Disclaimer: This is not meant to be medical advice, and always discuss with your care manager, prescriber or other doctor before making any medication changes or taking action, unless otherwise indicated. Please refer to the package insert included with your medication.
What is Citalopram (Celexa®)?
Citalopram, or Celexa®, is a type of medication known as an SSRI (selective serotonin reuptake inhibitor) and one of the most commonly prescribed medications to treat depression and anxiety. Even though it’s not FDA approved for anxiety, doctors and nurse practitioners often prescribe it to reduce the symptoms of anxiety.
How does Citalopram (Celexa®) work?
There is extensive evidence for the use of citalopram and other SSRIs as first-line treatments for depression and anxiety disorders. Generally, SSRIs block the breakdown of the neurotransmitter serotonin in the brain, making more serotonin available to transmit messages among brain cells. There also may be a less potent effect on dopamine transmission. The neuroscience is likely more complicated, but extensive studies show that SSRIs really improve people’s mood and anxiety levels.
The very important NIMH STAR*D study used citalopram as its first line treatment for depression, which is why many prescribers use it as first line for moderate depression even today.
How long does it take Citalopram (Celexa®) to work?
Improvement in anxiety often takes place within 1 week of starting a reasonable dose. Mood benefits, such as no longer feeling depressed or feeling happier, may take longer (2 to 4 weeks). If you don’t experience improvement at higher doses, this medication may not work for you. However, if you have not improved at lower doses, it may be that the dose is just too low. Finding the right dose of a medication sometimes takes time, but your provider will help guide you through the process by closely following your symptoms and adjusting treatment as necessary.
How do I take Citalopram (Celexa®)?
You can take Citalopram in the morning or at night. Most people take it in the morning, but a small group feels mildly tired on it, and they take it at night. The most important thing is to pick a time when you are most likely to be consistent. You can take Citalopram with or without food. Taking it with food reduces the most common side effects of Citalopram, a mild stomach upset or nausea. This nearly always goes away with time. You will likely not need to do this forever, but it is helpful when you are starting or when you are increasing the dose.
What if I miss a dose of Citalopram (Celexa®)?
If it is almost time for your next dose, skip the missed dose and go back to taking at your normal time. Do not take 2 doses at the same time or extra doses. If you find yourself consistently missing your medication, let your care manager or prescriber know.
Can I take Citalopram (Celexa®) while drinking?
All SSRIs, including Citalopram, can increase your sensitivity towards alcohol. The most conservative psychiatrists will tell you that it makes 1 drink feel like 2. Patients often note that when they drink, they feel much more intoxicated than they usually do. This can even at times lead to a blackout. Please be careful when drinking alcohol on SSRIs.
Can I take Citalopram (Celexa®) with other medications?
It is important you tell all clinicians you work with what other medications you take. Some medications must be taken very carefully or cannot be taken with SSRIs as the combination can cause a serious condition called serotonin syndrome (see below). Common examples include:
- Triptans (used for migraines)
- Cyclobenzaprine (Flexeril™)
- Saint John’s Wort
- Dextromethorphan (used in many cough and cold meds)
- Drugs like ecstasy, cocaine, and LSD
What is the difference between Escitalopram (Lexapro®) and Citalopram (Celexa®)?
Escitalopram and Citalopram are actually the same molecules with a subtle chemical difference. The explanation of the difference is beyond the scope of this Q&A, but this small chemical difference gives the medications slightly different efficacy and side effect profiles. Additionally, each medicine is approved for its own set of conditions by the FDA.
The FDA recommends that people on 40mg of citalopram (Celexa®) get an electrocardiogram (EKG) at least annually to ensure they are not at risk for arrhythmia.
Important Safety Information
All medications have risks. While most of the side effects from Citalopram are either mild or very rare, you should discuss the risks and benefits of the medication. If you experience any side effects, please notify your provider immediately. If you have a serious side effect, contact your in-person health care provider immediately. If you are having an emergency, call 911 or go to your nearest emergency room.
Read the Medication Guide that comes with Celexa before you start taking it and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment. Talk with your healthcare provider if there is something you do not understand or want to learn more about.
What is the most important information I should know about Celexa?
Celexa and other antidepressant medicines may cause serious side effects, including:
1. Suicidal thoughts or actions:
- Celexa and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment or when the dose is changed.
- Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions.
- Watch for these changes and contact your Mantra-affiliated provider right away if you notice: New or sudden changes, in mood, behaviors, thoughts, or feelings, especially if severe. Pay particular attention to such changed when Celexa is started or when the dose is changed.
Keep all follow-up visits with your Mantra-affiliated provider and call between visits as needed, especially if you have concerns about symptoms.
Call a healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:
- attempts to commit suicide
- acting on dangerous impulses
- acting aggressive, being angry, or violent
- thoughts about suicide or dying
- new or worse depression
- new or worse anxiety or panic attacks
- feeling very agitated, restless, angry or irritable
- trouble sleeping
- an increase in activity and talking (mania)
- other unusual changes in behavior or mood
Call your Mantra-affiliated provider right away if you have any of the following symptoms, or call 911, if an emergency. Celexa may be associated with these serious side effects:
2. Changes in the electrical activity of your heart (QT prolongation and Torsade de Pointes). This condition can be life-threatening. The symptoms may include:
- chest pain
- fast or slow breathing
- shortness of breath
- dizziness or fainting
3. Serotonin Syndrome. This condition can be life-threatening and may include:
- agitation, hallucinations, coma or other changes in mental status
- coordination problems or muscle twitching (overactive reflexes)
- racing heartbeat, high or low blood pressure
- sweating or fever
- nausea, vomiting, or diarrhea
- muscle rigidity
4. Severe allergic reactions:
- trouble breathing
- swelling of the face, tongue, eyes or mouth
- rash, itchy welts (hives) or blisters, alone or with fever or joint pain
5. Abnormal bleeding: Celexa and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal antiinflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.
