Celexa
Pronunciation: suh-leks-uh
Generic name: citalopram
Dosage form: oral tablet (10 mg; 20 mg; 40 mg)
Drug class: Selective serotonin reuptake inhibitors
What is Celexa?
Celexa is a prescription medicine used to treat severe depression in adults, called major depressive disorder (MDD).
Celexa is a selective serotonin reuptake inhibitor (SSRI) that blocks the reuptake of serotonin (5-HT) by the nerves of the central nervous system, which enhances serotonergic activity. The exact way it works in depression is unclear.
Celexa belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Citalopram works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
Celexa side effects
Common Celexa side effects may include:
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sexual problems;
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dizziness, drowsiness;
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dry mouth, thirst, increased sweating or urination;
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loss of appetite, nausea, diarrhea, constipation;
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feeling anxious, agitated, or shaky;
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feeling weak or tired, sleep problems (insomnia), yawning;
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increased muscle movement;
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nosebleed, heavy menstrual bleeding; or
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cold symptoms such as stuffy nose, sneezing, or sore throat.
Serious side effects
Get emergency medical help if you have signs of an allergic reaction to Celexa: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.
Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.
Citalopram may cause serious side effects. Call your doctor at once if you have:
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a light-headed feeling, like you might pass out;
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blurred vision, eye pain or redness, seeing halos around lights;
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fast or pounding heartbeats, pain or fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
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a seizure;
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unusual bleeding - nosebleeds, bleeding gums, abnormal vaginal bleeding, any bleeding that will not stop;
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manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative;
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severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; or
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low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Citalopram can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using Celexa.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Warnings
Do not stop taking Celexa without your doctor's advice.
Citalopram can cause a serious heart problem. Call your doctor right away if you have chest pain, fast or pounding heartbeats, shortness of breath, and sudden dizziness.
You should not use Celexa if you also take pimozide, as the combination can cause problems with your heart rhythm.
Do not use Celexa if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine) or have received a methylene blue injection. A fatal reaction may occur.
Antidepressants, such as Celexa, increase the risk of suicidal thoughts and behaviors in young adults. People with depression or mental illness may have thoughts about suicide. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Report any new or worsening symptoms to your doctor, such as mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
SSRIs, including Celexa, may cause sexual problems. Symptoms in males may include delayed ejaculation or inability to have an ejaculation, decreased sex drive, problems getting or keeping an erection. Symptoms in females may include decreased sex drive, delayed orgasm, or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with Celexa. There may be treatments your healthcare provider can suggest.
Do not stop using Celexa without first asking your doctor.
Before taking this medicine
You should not use Celexa if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide.
Do not use Celexa if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine. Wait at least 14 days after stopping an MAO inhibitor before you take Celexa.
Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with citalopram could cause a serious condition called serotonin syndrome.
To make sure Celexa is safe for you, tell your doctor if you have ever had:
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heart problems, high blood pressure, long QT syndrome;
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a stroke;
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bleeding problems;
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sexual problems;
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narrow-angle glaucoma;
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bipolar disorder (manic depression) in you or a family member;
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an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood); or
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liver or kidney disease
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are pregnant or intending to become pregnant
- are breastfeeding.
People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.
Pregnancy
Taking this medicine during the last 3 months of pregnancy may harm the unborn baby, but stopping the medicine may not be safe for you. Do not start or stop Celexa without asking your doctor.
If you are pregnant, there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. You can register by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at https://womensmentalhealth.org/research/pregnancyregistry/antidepressants.
There is a less than 2-fold increased risk for severe bleeding after delivery (postpartum hemorrhage) in mothers exposed to SSRIs, particularly in the month before delivery.
Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with Celexa. There may be treatments your healthcare provider can suggest.
Breastfeeding
Ask a doctor if it is safe to breastfeed while using this medicine.
How should I take Celexa?
Take Celexa exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes.
You may take Celexa with or without food, but take it the same way each time.
Measure liquid medicine with the supplied measuring device (not a kitchen spoon).
Your symptoms may not improve for up to 4 weeks.
Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated.
Do not stop using Celexa suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Follow your doctor's instructions about tapering your dose.
You may need frequent vision exams before starting treatment.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
Celexa dosing information
Usual Adult Dose for Depression:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Maximum dose: 40 mg orally per day
Comments:
-The initial dose may be increased if necessary to 40 mg once a day after at least 1 week of therapy.
-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.
-Acute episodes of depression may require several months or more of sustained pharmacologic therapy
Usual Senior Dose for Depression:
Over 60 years of age:
Recommended dose: 20 mg orally once a day
Comments:
-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.
-Acute episodes of depression may require several months or more of sustained pharmacologic therapy.
Related/similar drugs
trazodone, sertraline, fluoxetine, venlafaxine, Lexapro, citalopram, Zoloft, Cymbalta, Prozac, paroxetine
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Celexa?
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with citalopram may cause you to bruise or bleed easily.
Do not drink alcohol.
Avoid driving or hazardous activity until you know how Celexa will affect you. Your reactions could be impaired.
What other drugs will affect Celexa?
Citalopram can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Tell your doctor about all your current medicines. Many drugs can interact with citalopram, especially:
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a diuretic or "water pill";
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methadone, fentanyl, or other opioids; or
SSRIs, including Celexa, can precipitate serotonin syndrome, a potentially life-threatening condition. The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, such as MAOIs. Serotonin syndrome can also occur when these drugs are used alone.
This list is not complete and many other drugs may affect Celexa. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Ingredients
Active ingredient: citalopram hydrobromide.
Inactive ingredients: copolyvidone, corn starch, crosscarmellose sodium, glycerin, lactose monohydrate, magnesium stearate, hypromellose, microcrystalline cellulose, polyethylene glycol, titanium dioxide and iron dioxide for coloring.
Manufacturer
Distributed by Allergan USA Inc, Madison, NJ 07960, USA.
Frequently asked questions
- SSRIs vs SNRIs - What's the difference between them?
- What is the difference between Celexa and Lexapro?
- What are some common side effects of antidepressants?
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