Celexa (Citalopram): Uses, Side Effects, Dosage, & More

What Is Celexa (Citalopram)?

Celexa, with the active ingredient citalopram, is an antidepressant used to treat major depressive disorder.¹ It belongs to the antidepressant drug class known as selective serotonin reuptake inhibitors (SSRIs). Celexa is taken as a tablet by mouth once per day. The generic medication, citalopram, also comes as a capsule and as a solution.

How Does Celexa Work?

Celexa is thought to work by increasing the amount of serotonin levels, a body chemical involved in mood regulation, in the brain.¹ For some, this improves well-being and reduces symptoms of depression.

What Is Celexa Used to Treat?

Celexa is FDA-approved to treat major depression in adults 18 years and older.¹

Off-Label (Non-FDA-Approved) Uses of Celexa

Celexa may be used off-label to treat certain conditions. An off-label use of a medication is one that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Celexa may be used off-label (non-FDA approved) for disorders such as:²

• Generalized anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Binge eating disorder
• Panic disorder
• Premenstrual dysphoric disorder (PMDD)
• Social anxiety disorder
• Post-traumatic stress disorder (PTSD)

How Effective Is Celexa?

In two short term studies (4 to 6 weeks), Celexa was shown to be effective in treating depression. Patients were evaluated by the Hamilton Depression Rating Scale (HAMD) scale, which measures severity of depression symptoms. When compared to patients not taking Celexa, those taking Celexa doses of 40 mg or higher once daily showed significant improvement of symptoms.¹ Two long term studies also showed that patients taking Celexa had a significantly lower rate of depression relapse, meaning depression returned or came back, over six months.¹

There were also three trials conducted that did not show a significant difference in depression symptoms. It is important to note that patients on doses lower than 40 mg did not show a short term reduction in depression symptoms. These are reminders that each patient responds differently to treatment. No matter what treatment you use, constant communication with your provider is essential for dose reevaluations and adjustments.

How Long Does it Take for Celexa to Work?

It can take about 4-8 weeks for Celexa to become fully effective, but some individuals may start to feel better after the first week or two. Each person may have a different response time based on how their body absorbs and processes the medication.

How Long Do I Need to Keep Taking Celexa?

The length of time a patient uses Celexa will vary for each individual. It can take up to 4 to 6 weeks for Celexa to reduce depression symptoms. Celexa has been studied in patients for at least 6 months and many patients continue to take Celexa for longer periods. You and your prescriber will work together to decide how long you may need to take Celexa. Examples of factors that may influence this decision include depression symptoms, Celexa side effects, new medications, or changes in lifestyle.

If you are planning to stop treatment, work with your prescriber to safely decrease the dose of Celexa. The longer treatment lasts and the higher the dose, the longer you may need to take Celexa to slowly decrease and stop the dose. Your prescriber will provide specific directions about what dose of Celexa you should take every week when you are changing your dose or stopping Celexa.

Common Celexa Side Effects

Individuals taking Celexa may experience common side effects that affect their digestive system, sleep, appetite, and sexual functioning. Some Celexa side effects may require medical attention but many often resolve on their own.

Common side effects of Celexa may include:*¹

• Nausea
• Dry mouth
• Increased sweating
• Delayed ejaculation
• Fatigue or drowsiness
• Insomnia
• Tremor

*All medications, including Celexa, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

Serious Celexa Side Effects

There is a risk for Celexa side effects to be severe or persistent. If these side effects appear, it is important to seek immediate medical attention.

Serious side effects of Celexa that require immediate medical attention include:*^{1, 3}

• Suicidal thoughts or actions
• Bruising or unusual bleeding
• Symptoms of mania or hypomania
• Seizures or convulsions
• Allergic reactions
• Low sodium levels in the blood
• Angle-closure glaucoma (serious eye condition)
• Muscle rigidity, fever, and/or seizures (Could be a sign of serotonin syndrome)

*All medications, including Celexa, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

What Are The Long-term Effects of Taking Celexa?

