citalopram, Celexa

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    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Understanding Depression Slideshow

What is citalopram, and how does it work (mechanism of action)?

Citalopram is an antidepressant medication that affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Citalopram was approved by the FDA in July 1998.

Citalopram is approved for treating depression. It is also used off-label for treating:

  • Alcoholism
  • Binge-eating disorder
  • Generalized anxiety disorder
  • Panic disorder
  • Hot flashes
  • Obsessive compulsive disorder

Do I need a prescription for citalopram?

Yes

What are the side effects of citalopram?

The most common side effects associated with citalopram are

Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Citalopram is also associated with sexual dysfunction. Some patients may experience withdrawal reactions upon stopping citalopram. Symptoms of withdrawal include

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Quick GuidePhysical Symptoms of Depression in Pictures

Physical Symptoms of Depression in Pictures

What is the dosage for citalopram?

The usual starting dose is 20 mg in the morning or evening. The dose may be increased to 40 mg daily after one week. A dose of 60 mg has not been shown to be more effective than 40 mg. As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often slowly adjusted upwards to find the most effective dose.

Which drugs or supplements interact with citalopram?

All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started. Tryptophan, a common dietary supplement, can cause headaches, nausea, sweating, and dizziness when taken with any SSRI. Linezolid and intravenous methylene blue are also MAO inhibitors and should not be combined with citalopram.

Use of an SSRI with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.

Is citalopram safe to take if I'm pregnant or breastfeeding?

Exposure of neonates to citalopram in the third trimester may cause complications.

Citalopram is excreted in breast milk. Breastfeeding by a citalopram treated woman may cause adverse effects in the infant.

What else should I know about citalopram?

Do I need a prescription for citalopram?

Yes, a prescription is needed.

Is citalopram available as a generic drug?

GENERIC AVAILABLE: Yes

What brand names are available for citalopram?

Celexa

What preparations of citalopram are available?

Tablets: 10, 20, and 40 mg. Solution: 10 mg/5 ml

How should I keep citalopram stored?

Citalopram should be stored at room temperature, 15 to 30 C (59 to 86 F).

Reference: FDA Prescribing Information

Quick GuidePhysical Symptoms of Depression in Pictures

Physical Symptoms of Depression in Pictures

Summary

Citalopram (Celexa) is an antidepressant drug used to treat:

Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking any medication.

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See more info: citalopram on RxList
Reviewed on 8/30/2017
References
Reference: FDA Prescribing Information

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