Celexa (Citalopram) For Anxiety: Effectiveness, Dosage, & More

What is Celexa (Citalopram)?

Celexa is a selective serotonin reuptake inhibitor (SSRI) antidepressant that is FDA approved to treat major depressive disorder (MDD) in adults.¹ Celexa is also sometimes used in treatment for anxiety in adults as an “off-label” (non-FDA approved) medication. Celexa works to restore the balance of a specific natural substance, serotonin, in the brain, which can help patients improve energy levels and feelings of well-being.² Celexa is only approved for use in adults. Talking with a doctor is needed to discuss options for children.

Why Is Celexa Used to Treat Anxiety Disorders?

Although Celexa is mainly used to treat symptoms of major depressive disorders, it is sometimes prescribed off-label for anxiety disorders. Celexa cannot cure anxiety but can help reduce anxiety symptoms in some people and works best as part of anxiety treatment. This knowledge is based on evidence from specific studies that have found Celexa may improve the symptoms of generalized anxiety disorders and is also effective in improving sleep quality (such as counteracting insomnia).³

Celexa may be able to help treat specific types of anxiety disorders, such as:

• Social anxiety
• Panic attacks (as part of panic disorders)
• Specific phobias 

While Celexa is less studied as a medication for anxiety than other SSRIs, healthcare providers may still prescribe it when other SSRIs fail to treat anxiety symptoms. They usually will not try Celexa before trying other medications for anxiety. The effectiveness of Celexa in treating anxiety disorders is due to its benefits of regulating mood and ensuring the brain has adequate serotonin levels.

How Does Celexa Help With Anxiety?

Since Celexa is an SSRI, it boosts serotonin levels in the brain. Serotonin, as a hormone, plays an essential role in sleep and mood, which studies have linked to having impacts on depression and anxiety. The same physiological changes that Celexa helps with managing anxiety are the same for other mental health disorders such as depression, OCD, and PTSD, helping improve a person’s ability to cope with life stressors and improve their quality of life.

How to Take Celexa for Anxiety?

Celexa only comes in the form of tablets, but the generic citalopram is also available as capsules and oral solutions. Celexa can be taken at any time of the day, with or without food. But it is recommended to take Celexa at the same time every day, either in the morning or in the evening.

Adults usually take 20 mg of Celexa once daily in the morning or evening. However, your prescriber may increase your dose as needed should you not experience benefits in the first few months. Doses above 40mg are not recommended due to the risk of QT prolongation. If you have any other conditions, you should consult your prescriber before taking the medications to avoid potentially severe side effects.

How Long Does it Take for Celexa to Work For Anxiety?

The timing of Celexa to show impacts on mood depends on various factors, including a patient’s health conditions and life stressors. Generally, the time for antidepressants to work will take about four to six weeks after the initial dose to start producing the desired result. It is also important to note that the antidepressant may never work or produce desired effects in some people. For this reason, the person will have to increase their dosage or try other SSRI medications to get the wanted results.

Celexa Dosage For Anxiety

The effectiveness of Celexa dosage to help anxiety symptoms mainly varies based on several factors, including age and the nature of the anxiety disorder. Because Celexa is not FDA-approved for anxiety, no clinical trials evaluate the safety and efficacy of different doses of Celexa for treating anxiety. A doctor will help to determine the proper and safe dose of Celexa if it is prescribed off-label.

The maximum dosage of Celexa is 40 mg, and the initial dose will likely be lower and increased up to 40mg once per day only if needed and only under your prescriber’s guidance. This process of starting at lower dosages is done to see how effective Celexa is at treating anxiety symptoms, as any prescription of Celexa can cause severe side effects, including serotonin syndrome and a risk of suicidal thoughts in some people.⁴
Adherence to the prescribed amount by your practitioner is crucial to the success of the medication.

Can You Overdose on Celexa?

A lack of knowledge of how Celexa works as a long-acting medication and the potentially severe side effects of 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

If you experience these symptoms or think you may have overdosed on Celexa, you should call 9-1-1 or  visit the nearest emergency room as soon as possible. Your caregiver or physician should consider contacting a poison control center (1-800-222-1222) for additional information on treating any overdose.⁵

Side Effects of Celexa While Treating Anxiety

Common side effects of Celexa are often mild and do not need immediate medical attention. You should talk with your doctor about any side effects you experience while taking Celexa so that they can ensure they are not dangerous and provide any guidance on managing the side effects.  The common Citalopram side effects usually last for a few weeks after the initial dose but may last longer in some people.⁶

Common Celexa side effects include:¹

• Nausea
• Sexual disorders such as erectile dysfunction and decreased libido
• Drowsiness
• Dry mouth
• Constipation
• Diarrhea
• Vomiting
• Stomach pains
• Weight loss
• Sweating
• Weight gain
• Joint pains
• Fatigue
• Heavy menstrual periods

