Citalopram : Uses, Dosage and Side Effects

 

Citalopram : Uses, Dosage and Side Effects

What is citalopram?

Citalopram is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Citalopram is a prescription medicine used to treat depression.

Citalopram is also used to treat major depressive disorder (MDD).

Warnings

Citalopram can cause a serious heart problem. Call your doctor right away if you have chest pain, fast or pounding heartbeats, shortness of breath, and sudden dizziness.

You should not use citalopram if you also take pimozide, as the combination can cause problems with your heart rhythm.

Do not use citalopram if you have used a MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine) or have received a methylene blue injection. A fatal reaction may occur.

People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not stop using citalopram without first asking your doctor.

Before taking this medicine

You should not use citalopram if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide.

Do not use citalopram within 2 weeks before or after using an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.

To make sure citalopram is safe for you, tell your doctor if you have ever had:

  • heart problems;

  • long QT syndrome (in you or a family member);

  • high blood pressure;

  • a stroke;

  • bleeding problems;

  • sexual problems;

  • liver or kidney disease;

  • narrow-angle glaucoma;

  • seizures or epilepsy;

  • bipolar disorder (manic depression); or

  • an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood).

Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with citalopram could cause a serious condition called serotonin syndrome.

People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop citalopram without asking your doctor.

You should not breastfeed while taking .

How should I take citalopram?

Take citalopram exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Your symptoms may not improve for up to 4 weeks.

Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated.

If you stop using citalopram suddenly, you may have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Depression:

Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Maximum dose: 40 mg orally per day

Comments:
-The initial dose may be increased if necessary to 40 mg once a day after at least 1 week of therapy.
-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.
-Acute episodes of depression may require several months or more of sustained pharmacologic therapy

Use: Treatment of depression

Usual Geriatric Dose for Depression:

Over 60 years of age:
Recommended dose: 20 mg orally once a day

Comments:
-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.
-Acute episodes of depression may require several months or more of sustained pharmacologic therapy.

Use: Treatment of depression

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking citalopram?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with citalopram may cause you to bruise or bleed easily.

Avoid drinking alcohol.

Avoid driving or hazardous activity until you know how citalopram will affect you. Your reactions could be impaired.

Citalopram side effects

Get emergency medical help if you have signs of an allergic reaction to citalopram: hives, rash, blisters; fever, joint pain; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • blurred vision, eye pain or redness, seeing halos around lights;

  • fast or pounding heartbeats, pain or fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);

  • a seizure;

  • manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative;

  • severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; or

  • low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common citalopram side effects may include:

  • sexual problems;

  • dizziness, drowsiness;

  • dry mouth, thirst, increased sweating or urination;

  • loss of appetite, nausea, diarrhea, constipation;

  • feeling anxious, agitated, or shaky;

  • feeling weak or tired;

  • sleep problems (insomnia);

  • yawning;

  • increased muscle movement;

  • nosebleeds, heavy menstrual bleeding; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect citalopram?

Citalopram can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Tell your doctor about all your current medicines. Many other drugs can affect citalopram, especially:

  • cimetidine;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • a diuretic or "water pill";

  • lithium;

  • St. John's wort;

  • tramadol; or

  • tryptophan (sometimes called L-tryptophan).

This list is not complete and many other drugs may affect citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Generic name: citalopram [ si-TAL-o-pram ]
Brand name: Celexa
Dosage forms: oral solution (10 mg/5 mL); oral tablet (10 mg; 20 mg; 40 mg)
Drug class: Selective serotonin reuptake inhibitors

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