GENERIC NAME: Citalopram

COMMON BRANDS: Celexa, Cipramil, Estar, Zetalo

Citalopram comes under the class of antidepressant drug called selective serotonin reuptake inhibitors (SSRIs). Citalopram oral tablet is a prescription medicine that’s available by the brand-name drug “Celexa”. Citalopram also comes as an oral solution. It is also available under the generic drug name. In sometimes, they may not be available in every strength or form as the brand name drug. These drugs are often used to treat the same conditions. SSRIs acts on the brain by increasing levels of a natural chemical substance called serotonin. The increased amount of serotonin in the brain can improve symptoms of depression.

What are the uses of Citalopram?

Citalopram is used for the treatment of depression. It may improve your energy level and boosts the feelings of well-being. It is also known as a selective serotonin reuptake inhibitor or SSRI. This medication acts by restoring the balance of certain natural chemical substance in the brain such as serotonin.

How to use Citalopram?

Carefully read the Medication Guide and the Patient Information Leaflet provided by your pharmacist before you start taking citalopram if accessible and each time you have to get a refill.

Take this medication with or without meals as advised by your doctor/physician, usually once a day in the morning/ evening. The dosage depends on your medical examination, response to treatment, age, laboratory tests, and other medications you may be using. Remember to inform your doctor/physician and pharmacist about all the products you use (for example prescription drugs, nonprescription drugs, and any herbal products). The maximum dosage for citalopram is 40mg/day.

In the case of the liquid form of this medication, measure the dose carefully by using a special measuring device/spoon. Don’t use a household spoon as you may not get the accurate dose.

To decrease your danger of side effects, your doctor/physician may advise you to start using this drug at a lower dose and slowly increase the dose. Follow your doctor’s directions carefully. Do not increase the dose or use this drug often or for longer than you are prescribed. Doing so your condition will not improve any faster, and your chance of side effects will be higher. Use it regularly at the same time daily for best results.

It is important to continue this medication even if you feel healthy. Do not discontinue taking this medication without your doctor’s advice. You may experience some conditions may becoming worse if this drug is stopped suddenly. You may also observe symptoms such as a headache, tiredness, sleep changes, mood swings and brief feelings that resembles electric shock. To prevent these symptoms while you decide to stop the treatment with this drug, your doctor/physician may reduce the dose gradually. See your doctor or pharmacist for further details. Report any new or worsening symptoms as soon as possible. The treatment may take 1 to 4 weeks to get the benefit from this drug and up to several weeks before you get total benefit. Notify your doctor if your condition does not improve or if it worsens.

What are the side effects of Citalopram?

Also, see warning and precautions.

Nausea, dry mouth, sweating, blurred vision, loss of appetite, tiredness, drowsiness, and yawning may occur. If any of these effects remain or worsen, inform your doctor or pharmacist promptly.

Remember, your doctor/physician has prescribed this medication because the doctor/physician has found benefits to you are higher than the chance of side effects. Several people using this medication do not experience serious side effects.

Seek medical assistance immediately if you observe dangerous side effects, including fainting, fast/irregular heartbeat, black stools, vomit that resembles like coffee grounds, eye pain/swelling/redness, widened pupils, seizures, vision changes (for example seeing rainbows around lights at night).

This drug may increase serotonin level and rarely cause a very severe condition known as serotonin syndrome/serotonin toxicity. The risk is higher if you are also using other medicines that increase serotonin level. Notify your doctor/physician or pharmacist of all the drugs you are using (also see Drug Interactions section). Get medical help immediately if you get some of the symptoms like an increase in heartbeat, difficulty in coordination, severe dizziness, severe nausea/vomiting/diarrhea, hallucinations, unexplained fever, unusual agitation/restlessness, and twitching muscles.

Sometimes, males may experience a painful or prolonged erection which can last up to 4 or more hours. If this condition occurs, stop using this drug and get medical assistance right away, or this problem may occur permanently.

A severe allergic reaction to this drug is uncommon. However, get medical assistance immediately if you mark any symptoms of a severe allergic reaction like swelling/itching (especially of the face/tongue/throat), rash, severe dizziness, and breathing problems.

