*An off-label use of a medication is a use 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 (citalopram) is an antidepressant FDA-approved to treat depression in adults. Celexa may also be used off-label to treat conditions such as social anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Some may experience mild symptoms such as vomiting and nausea at the beginning of treatment.
If you’re considering Celexa, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Celexa or another medication may help your symptoms.
Boxed Warning: Citalopram (Celexa) - Risk of suicidal thoughts and behaviors in certain people
Citalopram, the active ingredient in Celexa, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Citalopram can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with citalopram and any other medications before starting treatment.
Key Takeaways
Celexa is a prescription antidepressant medication used to treat major depression in adults. Celexa may also be used off-label to treat conditions such as generalized anxiety disorder, OCD, and PTSD.
Celexa, with the active ingredient citalopram, is a selective serotonin reuptake inhibitor (SSRI).
If you are considering Celexa, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry, or Circle Medical.
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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
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What Are the Risks & Warnings for Celexa?
Suicidal Thoughts or Behaviors
Citalopram, the active ingredient in Celexa, has a black boxed warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Celexa can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with citalopram and any other medications before starting treatment.
Triggering Manic Episodes
For some people with bipolar disorder, taking Celexa can increase the risk of triggering manic episodes. Prior to starting treatment with an antidepressant like Celexa, patients with depressive symptoms should be screened to determine if they are at risk for bipolar disorder.
Allergic Reactions
For some people taking Celexa, an allergic reaction may occur which may be dangerous. If you experience wheezing, difficulty breathing, or swelling in the throat, seek immediate medical help.
Severe allergic reactions to Celexa can include breathing problems, swelling, and a rash or hives.
Serotonin Syndrome
Taking Celexa may increase the risk of a serotonin syndrome, a potentially life-threatening condition resulting from high levels of serotonin in the body.
Symptoms include fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhea.
Heart Problems
For some people, taking Celexa may increase the risk of heart-related problems, such as an irregular heart rate that
Seizures
Celexa can increase the risk of seizures, especially if too much is taken.
Angle-closure Glaucoma (Serious Eye Condition)
If you have an eye condition, glaucoma, Celexa can increase the pressure in your eye, which may lead to vision loss.
Abnormal Bleeding
Medications that affect serotonin activity, such as Celexa, can increase the risk of abnormal bleeding. Signs of abnormal bleeding can include bruising under the skin, a cut that does not stop bleeding, discolored stool, nose bleedings, or vomiting blood.
Pregnancy Risks
It’s unclear if Celexa is safe to take while pregnant. A doctor can help to talk through the potential risks and benefits.
Breastfeeding Risks
Taking Celexa while breastfeeding may cause serious harm to an infant. It is recommended to stop breastfeeding while using the medication.
Hyponatramia (Low Sodium Levels)
A rare but serious side effect, hyponatremia (low sodium levels), has been associated with the use of antidepressants such as Celexa. Low sodium levels in your blood may be serious and may cause death. Elderly people may be at greater risk for this.
Risks for Older Adults
Celexa is not recommended for people over 65 unless specified by a doctor due to an increased risk of side effects.
Drug Interactions
Taking certain medications, herbs, or supplements alongside Celexa can change how Celexa works in your body or increase the risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Substances you should avoid using while taking Celexa include:
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Alcohol
This is not a comprehensive list of medications that interact with Celexa. Be sure to talk with your doctor or pharmacist about any prescription or over the counter medications you take, as well as supplements, herbs, and teas.
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.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Questions to Ask Your Provider
It is important to discuss the potential side effects of Celexa with your doctor, psychiatrist, or therapist you may experience immediately after starting the treatment. Ask them whether these side effects will go away on their own or if any intervention is needed.
Also, many online psychiatry services are available with convenient access to mental health care for depressive disorders. Individuals may even change prescribers and get a mental health evaluation, diagnosis, and personalized treatment plan.
Questions to ask your care team about Celexa include:
- Is it safe to take Celexa with my other medications?
- Will Celexa be covered by my insurance?
- Does my medical history indicate a need to adjust my dosage?
- How long will it take before my symptoms improve?
- Should I let my therapist know I am taking this medication?
- What should I do if I want to stop taking Celexa?
- How long will it take for me to adjust to taking Celexa?
- How quickly can Celexa cause side effects?
- What are the first days of Celexa side effects like?
Frequently Asked Questions
Can Celexa Be Used During Pregnancy?
It’s unclear if Celexa is safe to take while pregnant. Your provider can help to talk through the potential risks and benefits of taking this medication while pregnant.
Can Celexa Be Used While Breastfeeding?
Taking Celexa while breastfeeding can cause serious harm to an infant. It is recommended to stop breastfeeding while using the medicine.
Does Celexa Cause Weight Gain?
It’s possible. Weight gain is a common concern for those currently or considering taking antidepressant drugs, especially an SSRI such as Celexa. Antidepressants are commonly linked to changes in appetite and metabolism, which can lead to weight gain or weight loss. These reactions can vary from person to person.
Is It OK to Drink Alcohol While Taking Celexa?
No, it is not advised to drink alcohol while taking Celexa. Higher dosages of either Celexa or alcohol may lead to irregular heart rates. Taking alcohol can increase the nervous system side effects of Celexa, such as dizziness and difficulty concentrating. Celexa can also cause drowsiness and may affect your decision making. Do not drive, operate heavy machinery, or do other dangerous activities until you know how Celexa affects you.
What Are Common Side Effects of Celexa?
Common Celexa side effects include nausea, fatigue, changes in sleep and appetite, and sexual dysfunction.
How Long Will Celexa Side Effects Last?
Common Celexa side effects usually last for a few weeks after the initial dose but may last longer in some people.
What’s the Number One Side Effect of Celexa?
In the clinical trials for Celexa, the most commonly reported side effect was delayed ejaculation.1
Should I Stop Taking Celexa If I Start Feeling Side Effects?
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 you are experiencing side effects from your medication, tell your provider. They will help you determine the best course for continued treatment.
ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Celexa- citalopram tablet, film coated. (November 13, 2023). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. [Updated 2023 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482222/
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Scotton WJ, Hill LJ, Williams AC, Barnes NM. (2019, Sep 9). Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions. International Journal of Tryptophan Research. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734608/
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National Institute of Diabetes and Digestive and Kidney Diseases. (2017, October 12). Citalopram – LiverTox – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK548395/
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary updates: Added “Key Takeaways” feature. Edited for clarity. Revised and retitled content in “What is Celexa & How Is it Used?”, Added sections titled “How Effective Is Celexa?”, “How Long Does Celexa Take to Work?” How Long Do I Need to Keep Taking Celexa?”, “What Are the Long-term Effects of Celexa?”. Consolidated “Allergic Reactions to Celexa” and “Celexa Warnings & Associated Risks” into new “Risks” feature. Added “Who Should Not Take Celexa?”, “Celexa Withdrawal”, “How Should I Take Celexa?”, “How to Get a Prescription for Celexa”. Retitled “Questions to Ask Your Health Team About Citalopram” to “Questions to Ask Your Provider”. Removed “History of Citalopram” and “For Further Reading” sections, added FAQs. Replaced “Final Thoughts” with “Prescriber’s Tips” feature.
Author: Diana Rangaves, PharmD, RPh
Medical Reviewer: Dena Westphalen, PharmD
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