Panic Disorder Treatment Celexa for Anxiety Disorders By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on April 28, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Take A Pix Media / Blend Images / Getty Images Table of Contents View All Table of Contents Uses Effectiveness Precautions and Contraindications Side Effects Warnings and Interactions Celexa (citalopram) belongs to a class of antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs). Serotonin, sometimes called the feel-good neurotransmitter, regulates several aspects of brain function including sleep, mood, and emotion. An SSRI like Celexa can prevent serotonin from being reabsorbed back into the nerve cells that previously released it. This simple act can improve mood, reduce feelings of anxiety, and decrease the severity of panic attacks and other panic disorder symptoms. Uses Celexa is approved by the Food and Drug Administration to treat major depressive disorder in adults, but it is sometimes prescribed off-label to treat other conditions. For example, if you've been diagnosed with an anxiety disorder such as generalized anxiety disorder or panic disorder, your doctor may prescribe Celexa to reduce your symptoms. Other off-label uses for Celexa include: Bipolar depression Disordered eating Obsessive compulsive disorder Post-traumatic stress disorder Premenstrual dysphoric disorder Although commonly prescribed to adults, Celexa is rarely given to anyone younger than 18 years of age. Should I Take My Antidepressant at Night or in the Morning? Effectiveness Dealing with the symptoms of panic disorder can be extremely difficult and it's normal to want to find relief as soon as possible. When starting a new antidepressant medication, it's important to be patient and not expect immediate results. Many people report that they notice positive changes and reduced symptoms within the first days to weeks of starting on Celexa, but it can take up to several months before the full effect of Celexa kicks in. Precautions and Contraindications Celexa may not be right for you if you have or have had certain medical conditions, including: Bipolar disorder or maniaBleeding problemsHeart problemsKidney problemsLow sodium levels in your bloodLiver problemsSeizuresStroke Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case. Pregnancy and Nursing Celexa can be passed on from mother to child during pregnancy or while nursing. If you're trying to become pregnant, already pregnant, or breastfeeding, talk with your doctor about the benefits and risks of taking Celexa. Taking Antidepressants During Pregnancy Black Box Warning The FDA released a black box warning in 2007 cautioning that the use of SSRIs may lead to increased suicidal thoughts and behaviors. The FDA warned that this problem can be especially problematic for adolescents and young adults who are on SSRIs. Doctors who prescribe SSRIs, including Celexa, need to monitor for potential worsening of mood or thoughts of suicide, especially for young people just beginning their prescription or changing dosages. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Alcohol Use Alcohol consumption should be minimized while taking Celexa. The effects of alcohol may be intensified with Celexa and alcohol has the potential to interfere with its effectiveness. Side Effects It may take several weeks or longer for Celexa to be fully effective. During this time, you may experience side effects before you notice benefits. Most side effects of Celexa pass with time. Common People taking Celexa may experience some side effects, including: Nausea Sleep disturbances Drowsiness and lightheadedness Dry mouth Fatigue Increased sweating Sexual side effects If these side effects are troublesome or do not go away, discuss them with your doctor. They may lower your dosage or change your medication. Severe Contact your doctor immediately if you experience any of the following rare side effects: Indicators of an allergic reaction (hives, rash, difficulty swallowing, restricted breathing, or swelling of the face, mouth, or tongue)HallucinationsConfusionVomitingSeizuresExtreme nervousness and anxietyAccelerated heart rateSuicidal thoughts or behaviors Rare and Potentially Serious Side Effects of Antidepressants Warnings and Interactions It is possible to experience serious drug interactions while taking Celexa with other substances or medications. Make sure your prescribing doctor is up to date on all of your current prescriptions and over-the-counter medications. The following medications can interact with Celexa: Monoamine oxidase inhibitors (MAOIs): Celexa should not be taken with or within two weeks of taking an MAOI. These include Azilect (rasagiline), Emsam (selegiline), Marplan (isocarboxazid), Nardil (phenelzine), and Parnate (tranylcypromine). Taking Celexa with a MAOI can be fatal. Non-steroidal anti-inflammatory drugs (NSAIDs): Taking Celexa may increase your risk of internal bleeding. This risk is even greater when you combine Celexa with over-the-counter pain relievers such as ibuprofen (Advil, Motrin) and naproxen (Aleve) or anticoagulants like warfarin (Coumadin). Other drugs that increase serotonin levels: Taking Celexa with other drugs that affect your serotonin levels may increase your risk of developing serotonin syndrome. Therefore, avoid over-the-counter supplements like St. John’s wort and tryptophan, and medicines like Lexapro (escitalopram) and Zoloft (sertraline). If you want to stop taking Celexa, it's extremely important to consult with your doctor first. They will help you gradually reduce your dosage. If you stop taking Celexa abruptly, you may experience withdrawal-like symptoms, which can include: AnxietyConfusionDizzinessIrritabilityHeadacheParesthesias (prickling, tingling sensation on the skin) Celexa withdrawal symptoms can begin within three to six days of your last dose and last up to a month in some cases. How Long Does Withdrawal From Celexa Last? Forgetting a Dose Take any missed dose of Celexa as soon as you remember, unless it's close to the time for your next dose. Never take a double dose; instead, skip the missed dose and take the next dose on your regular schedule. Tips to Reduce Antidepressant Discontinuation Symptoms A Word From Verywell The information provided here is meant to be an overview of using Celexa for anxiety disorders. It doesn't cover all possible scenarios. Always consult your medical provider or pharmacist about any questions or concerns you may have about your Celexa prescription. 3 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. Food and Drug Administration. Celexa label. Published January 11, 2019. Food and Drug Administration. Revisions to Product Labeling. Yuet WC, Derasari D, Sivoravong J, Mason D, Jann M. Selective serotonin reuptake inhibitor use and risk of gastrointestinal and intracranial bleeding. J Osteopath Med. 2019;119(2):102-111. doi:10.7556/jaoa.2019.016 By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.