6. Seizures or convulsions
7. Manic episodes:
- greatly increased energy
- severe trouble sleeping
- racing thoughts
- reckless behavior
- unusually grand ideas
- excessive happiness or irritability
- talking more or faster than usual
8. Changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.
9. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:
- weakness or feeling unsteady
- confusion, problems concentrating or thinking or memory problems
10. Visual problems
- eye pain
- changes in vision
- swelling or redness in or around the eye
Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
Do not stop Celexa without first talking to your healthcare provider. Stopping Celexa too quickly may cause serious symptoms including:
- anxiety, irritability, high or low mood, feeling restless or changes in sleep habits
- headache, sweating, nausea, dizziness
- electric shock-like sensations, shaking, confusion
What is Celexa?
Celexa is a prescription medicine used to treat depression. It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider. Celexa is also used to treat:
- Major Depressive Disorder (MDD)
Talk to your healthcare provider if you do not think that your condition is getting better with Celexa treatment.
Who should not take Celexa?
Do not take Celexa if you:
- are allergic to citalopram hydrobromide or escitalopram oxalate or any of the ingredients in Celexa. See the end of this Medication Guide for a complete list of ingredients in Celexa.
- take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
- Do not take an MAOI within 2 weeks of stopping Celexa unless directed to do so by your physician.
- Do not start Celexa if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician. People who take Celexa close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms: high fever, uncontrolled muscle spasms, stiff muscles, rapid changes in heart rate or blood pressure, confusion, or loss of consciousness (pass out).
- take the antipsychotic medicine pimozide (Orap®) because this can cause serious heart problems.
- have a heart problem including congenital long QT syndrome
What should I tell my healthcare provider before taking Celexa?
Ask if you are not sure. Before starting Celexa, tell your healthcare provider if you
- Are taking certain drugs such as: medicines for heart problems; Medicines that lower your potassium or magnesium levels in your body; Cimetidine; Triptans used to treat migraine headache; Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, amphetamines, or antipsychotics; Tramadol; Over-the-counter supplements such as tryptophan or St. John’s Wort
- have liver problems
- have kidney problems
- have heart problems
- have or had seizures or convulsions
- have bipolar disorder or mania
- have low sodium levels in your blood
- have a history of a stroke
- have high blood pressure
- have or had bleeding problems
- are pregnant or plan to become pregnant. It is not known if Celexa will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy
- are breast-feeding or plan to breastfeed. Some Celexa may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking Celexa.
Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Celexa and some medicines may interact with each other, may not work as well, or may cause serious side effects.
Your healthcare provider or pharmacist can tell you if it is safe to take Celexa with your other medicines. Do not start or stop any medicine while taking Celexa without talking to your healthcare provider first.
If you take Celexa, you should not take any other medicines that contain citalopram hydrobromide or escitalopram oxalate including: Lexapro.
How should I take Celexa?
- Take Celexa exactly as prescribed. Your healthcare provider may need to change the dose of Celexa until it is the right dose for you.
- Celexa may be taken with or without food.
- If you miss a dose of Celexa, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Celexa at the same time.
- If you take too much Celexa, call your healthcare provider or poison control center right away, or get emergency treatment.
What should I avoid while taking Celexa?
Celexa can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Celexa affects you. Do not drink alcohol while using Celexa.
What are the possible side effects of Celexa?
Celexa may cause serious side effects, including:
See “What is the most important information I should know about Celexa?” above.
Common possible side effects in people who take Celexa include:
- Feeling anxious
- Trouble sleeping
- Sexual problems
- Not feeling hungry
- Dry mouth
- Respiratory Infections
Other side effects in children and adolescents include:
- increased thirst
- abnormal increase in muscle movement or agitation
- nose bleed
- urinating more often
- heavy menstrual periods
- possible slowed growth rate and weight change. Your child’s height and weight should be monitored during treatment with Celexa.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Celexa. For more information, ask your healthcare provider or pharmacist.
CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1 800-FDA-1088.
How should I store Celexa?
- Store Celexa at 25°C (77°F), between 15°C to 30°C (59°F to 86°F).
- Keep Celexa bottle closed tightly.
Keep Celexa and all medicines out of the reach of children.
General information about Celexa
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Celexa for a condition for which it was not prescribed. Do not give Celexa to other people, even if they have the same condition. It may harm them.
This Medication Guide summarizes the most important information about Celexa. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about Celexa that is written for healthcare professionals.
For more information about Celexa call 1-800-678-1605 or go to www.Celexa.com.
What are the ingredients in Celexa?
Active ingredient: citalopram hydrobromide Inactive ingredients:
- Tablets: copolyvidone, corn starch, crosscarmellose sodium, glycerin, lactose monohydrate, magnesium stearate, hypromellose, microcrystalline cellulose, polyethylene glycol, titanium dioxide and iron dioxide for coloring.
Tell your healthcare providers
Telemedicine does not replace your primary care physician. It is important to keep your primary care physician, other healthcare providers, and pharmacist informed of all medications you are taking, including those prescribed by your Mantra-affiliated provider, as they can interact with other medicines you may be taking.