Citalopram

Pronunciation

Generic Name: citalopram (sye-TAL-oh-pram)
Brand Name: Celexa

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using citalopram outweigh the risks.

Families and caregivers must closely watch patients who take citalopram. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Citalopram is not approved for use in children. Talk with the doctor.


Citalopram is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Citalopram is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Do NOT use citalopram if:

  • you are allergic to any ingredient in citalopram or to escitalopram
  • you have a certain type of irregular heartbeat (long QT syndrome), slow heartbeat, severe heart failure, a recent heart attack, or uncorrected low blood potassium or magnesium levels
  • you are taking or have taken linezolid, a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline), or St. John's wort within the last 14 days
  • you are taking certain antiarrhythmics (eg, dronedarone, quinidine, procainamide, amiodarone, sotalol), certain antibiotics (eg, gatifloxacin, moxifloxacin), bedaquiline, escitalopram, a fenfluramine derivative (eg, dexfenfluramine), levomethadyl, methadone, nefazodone, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine, venlafaxine), sibutramine, other SSRIs (eg, fluoxetine, paroxetine), toremifene, or tryptophan

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using citalopram:

Some medical conditions may interact with citalopram. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you or a family member has a history of bipolar disorder (manic depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
  • if you have a history of seizures, liver problems, kidney problems, heart problems (eg, heart failure, slow or irregular heartbeat), high blood pressure, stroke, bleeding problems, or stomach or bowel bleeding
  • if you have a condition or take medicine that may increase your risk of low potassium or magnesium levels. Check with your doctor if you are not sure if any of your conditions or medicines may increase this risk
  • if you are dehydrated, have low blood volume or low blood sodium levels, or drink alcohol
  • if you will be having electroconvulsive therapy (ECT)
  • if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
  • if you are taking a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with citalopram. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Many prescription and nonprescription medicines (eg, used for aches and pain, allergies, autism, blood thinning, cancer, heartburn, high blood pressure, immune system suppression, infections, irregular heartbeat or other heart problems, migraine headaches, nausea and vomiting, schizophrenia or other mental or mood problems, seizures, stomach or bowel problems, swelling or fluid retention, weight management), multivitamin products, or herbal or dietary supplements because they may interact with citalopram. Ask your doctor or pharmacist if you are unsure if any of your medicines might interact with citalopram

This may not be a complete list of all interactions that may occur. Ask your health care provider if citalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use citalopram:

Use citalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Citalopram comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get citalopram refilled.
  • Take citalopram by mouth with or without food.
  • Taking citalopram at the same time each day will help you remember to take it.
  • Do not suddenly stop taking citalopram without checking with your doctor. You may have an increased risk of side effects (eg, mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, unusual tiredness). If you need to stop citalopram, your doctor may need to gradually lower your dose.
  • Continue to take citalopram even if you feel well. Do not miss any doses.
  • If you miss a dose of citalopram, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use citalopram.

Important safety information:

  • Citalopram may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use citalopram with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol while you are using citalopram.
  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using citalopram; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • One to 4 weeks may pass before your symptoms improve. Do NOT change your dose or use citalopram for longer than prescribed without checking with your doctor.
  • Children, teenagers, and young adults who take citalopram may be at increased risk for suicidal thoughts or actions. Watch all patients who take citalopram closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Citalopram and a medicine called escitalopram have the same active ingredient. Do not take citalopram if you are also taking escitalopram.
  • Citalopram may cause an increased risk of a certain type of severe irregular heartbeat (QT prolongation). The risk may be higher with high doses of citalopram. It may also be higher if you have a certain type of irregular heartbeat (long QT syndrome) or low blood potassium or magnesium levels. Tell your doctor right away if you develop chest pain; fast, slow, or irregular heartbeat; shortness of breath; dizziness; or fainting. Discuss any questions or concerns with your doctor.
  • If your doctor tells you to stop taking citalopram, you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking citalopram.
  • Citalopram may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
  • Serotonin syndrome is a possibly fatal syndrome that can be caused by citalopram. Your risk may be greater if you take citalopram with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
  • Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by citalopram. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
  • Tell your doctor or dentist that you take citalopram before you receive any medical or dental care, emergency care, or surgery.
  • Use citalopram with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
  • Caution is advised when using citalopram in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
  • Citalopram should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • Citalopram may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take citalopram.
  • PREGNANCY and BREAST-FEEDING: Citalopram may cause harm to the fetus if taken during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking citalopram while you are pregnant. Citalopram is found in breast milk. Do not breast-feed while taking citalopram.

Possible side effects of citalopram:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; increased thirst; loss of appetite; nausea; stuffy nose; trouble sleeping; weakness; yawning.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; change in the amount of urine produced; chest pain; confusion; decreased concentration; decreased coordination; fainting; fast, slow, or irregular heartbeat; hallucinations; memory problems; menstrual period changes; new or worsening mental, mood, or behavior changes (eg, agitation, anxiety, depression, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being); persistent, painful erection; persistent trouble sleeping; red, swollen, blistered, or peeling skin; seizures; severe or persistent headache or dizziness; shortness of breath; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual weakness; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blue skin or lips; coma; confusion; fast breathing; fast, slow, or irregular heartbeat; increased sweating; memory loss; muscle pain; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting; tremor.

Proper storage of citalopram:

Store citalopram at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep citalopram out of the reach of children and away from pets.

General information:

  • If you have any questions about citalopram, please talk with your doctor, pharmacist, or other health care provider.
  • Citalopram is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take citalopram or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about citalopram. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to citalopram. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using citalopram.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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