Celexa (Citalopram): Drug Uses, Warnings, Dosage, & More

What is Celexa & How Is it Used?

Celexa is an antidepressant used to treat depression.¹ Celexa is the brand name of citalopram. Celexa is taken as a tablet by mouth once per day. The generic medication, citalopram, also comes as a capsule and as a solution.  Celexa belongs to the antidepressant drug class known as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the amount of serotonin in your brain.² However, side effects are still possible as the body adjusts to the medication.

Since Celexa is not suitable for everyone, your doctor may recommend other alternatives to treat depression, especially if the condition is persistent or severe. Taking Celexa as directed by your doctor to avoid its adverse health side effects is crucial.

Celexa is FDA-approved for use with disorders such as:³

• Major Depressive Disorder in adults

Celexa is an off-label (non-FDA approved) medication for disorders such as:³

• General Anxiety Disorder (Celexa for anxiety)
• Obsessive-Compulsive Disorder
• Eating Disorders
• Panic Disorder
• Premenstrual Dysphoric Disorder
• Social Anxiety Disorder
• Post-Traumatic Stress Disorder

Celexa changes how the brain reabsorbs the neurotransmitter serotonin, making it more available for use by preventing the reuptake process, which usually reduces availability. This physiological process increases the feeling of improved well-being that all antidepressants aim to make you feel.

Some people may respond differently to Celexa compared to other antidepressants. Celexa is an SSRI. The significant difference between SNRIs and SSRIs is that SSRIs block serotonin reuptake where as SNRIs inhibit both serotonin and norepinephrine reuptake.⁴

What Are Common Celexa Dosages and Delivery Methods?

Based on a patient’s symptoms and age considerations, a prescriber may adjust the Celexa dosage. For example, some patients may benefit from an increased dosage of 40 mg, while others may have a positive response at 20 mg.

The typical dosage of Celexa for adults includes:

• An Initial dose of 20 mg
• The maintenance dose is between 20 to 40 mg
• A maximum dose of 40 mg

The recommended dose for adults over 60 years is 20 mg orally once a day. Celexa is only available as a tablet, but generic citalopram is available as a capsule and as an oral solution. Other SSRIs and antidepressants may be tried if the response to Celexa is inadequate.

Celexa Warnings & Associated Risks

As with any medication, there are potential risks and side effects with taking Celexa. Celexa has a black box warning for the increased risk of suicidal thoughts and actions in certain people, so it is not suitable for everyone.⁵ Taking alcohol is also not recommended when using Citalopram as it can worsen the side effects of Celexa and damage the central nervous system and other organs. These effects of alcohol and Celexa can include angle-closure glaucoma, a form of glaucoma that occurs when iris bulges block the drainage angle.

Health conditions to mention to your doctor before taking Celexa include:^{6, 7, 8}

• Breastfeeding: Taking Celexa while breastfeeding can cause serious harm to an infant. It is recommended to stop breastfeeding while using the medicine.
• Pregnant: It’s unclear if Celexa is safe to take while pregnant. A doctor can help to talk through the potential risks and benefits.
• Heart problems: If you have heart problems, it is best to consult your doctor before taking citalopram. This medicine can cause fatal changes to the heart’s electrical activity.
• Use of MAO inhibitors: Before taking an MAO inhibitor, wait for 14 days after stopping citalopram. Taking citalopram and an MAO inhibitor together makes you likely to develop severe seizures or confusion.
• Sexual disorders: It’s possible for anyone taking Celexa or other SSRIs to experience erectile dysfunction and this can be worsened in people who already have sexual disorders.
• Glaucoma: if you have an eye condition, glaucoma, Celexa can increase the pressure in your eye, which may lead to vision loss.
• Seizures: Celexa can increase the risk of seizures, especially if too much is taken.
• Bipolar disorder: Celexa is not suitable for treating bipolar disorder. It can worsen manic symptoms if used on a long-term basis.
• Older people: Celexa is not recommended for people over 65 unless specified by a doctor due to an increased risk of side effects.
• Use of other antidepressants: Taking Celexa and any other SSRIs is not recommended, as it increases the risk for a dangerous side effect known as serotonin syndrome.
• Bleeding problems: If you have bleeding problems, consult your doctor before taking Celexa. Some studies have reported SSRIs increase the risk of bleeding.

If you have any medical issues, see your doctor before using Celexa, as it will help them in preventing additional side effects of Celexa.

Side Effects of Celexa (Citalopram)

Common side effects when taking Celexa include nausea and insomnia. All side effects should be discussed with a doctor, as better treatment options may be available.