This is not a full record of all possible side effects. If you observe other side effects not listed, reach out to your doctor/ physician/ pharmacist.

What are the precautions while using Citalopram?

Before using citalopram, inform your doctor/ physician/ pharmacist if you are allergic to citalopram or escitalopram or if you have any other allergies. This product may consist of some inactive ingredients that can cause allergic reactions or some other problems. Talk to your pharmacist for further information.

Before using this medication, tell your doctor/ physician/ pharmacist about your medical history, especially about personal/ family history of manic-depressive/ bipolar disorder, personal or family records of any suicide attempts, liver disease, convulsions, low sodium in the blood, intestinal ulcers/bleeding (peptic ulcer disease) or bleeding problems, personal or family records of glaucoma like angle-closure.

Citalopram may create a condition that modifies the heart rhythm (QT prolongation). QT prolongation can sometimes cause severe (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that require medical attention right away.

The chance of QT prolongation may build if you have some medical conditions or are taking other medications that may make QT prolongation. Before using citalopram, tell your doctor/ physician/ pharmacist of all the medicines you use and if you are suffering from conditions such as certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), recent heart attack, family record of some heart-related issues (QT prolongation in the EKG, sudden cardiac death).

Low magnesium or potassium in the blood may also increase your chance of QT prolongation. This risk may become severe if you are using certain drugs (for example diuretics) or if you are suffering from conditions like severe diarrhea, sweating, vomiting. Talk to your doctor/physician about the safe use of citalopram.

This drug can cause drowsiness or blurred vision. Alcohol or marijuana can make you drowsier. Strictly avoid driving, use of machinery, or anything that requires sharpness or clear vision until you can do it safely. Avoid alcoholic beverages. Inform your doctor/ physician if you are a marijuana user.

Before going through any surgery, inform your doctor/ dentist regarding any product you are using (including prescription drugs, nonprescription drugs, and any herbal product).

Older people can be more susceptible to the side effects of this drug like bleeding, loss of coordination, and prolongation of QT. They can be more likely to cause a type of salt imbalance known as hyponatremia, especially if they are also taking “water pills” known as diuretics.

In pregnancy, this medication should be used only when required, as it may harm the fetus. Children born to mothers who used this drug during pregnancy in their last three months of pregnancy may sometimes develop withdrawal symptoms like muscle stiffness, feeding/ breathing difficulties, constant crying, or seizures. If you notice any above-mentioned symptoms in your newborn baby, tell the doctor promptly.

Children can be more susceptible to the side effects of this medicine, mainly loss of hunger and loss of weight. Check weight and height in children who are using this medicine.

Since untreated mental/mood problems (such as depression, obsessive-compulsive disorder, panic disorder) can be a serious condition, do not discontinue taking this medication unless directed by a doctor/physician. If you are planning a pregnancy/become pregnant. Talk to your doctor/physician about using this medication safely during pregnancy.

This drug crosses into breast milk and may have unacceptable effects on a nursing infant. Consult your doctor before breastfeeding.

What are the drug interactions of Citalopram?

Also, see Precautions section.

Drug interactions may alter the mechanism of action or may increase your chance for dangerous side effects. This record does not contain all likely drug interactions. Keep a record of all the products you are using (for example prescription/nonprescription drugs and any herbal product) and share it with your doctor/ physician and pharmacist. Do not start, stop, or alter the dose of any medicines without your doctor’s permission.

Few products that may interact with this drug are, drugs that can cause bruising/ bleeding, “blood thinners” (like warfarin), antiplatelet drugs (like clopidogrel), NSAIDs (like ibuprofen).

Drugs like aspirin can increase the risk of bleeding when combined with or used with this medication. However, if your doctor/ physician has instructed you, start at low-dose aspirin for heart stroke or attack prevention (generally at a dose between 81-325 mg per day), you should continue taking it unless your doctor/ physician instructs you otherwise. Ask your doctor/ physician or pharmacist for further details.

MAO inhibitors may cause serious (possibly fatal) drug interaction when combined with this drug. Avoid taking MAO inhibitors (for example isocarboxazid, moclobemide, linezolid, tranylcypromine, methylene blue, phenelzine, procarbazine, safinamide, rasagiline, selegiline) during treatment with this medication. Some of the MAO inhibitors must be avoided for at least two weeks before and after starting treatment with this medication. Seek advice from your doctor regarding when to start or stop using this medication.