Your provider will closely monitor you while taking Celexa to watch for potential signs of long-term side effects. Chronic conditions that could be caused by prolonged use of Celexa include:⁴

• Liver damage
• Heart rhythm abnormalities

Who Should Not Take Celexa?

Some patients may experience side effects from Celexa more than others. While predicting who will respond poorly is difficult, specific patient populations should be cautious with Celexa. Patients taking other SSRIs, SNRIs, or medications that increase serotonin in the brain should avoid Celexa due to the risk of serotonin syndrome.

Adolescent patients and their parents should be aware of the risk of increased suicidal thoughts and behaviors when starting Celexa. It is essential to discuss your health conditions with your physician to select the medication that is the most suitable for you.

Populations with increased risk for experiencing side effects include those who are or have:¹

• Kidney problems
• Liver problems
• Heart problems, specifically QT prolongation
• Bipolar disorder or mania
• Prior allergic reactions to citalopram
• Prior vision issues such as glaucoma
• A history of seizures
• High blood pressure
• A history of serotonin syndrome
• Bleeding problems
• A history of suicidal thoughts or behaviors
• Pregnant or who plan to become pregnant
• Breastfeeding or who plan to breastfeed

Drug Interactions With Celexa

Taking certain medications, herbs, or supplements alongside Celexa can change how Celexa works in your body or increase the risk for serious side effects. Always talk with your prescriber about what to avoid while using Celexa.

Substances you should avoid using while taking Celexa include:¹

• Additional SSRI or SNRI medications
• Monoamine oxidase inhibitors (MAOIs)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Pimozide
• Linezolid
• Blood thinners
• Alcohol
• St. John’s wort

This is not a comprehensive list of the possible interactions with Celexa. You should talk with your provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Celexa.

Celexa Withdrawal

For some people, abruptly stopping Celexa can lead to antidepressant discontinuation syndrome, also known as antidepressant withdrawal.

Do not stop taking Celexa unless you have been advised to do so by your provider. Doing so can cause uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea. If your provider determines that stopping your medication is necessary, they will provide a plan for gradually lowering your dosage. Doing so can minimize your risk of developing withdrawal symptoms.

Celexa Dosages for FDA-Approved Treatment

The typical Celexa dosage for adults is 20 mg daily. Your provider may give you a smaller dose to start with and work up to a maximum daily dose of 40 mg based on your symptoms and age, your provider may adjust your dosage. Celexa is only available as a tablet, but generic citalopram is available as a capsule and as an oral solution.

How Should I Take Celexa?

Always follow the instructions from your provider or the medication label. You can take Celexa with or without food. If your provider specifies a certain time for you to take it, it’s important to follow this direction closely.

What Happens If I Miss a Dose of Celexa?

If you forget to take your Celexa dose, take it as soon as you remember. If your next dose is due soon, skip the missed one and take your next scheduled dose. Never take two doses at once, and continue taking your medication as prescribed unless your prescriber directs you to do otherwise.¹

Can You Overdose on Celexa?

Yes, you can overdose on Celexa. Taking excessive amounts of Celexa can result in an overdose. Celexa overdose can also occur due to combining Celexa with other substances such as alcohol or other drugs.

Common side effects of Celexa overdose include:¹

• Dizziness
• Sweating
• Nausea
• Tremors
• Sinus tachycardia (an irregular or faster-than-normal heartbeat)
• Vomiting

What Should You Do If You Take Too Much Celexa?

Call the poison hotline (1-800-222-1222) or go to a hospital if you take too much Celexa. An overdose of Celexa can cause severe symptoms, such as an irregular heart rate and seizures.

How to Get a Prescription for Celexa

To get a prescription for Celexa in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription for Celexa should be included in your treatment plan.

Can I Get Celexa Prescribed Online?

To get an online prescription for Celexa, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants.