Celexa (Citalopram) Medication Profile

Antidepressant

Woman in Bed With Antidepressants
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Celexa (citalopram) is a medication the drug family known as selective serotonin reuptake inhibitors (SSRIs) used to treat depression. These drugs work by making more of the brain hormone serotonin available between nerve cells, which has been shown to ease depression. It may be prescribed off-label to treat obsessive-compulsive disorder, panic disorder, anxiety disorder, and premenstrual dysphoric disorder.

Benefits of Celexa

Compared to the other drugs in its class, Celexa has a relatively high bioavailability (80 percent). This is a measure of how much of the drug in the pill becomes active in the body. A lower dose of Celexa can be taken to achieve the same level in the bloodstream as, for example, Paxil (paroxetine), which has a bioavailability of only 50 percent. Luvox (fluvoxamine) has a higher bioavailability score than Celexa—95 percent—but has far more potential for drug interactions than Celexa, as does Prozac (fluoxetine).

The half-life of Celexa is about 1.5 days, which means that if you stop taking it abruptly, it takes 36 hours for half of it to clear out of your system, another 36 hours for half of what's left to clear, etc. Medications with shorter half-lives are more likely to cause SSRI discontinuation syndrome if stopped suddenly. This syndrome includes flu-like symptoms or a sudden return of anxiety or depression. Celexa's half-life is longer than Luvox, Paxil, and Zoloft (sertraline), which are more likely to cause this syndrome. Prozac has a 9.3-day half-life, taking over a month to get out of your system, and is less likely to cause discontinuation syndrome.

Precautions and Warnings

Celexa may cause drowsiness, so you should not drive or operate machinery until you know how you will react to it. People taking Celexa are also advised not to drink alcohol. In addition:

  • As with other antidepressants, allow two weeks between starting or stopping Celexa and stopping or starting an MAOI antidepressant.
  • Be aware that taking any SSRI antidepressant with a triptan medication for migraines may cause a serious condition called serotonin syndrome. Fatal cases of serotonin syndrome have been reported when Celexa is mixed with the antibiotic Zyvox (linezolid).
  • Do not stop taking Celexa all at once unless your doctor approves due to serious side effects. The dose should be tapered off gradually.
  • Celexa (and other antidepressants) carries a slight risk of causing bleeding problems, especially if taken with aspirin, ibuprofen, naproxen, Coumadin (warfarin) or other drugs that affect bleeding.
  • Any antidepressant may induce mania in patients with bipolar disorder.
  • Celexa carries the same black box warning as other antidepressants. It can cause an increased risk of suicidal thinking and behavior in young adults ages 18 to 24 during initial treatment.
  • In July 2006, the Food and Drug Administration (FDA) released a warning that babies whose mothers took SSRI antidepressants late in pregnancy were six times more likely to have a serious breathing problem called persistent pulmonary hypertension of the newborn (PPHN). This is due to the blood vessels in the baby's lungs failing to open after birth, so the baby cannot take in enough oxygen. The FDA also notes that babies delivered to mothers taking Celexa late in pregnancy have developed problems such as difficulty breathing and feeding. Thus, if you are pregnant or plan to become pregnant, it is essential that you discuss your medications with all your doctors.
  • In 2011 and 2012, the FDA added new warnings to the label about the risk of abnormal heart rhythms in patients with certain conditions and in people older than age 60. Use of the drug is not recommended for those with a condition that prolongs the QT interval. People older than age 60 should not exceed 20 milligrams per day.

Citalopram Side Effects

Check with your doctor if any of the following side effects continue or are bothersome:

  • More common: drowsiness, dryness of mouth, nausea, trouble in sleeping
  • Less common: Abdominal pain, anxiety, change in sense of taste, diarrhea, gas, headache, heartburn, increased sweating, increased yawning, loss of appetite, pain in muscles or joints, stuffy or runny nose, tingling, burning, or prickly feelings on skin, tooth grinding, trembling or shaking, unusual increase or decrease in weight, unusual tiredness or weakness, vomiting, watering of the mouth

Notify your doctor immediately for these side effects:

  • More common: Decrease in sexual desire or ability
  • Less common: Agitation, blurred vision, confusion, fever, increase in the frequency of urination or amount of urine produced, lack of emotion, loss of memory, menstrual changes, skin rash or itching, trouble in breathing
  • Rare: Bleeding gums, breast tenderness or enlargement or unusual secretion of milk (in females), dizziness or fainting, irregular heartbeat, low blood sodium (confusion, convulsions [seizures], drowsiness, dryness of mouth, increased thirst, lack of energy), mood or mental changes, nosebleed, painful urination, purple or red spots on skin, sore throat, fever, and chills, red or irritated eyes, redness, tenderness, itching, burning, or peeling of skin

Symptoms of Complications

Be aware of these symptoms that you could be developing a problem:

  • Signs of serotonin syndrome: Agitation, confusion, diarrhea, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, twitching), trouble in holding or releasing urine, unusual or sudden body or facial movements or postures
  • Celexa withdrawal side effects: Always notify your doctor if you have discontinued the medication and experience anxiety, dizziness, nervousness, trembling, or shaking

Celexa Overdose Effects

Notify your doctor immediately if you have these symptoms of an overdose:

  • More common: Dizziness, drowsiness, fast heartbeat, nausea, sweating, trembling or shaking, vomiting
  • Rare: Bluish-colored skin or lips, confusion, convulsions (seizures), coma, deep or fast breathing with dizziness, fainting, general feeling of discomfort or illness, loss of memory, muscle pain, slow or irregular heartbeat, weakness

Other side effects not listed above may also occur in some patients. If you notice any other symptoms, check with your doctor.

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