your doctor. They might suggest alternative forms of Celexa, such as an oral liquid solution or a tablet that dissolves on your tongue.
How Celexa functions
Celexa is used to treat depression in adults. Depression is a mood disorder characterized by feelings of sadness and a loss of interest in activities you previously enjoyed. Depression can be caused by an imbalance of certain chemicals in your body and brain, including serotonin and dopamine.
Major depressive disorder (MDD) is a type of chronic depression where symptoms often persist for long periods.
Celexa works by increasing the level of serotonin in your central nervous system (CNS) and restoring balance to the chemicals in your body and brain. The CNS encompasses your brain and spinal cord. If you have MDD, Celexa may help improve your mood, sleep, emotions, and enjoyment of daily activities.
Timeframe of effects
You may notice an improvement in your depression symptoms after taking Celexa for a few weeks. In some cases, it may take around a month to see changes in your feelings.
Celexa is typically taken for an extended period (months to years), so it may take time to experience the medication's full benefits after starting or increasing the dose.
Common questions about Celexa
Here are answers to some frequently asked questions about Celexa.
Does Celexa cause hair loss?
It's unclear if Celexa causes hair loss. While hair loss was observed in a 2019 case report, this side effect was not reported in clinical trials on Celexa. A study examining several antidepressants found some to increase the risk of hair loss more than others, with Celexa neither the most nor least likely to cause hair loss.
If you're concerned about hair loss, speak to your doctor. They can evaluate your medications and identify potential reasons for your hair loss.
Can Celexa be used to treat agitation caused by dementia?
Possibly. Dementia refers to a group of symptoms related to a decline in communication, thinking, and memory. Some people with dementia experience agitation, meaning they feel anxious or restless. Celexa might be prescribed to treat agitation caused by dementia, although the Food and Drug Administration (FDA) has yet to approve this use, meaning the use would be considered off-label.
For studies on Celexa's impact on agitation caused by dementia, refer to the "Celexa Uses" section above.
If you or someone close to you has dementia and is considering Celexa, it's crucial to have a conversation with your physician. They can help you evaluate the medication's advantages and disadvantages, ultimately choosing the most suitable treatment option.
Can I use painkillers like Tylenol during Celexa use?
Yes, it's possible. You can take over-the-counter painkillers like Tylenol during your Celexa treatment.
However, it's essential to remember that Celexa, like other antidepressants, might increase your vulnerability to bleeding. Therefore, if you're on Celexa, consult your doctor before ingesting any pain medication. This includes Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as aspirin (Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve). These medications may also boost your risk of bleeding.
Can I take Xanax for anxiety if I use Celexa?
Yes, you can. While taking Celexa, you can also utilize medications categorized as benzodiazepines to address anxiety. Some examples include:
- alprazolam (Xanax)
- lorazepam (Ativan)
- clonazepam (Klonopin)
Remember to exercise caution while driving or operating machinery until you're familiar with the medications' effects. Both Celexa and benzodiazepines can impact your central nervous system, potentially causing drowsiness, foggy thinking, or dizziness. Utilizing these medications concurrently might increase the likelihood of experiencing these side effects.
If you're using Celexa and have questions regarding anxiety treatment, speak with your doctor.
If sleeping difficulties arise while using Celexa, can I use supplements like melatonin?
It's typically better to consult your doctor first. The interaction between Celexa and supplements like melatonin has yet to be studied. Celexa can itself render you drowsy or fatigued.
Prior to ingesting other medications or supplements, make sure to discuss your Celexa treatment and its impact on you with your doctor.
Can I use Celexa if I have heart issues?
Yes, but your physician may closely monitor you or opt for other medications to manage your depression if you have heart conditions. Celexa might increase the likelihood of palpitations (feeling of skipped or extra heartbeats), abnormal heart rhythms, and bleeding.
If you're taking other drugs that can cause heart-related side effects, your doctor may suggest an alternative medication to Celexa. Before starting Celexa treatment, ensure to share a list of all your medications and supplements with your doctor.
Celexa Cautions
This medication comes with several warnings.
FDA warning: Suicide and antidepressant drugs
This drug has a . This is the most severe warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be hazardous.
As per short-term studies, antidepressants like Celexa may enhance the risk of suicidal thoughts and behavior in people under age 25. This includes children, teenagers, and young adults. Keep in mind that depression and other psychiatric disorders can also heighten your risk for suicidal thoughts and behavior.
If you're using Celexa and detect a shift in your mood or behavior, or have thoughts about self-harm, inform your doctor immediately. Your loved ones should also watch out for these signs. It's vital to maintain an open line of communication with your doctor throughout your treatment, allowing them to monitor your progress and response to the medication.
Seizure incidences. Individuals with a history of seizures may experience an increased risk of seizures when utilizing Celexa. however, research has not established a direct link between Celexa and seizures. If you've had a seizure earlier, it's essential to inform your doctor before commencing a Celexa regimen. They will assist in determining the most suitable treatment for your situation.
QT prolongation and torsades de pointes. Those with cardiac rhythm conditions such as QT prolongation or torsades de pointes might experience side effects related to the heart when using Celexa. Symptoms can include dizziness and fainting. During Celexa therapy, your doctor will closely monitor you for these side effects, and may prescribe an alternate medication for depression management in some instances.
Bipolar depression. Celexa use for individuals with bipolar depression may increase the risk of mania or hypomania symptoms, including racing thoughts or periods of high energy. Before initiating Celexa treatment, your doctor may assess you for bipolar depression. You can explore this further by reviewing the "Celexa uses" section provided in the text.