Severe side effects of Celexa can include:

• Suicidal thoughts: Celexa can increase suicidal thoughts among teenagers and young adults. Suicidal ideation can make them more violent and agitated and may lead them to attempt suicide. Celexa carries a black box warning for this risk.
• Heart rhythm changes: Celexa can cause serious heart problems, leading to chest pain, shortness of breath, and slow or fast heart rate.
• Serotonin syndrome: Celexa can increase serotonergic activity in the central nervous system, which may result in coordination problems or muscle rigidity.
• Mania: Celexa can have a severe side effect on people with mania in bipolar disorder, leading to reckless behavior, excessive happiness, or irritability.
• Sexual dysfunction: Some people may develop sexual side effects from Celexa, including problems with ejaculation and erectile function in men and low libido in women.
• Seizures: If you have seizures and take Celexa, the medication can trigger episodic seizures leading to convulsions or sudden loss of awareness.
• Visual problems: a person with glaucoma can experience severe effects when taking Celexa since the medicine increases pressure on the eye leading to eye pain or blurred vision.
• Hyponatremia: Citalopram can cause low salt levels in the blood, especially among older people or those taking diuretic medicines for high blood pressure.
• Electrolyte imbalance: Citalopram can cause electrolyte imbalance. It is essential to correct any electrolyte imbalances before taking Citalopram.

Common Celexa side effects can include:

• Nausea
• Weakness
• Yawning
• Constipation
• Dry mouth
• Diarrhea
• Shaking
• Dizziness
• Anxiousness
• Hunger
• Respiratory infections
• Frequent urination
• Increased thirst
• Insomnia or trouble sleeping

Allergic Reactions to Celexa

It is possible for Celexa to cause allergic reactions, leading to itchy, lumpy rashes or urticaria. These are the common reactions of those allergic to antidepressant medication. However, an allergic reaction is rare and does not affect everyone taking Celexa. People with a history of escitalopram allergies should consult their doctors before using this antidepressant. This way, doctors can advise them on better alternatives to taking Celexa.⁹

Medication Interactions with Celexa

Disclaimer: Taking certain medications, herbs, or supplements alongside Celexa can change how Celexa works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change medicines’ dosage without your doctor’s approval.

Some substances that can have harmful interactions with Celexa include:

• Alcohol: it can increase the effects of drowsiness of Celexa
• Blood thinners: may increase the risk of bleeding
• St John’s Wort: this can increase the risk of serotonin syndrome
• Migraine drugs: increases the risks of serotonin syndrome
• NSAIDs: increase the risk of bleeding
• MAOIs: increases the risk of serotonin syndrome

What to Do If You Overdose

The symptoms are generally mild. Still, if you overdose on Citalopram, you should seek medical attention or call the poison line (1-800-222-1222). Citalopram is not commonly abused, but its misuse has significantly increased as individuals look for a quick fix to symptoms. Overdose mainly happens when one increases the prescribed dosage when they feel the drug is not working well enough for them. This action poses a severe health concern.

The common symptoms of Celexa overdose include:

• Dizziness
• Drowsiness
• Headache
• Tremors
• Heart palpitations

Overdose symptoms can become severe when it leads to serotonin syndrome, which has symptoms including:

• Increased heartbeat
• Fever
• Agitation
• Confusion
• Muscle twitching

To avoid this, Celexa should be taken as directed by your doctor, with increases to dosages taken slowly and monitored by a professional.

What if I Miss a Dose of Citalopram?

It is recommended not to abruptly stop taking antidepressants, such as Celexa (citalopram). Instead, doctors will recommend gradually tapering antidepressant medications under medical guidance to minimize Celexa withdrawal symptoms. This slow taper is needed as antidepressant discontinuation syndrome can produce muscle aches and mood changes which can cause a relapse of depression.¹⁰

Sometimes, prescribers may recommend people stop taking the medications if side effects of loss of sexual desire or decreased arousal outway the benefits of the drug. Despite these factors, your doctor will suggest you keep taking the medicines even after your symptoms improve. This treatment technique is known as continuation therapy, which is crucial to preventing depression symptoms from returning.

Questions to Ask Your Health Team About Citalopram

Celexa is one of the best available antidepressants to treat depression. Many people would consider it over other antidepressants because of its effectiveness in treating mental illnesses like depression.

11 questions to ask your care team about before taking citalopram (Celexa) include:

1. Why should I take citalopram medication?
2. What side effects am I likely to experience?
3. How long will the medication last?
4. What will happen if you take Citalopram with other medicines?
5. What factor does my medical history play when choosing citalopram medication?
6. If I stop taking the medication, what will happen to my well-being?
7. What should I do if I want to stop taking Citalopram?
8. Should my therapist know I am taking this medication?
9. Will my insurance cover Citalopram?
10. I stopped taking my medication. Should I start immediately?
11. Based on my age, how should I take citalopram medication?

History of Citalopram

There are several manufacturers of Citalopram in different regions. Forest Laboratories manufactures the selective serotonin reuptake inhibitor Celexa (Citalopram) for U.S and Canadian markets. H. Lundbeck A/S manufactures Citalopram for Turkey and Denmark, selling it under the brand name Cipram.

Forest laboratories produce several products, including AeroBid for allergic rhinitis, Campral, and Daliresp. H. Lundbeck A/S produces Sabril for Huntington’s disease and xenazine for migraine.

Final Thoughts

Citalopram is an antidepressant used to treat depression and other mental problems. The antidepressant increases the amount of serotonin to help maintain mental balance. However, citalopram medication can lead to mild to severe side effects, including suicidal thoughts, serotonin syndrome, and sleeping problems. Therefore, patients should take this medication with caution and by the supervisor of a prescriber. This antidepressant should not be used with other SSRIs to avoid risks associated with Citalopram interactions and other antidepressants. If you need further assistance using Citalopram, consult your therapist.