Serious Celexa side effects that may need additional medical attention include:¹

• Suicidal thoughts and behaviors– children, teenagers, and young adults taking Celexa are at increased risk of experiencing suicidal ideation.
• Glaucoma – Celexa can increase the pressure on the eye resulting in vision problems.
• Hyponatremia (low sodium levels) – This condition is more frequent in older people or patients taking diuretic medications for high blood pressure.
• Sexual dysfunction – Celexa sexual side effects can develop for some people, including ejaculatory delay or erectile dysfunction in male patients and a low sex drive in both male and female patients.
• Serotonin syndrome – If there is too much serotonin activity in the central nervous system due to taking Celexa, it can lead to muscle rigidity or coordination problems. This is a serious, sometimes fatal side effect. Your risk increases if you take other medications that increase your serotonin levels.
• Manic episodes – Taking Celexa in patients with bipolar disorder, especially when treating a depressive disorder, can precipitate a manic episode.
• Bleeding disorders – Celexa is an antidepressant drug that can interfere with serotonin reuptake inhibition, increasing bleeding risks. Your risk is increased if you are taking medications that are blood thinners, such as warfarin.
• QT-prolongation – Citalopram antidepressant causes dose-dependent QTc prolongation. This ECG abnormality has been linked with Torsade de Pointes (TdP) and sudden death.
• Seizures – Taking Citalopram while also experiencing seizures can be very dangerous. The antidepressant can trigger episodic seizures leading to convulsions or sudden loss of consciousness.

You should talk with your doctor about your medical history and any conditions you currently or previously have had so your doctor can determine if you would be at an increased risk for any side effects and if Celexa would be safe for you.

Warnings & Associated Risks of Taking Celexa for Anxiety

You should talk with your doctor about all warnings and side effects associated with taking Celexa to determine if the medication is safe for you.

Celexa has a black box warning, the most serious warning by the FDA for the increased risk of suicidal thoughts in children and young adults.

Taking Celexa with alcohol can make the symptoms of depression and anxiety worse. This reaction is because alcohol is a depressant while citalopram is antidepressant, and either substance can worsen the side effects of one another.

You should inform your prescriber if you have any of the following medical conditions to ensure Celexa is safe for you to use:¹

• People with a history of allergic reactions to citalopram or any other SSRIs
• Those with heart problems
• Pregnant women
• Those with glaucoma condition
• People with seizures
• Bleeding disorders

Substances to Avoid If You’re Taking 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 the dosage of any medicines without your doctor’s approval.

Mixing Celexa with other SSRI medications in treating anxiety can lead to severe side effects and increase the risk of serotonin syndrome. Drugs that can increase such risk include monoamine oxidase inhibitors (MAOIs), other SSRI antidepressants, and triptans for migraines. Serotonin syndrome can be fatal and require immediate medical attention.⁷

Some substances that can negatively interact with Celexa include:¹

• Blood thinners- Celexa may raise your risk of dangerous bleeding. These risks are higher if you are using blood thinners.
• NSAIDs – You should not mix nonsteroidal anti-inflammatory drugs such as ibuprofen and meloxicam used to treat pain and inflammation with Celexa. Taking Celexa with NSAIDs can increase the risk of bleeding.
• MAOIs – increases the risk of serotonin syndrome
• Migraine drugs – The use of triptans increases the risk of serotonin syndrome
• St John’s Wort Supplement – mixing Celexa with this medication can lead to serotonin syndrome
• Alcohol – this increases the effects of drowsiness and other side effects of Citalopram

This is not a complete list of possible medications that can interact with Celexa, you should talk with your doctor about any medications you are taking before starting Celexa.

Alternatives to Celexa for Anxiety

If you have been taking Celexa for anxiety for some time with no desirable results, your doctor will likely stop the medication and issue new alternatives. These alternatives include benzodiazepines, buspirone, and beta-blockers. While these alternative medications for anxiety are essential and better in some aspects, they also carry additional side effects.

Some alternatives to Celexa to treat anxiety include:

• Benzodiazepines– this medication takes effect very fast. It makes people feel the calming and relaxing benefits of the drugs and has side effects.
• Buspirone – unrelated to benzodiazepines, buspirone can take several weeks to make someone feel better.
• Beta-Blockers – these drugs can help with anxiety symptoms. Beta-blockers work in the body by reducing the levels of epinephrine in the body.

Questions to Ask Your Health Team About Taking Celexa For Anxiety

Before taking Celexa medication for anxiety, you should consult your doctor about the antidepressant and its potential side effects. Only your certified doctor or prescriber is allowed to prescribe this medication.

Questions to ask your care team about whether Celexa is right for you include:

1. Would Celexa be effective in treating my anxiety?
2. Is Celexa more effective at treating anxiety than the medication I am already taking?
3. Can I take Celexa with the medication I am already taking?
4. Will I need to change my anxiety medication if I start taking Celexa?
5. Are there better medication options besides Celexa to help treat my anxiety?
6. What are the best online psychiatrist options to get prescribed Celexa for anxiety?
7. Does my age affect the Celexa dosage I should take?
8. What other health conditions should I be concerned about before taking Celexa for anxiety?
9. Can I stop my Celexa for anxiety medication after some weeks?
10. I stopped my medication, but I want to continue it. Should I start immediately?
11. What side effects should I be worried about when taking Celexa for anxiety?

Final Thoughts

Celexa is mainly used to treat depression. However, it can be an effective treatment for anxiety, especially with therapy. Usually, some people will experience mild side effects after their initial Celexa dosage. Before taking Celexa, discuss a treatment plan with your doctor and care team to see if it’s the right option. This process will help prevent the severe side effects of Celexa you might experience, mainly if there is a chance you might mix the antidepressant with other substances such as alcohol or MAOIs.