The danger of serotonin syndrome/toxicity rises if you are also taking other drugs that increase serotonin concentration in your brain (for examples street drugs such as MDMA/”ecstasy,” St. John’s wort, tryptophan, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), are among others. The danger of serotonin syndrome/toxicity may be more apparent when you start or raise the dose of these drugs.

Inform your doctor/ physician or pharmacist if you are using other products that cause drowsiness such as alcohol, marijuana, muscle relaxants, antihistamines (for example cetirizine, diphenhydramine), and narcotic pain relievers (for example codeine), drugs for sleep or anxiety (for example zolpidem, alprazolam, diazepam).

Check the labels on all your medicines (for example an allergy or a cough and cold products) as they may consist of ingredients that can cause drowsiness. Seek advice from your pharmacist about using those products safely.

Many drugs besides citalopram may affect the heart rhythm (QT prolongation), including amiodarone, pimozide, procainamide, quinidine, sotalol, among others.

Citalopram is very similar to escitalopram. Do not use medications containing escitalopram while using citalopram.

This medication may interfere with some medical/laboratory test results (such as a brain scan for Parkinson’s disease), possibly producing incorrect test results. Ensure that laboratory personnel, and all your doctors know you use this drug.

WARNINGS:

Antidepressant drugs are used to treat a variety of conditions, for example, depression and mental/mood disorders. These medications help to prevent suicidal attempts/ thoughts and provide other significant benefits. However, a small number of people (particularly people below 25 years) who use antidepressants for any condition may observe worsening depression, other mental/ mood symptoms, or suicidal thoughts/attempts. However, it is necessary to seek advice from your doctor/physician about the risks and benefits of the antidepressant medication.

Inform your doctor/physician immediately if you notice worsening of depression / other psychiatric conditions, unexpected behavior changes (possible like suicidal thoughts/attempts), or other mental/mood changes (new/worsening anxiety, panic attacks, trouble sleeping, irritability, very rapid speech, hostile/angry feelings, impulsive actions, severe restlessness). Carefully observe these symptoms when a new antidepressant drug is started or when the dose is altered.

What are the forms and strengths of Citalopram?

Form: Oral tablet
Strength: 10mg, 20mg, 40mg

Form: Oral solution
Strength: 10mg/5mL

What is the dosage of Citalopram?

For the Treatment of Depression:

Adult (18–60 years)

Starting dose: 20mg, taken once a day.

Your doctor may increase the dose. Doses should not be increased more than once per week.

Maximum dose: 40mg, taken once per day. Don’t take more than 40mg per day since higher doses increase the risk of QT prolongation.

Pediatric

Children (0–17 years)

It is not confirmed that this drug is safe and effective for use in children under 18 years.

Geriatric (61 years and older)

The kidneys of older people may not work efficiently, and this can cause your body to metabolize drugs slowly. As a result, more of a drug remains in your body. This increases the chance for side effects. It is not recommended to take more than 20mg of this drug once a day in older adults.

Special Cases:

Cytochrome P450 2C19 poor metabolizers:

This is a protein present in our body that often helps to metabolize drugs, including citalopram. People with less 2C19 proteins or less activity of their 2C19 proteins are called “poor metabolizers.” These people should not take more than 20 mg of citalopram once per day.

People with liver disease:

Citalopram is metabolized by the liver. In case of liver problems, the levels of this drug in your body are high. You may have a high risk of side effects. People with liver disease should not take more than 20 mg of citalopram once per day.

Most common questions asked about Citalopram / Q&A’s:

What are the symptoms of Citalopram overdose?

Citalopram overdose symptoms may include dizziness, sweating, nausea, vomiting, uncontrollable shaking of a part of the body, drowsiness, fast, irregular, or pounding heartbeat, memory loss, confusion, seizures, coma (loss of consciousness), fast breathing, bluish color around mouth, fingers, or fingernails, muscle pain, dark-colored urine. Seek a medical emergency as soon as possible if you experience any of these symptoms.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.