Angle-closure glaucoma. Celexa can induce pupil dilation, which can lead to an angle-closure glaucoma attack in those already suffering from the condition. Before commencing Celexa treatment, your doctor may recommend a glaucoma screening. Based on the results, they'll help determine whether Celexa or another medication is ideal for you.
Bleeding problems. Celexa increases the risk of bleeding, especially when used alongside other medications that contribute to this risk. To minimize the risk of bleeding complications, inform your doctor about any bleeding problems before starting Celexa.
Low sodium levels. Celexa might further reduce sodium levels in individuals with hyponatremia. During Celexa treatment, your doctor will likely monitor your sodium levels to ensure they remain within a healthy range.
Pregnancy. There are uncertainties regarding the safety of Celexa during pregnancy. You can learn more by visiting the "Celexa and pregnancy" section outlined in the text.
Breastfeeding. Celexa safety during breastfeeding remains unclear. Examine the "Celexa and breastfeeding" section for further information.
Celexa side effects. For a comprehensive understanding of Celexa's potential adverse effects, consult the "Celexa side effects" section provided in the text.
Celexa overdose
Exceeding the recommended Celexa dosage may result in severe side effects.
Overdose symptoms
Symptoms of an overdose may include:
- Dizziness
- Sweating
- Tachycardia (rapid heart rate)
- Confusion
- Sleepiness
- Heart rhythm changes
Overdose management
If you suspect you've taken an excessive amount of the medication, contact your doctor immediately. Alternatively, you can reach out to the American Association of Poison Control Centers at 800-222-1222 or access their online tool. If your symptoms are severe, seek emergency medical attention by calling 911 or visiting the nearest emergency room as soon as possible.
Celexa storage, expiration, and disposal
When you acquire Celexa from your pharmacy, it will be labeled with an expiration date. This date is usually one year following the medication's dispensation.
The expiration date ensures the drug's effectiveness during this period. As recommended by the FDA, it's advisable to avoid using expired medications. If you have unused, expired medication, consult your pharmacist about the possibility of utilizing it.
Storage
Temperature and storage conditions can affect how long a medication remains viable.
Store Celexa tablets at room temperature (77°F/25°C) in an airtight container away from light. Avoid storing this medication in areas with high humidity, such as bathrooms.
Disposal
Proper disposal of unused Celexa is essential to prevent accidental use by children and pets, as well as environmental harm. The provides useful tips for disposing of medications. You can also contact your pharmacist for advice on medication disposal.
Professional information for Celexa
The following information is intended for healthcare professionals.
Indications
The FDA has approved Celexa for the treatment of depression in adults aged 18 and above. There are off-label uses of Celexa with varying levels of supporting evidence.
Mechanism of action
Celexa functions as a selective serotonin reuptake inhibitor (SSRI), inhibiting the reuptake of serotonin in the central nervous system, thereby increasing serotonin availability. Celexa is a racemic mixture, with most of its serotonin-related impact attributed to the S-enantiomer (S-citalopram or "escitalopram"). Celexa has minimal impact on dopamine and norepinephrine receptors.
After ingestion, Celexa attains its highest blood levels approximately 4 hours later. Achieving stable concentrations typically takes about a week. Its elimination half-life is around 35 hours.
In clinical studies, older adults showed extended half-lives for Celexa, leading to a suggested maximum daily dose of 20 mg for individuals over 60 years old.
Primary metabolism and elimination of Celexa are facilitated by the liver. For individuals with liver dysfunction, the recommended maximum daily dose remains 20 mg.
Celexa's primary decomposition is carried out by CYP2C19, with CYP3A4 contributing marginally. Primarily, significant changes occur through stimulation of the CYP2C19 route. Due to heightened risk of QT prolongation and torsades de pointes with increased drug concentrations in individuals with certain genetic variations, poor metabolizers of CYP2C19 should be limited to a maximum of 20 mg of Celexa daily.
Warnings & Contraindications
Concurrent use of Celexa and Monoamine Oxidase Inhibitors (MAOIs) should be avoided, with at least a 2-week hiatus following Celexa discontinuation before initiating MAOIs, to decrease the risk of serotonin syndrome.
Co-administration of Celexa with pimozide may lead to serious cardiac side-effects, such as QT prolongation or arrhythmias.
Celexa is not recommended for individuals who have previously developed an allergic reaction to citalopram or any of Celexa's inactive components.
Storage
Store Celexa at room temperature, between 77°F (25°C) as the optimal storage temperature, with a allowable range of 59°F to 86°F (15°C to 30°C).
Note: Medical News Today has taken great care to ensure all data is accurate, comprehensive, and up-to-date. However, this article should not be used as a substitute for a licensed healthcare professional's expertise. Always consult your healthcare provider prior to taking any medication. The medication details provided in this article may change over time and are not comprehensive enough to cover all potential uses, adverse effects, or interactions. Absence of specific information for a drug does not imply it is safe, effective, or suitable for all patients or specific uses.
The use of Citalopram, whether as the branded drug Celexa or its generic form, has been shown to be effective in reducing symptoms of depression in adults. However, it's important to note that the use of Citalopram can sometimes lead to serious side effects, including suicidal thoughts and behaviors. If anyone is experiencing such symptoms, they should contact their doctor immediately or reach out to the National Suicide Prevention Lifeline at 1-800-273-8255. This highlights the importance of monitoring mental health and seeking help when needed.