Celexa (generic: citalopram) is a prescription medicine used to treat depression. Celexa belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing the amount of serotonin in the space between nerve cells. This improves mood by allowing the brain to send and receive chemical messages.
Celexa is a prescription medicine used to treat depression (also known medically as major depression). Symptoms include: sadness, change in weight, difficulty sleeping, or oversleeping, and thoughts of death or suicide.
Celexa may cause serious side effects, including:
See "Drug Precautions" and "Black Box Warning".
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.
Tell your doctor about all the medicines you are taking or plan to take including prescription and non-prescription medicines, vitamins, and herbal supplements. Celexa may cause drowsiness. Sleeping pills, muscle relaxants, pain medicines, cold or allergy medicines, sedatives, and medicine for seizures or anxiety can add to sleepiness caused by Celexa. Tell your doctor if you regularly use any of these medicines.
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
- Triptans used to treat migraine headache
- Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, or antipsychotics
- Over-the-counter supplements such as tryptophan or St. John's Wort
This is not a complete list of Celexa drug interactions. Ask your healthcare provider or pharmacist for more information.
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, or young adults within the first few months of treatment or when the dose is changed.
- Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
- Watch for these changes and call your healthcare provider right away if you notice:
- New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
- Pay particular attention to such changes when Celexa is started or when the dose is changed.
Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:
- attempts to commit suicide
- acting on dangerous impulses
- acting aggressive or violent
- thoughts about suicide or dying
- new or worse depression
- new or worse anxiety or panic attacks
- feeling agitated, restless, angry or irritable
- trouble sleeping
- an increase in activity or talking more than what is normal for you
- other unusual changes in behavior or mood
Call your healthcare 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 heartbeat
- shortness of breath
- dizziness or fainting
3. Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. 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 anti-inflammatory 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
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
Do not take Celexa if you:
- are allergic to citalopram hydrobromide or escitalopram oxalate or any of the 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 14 days of stopping Celexa.
- Do not start Celexa if you stopped taking an MAOI in the last 14 days.
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
- 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
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.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Celexa there are no specific foods that you must exclude from your diet when receiving Celexa.
Before starting Celexa, tell your healthcare provider if you
- 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 breastfeeding 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. See "Drug Interactions".
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.
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if Celexa will harm your unborn baby.
Tell your doctor if you are breastfeeding or plan to breastfeed. Celexa may be excreted in human breast milk. It is not known if Celexa will harm your baby.
- 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.
- Celexa is available in an oral solution of 10mg/5ml and 10 mg, 20 mg and 40 mg oral tablets.
- Your doctor will tell you how much of this medicine to take and how often. The typical dose for adults is 20-40 mg daily. The maximum daily dose is 60 mg. A lower dose may need to be used if you are elderly or if you have liver problems.
- Measure the oral liquid medicine with a marked measuring spoon or medicine cup.
- You may take this medicine with or without food.
- Your dose may need to be changed several times in order to find out what works best for you. Do not take more medicine or take it more often than your doctor tells you to.
- You may need to take this medicine for several weeks before you feel better. Keep taking the medicine as your doctor ordered.
- You should avoid alcohol and any stimulants (including caffeine).
- Use caution when performing tasks that require alertness, as Celexa can cause dizziness, anxiety or blurred vision.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully.
- Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
If you have taken too much Celexa call your local Poison Control Center or seek emergency medical attention right away.
Celexa is available in tablet form in 10 mg, 20 mg, and 40 mg strengths. It is also available as a 10 mg/5 mL liquid (oral solution).
Active ingredient: citalopram hydrobromide
- Tablets: copolyvidone, corn starch, crosscarmellose sodium, glycerin, lactose monohydrate, magnesium stearate, hypromellose, microcrystalline cellulose, polyethylene glycol, titanium dioxide and iron dioxide for coloring.
- Oral Solution: sorbitol, purified water, propylene glycol, methylparaben, natural peppermint flavor, and propylparaben.
Store Celexa at room temperature between 59° and 86°F (15° and 30°C). Keep Celexa and all medicines out of the reach of children.
Suicidality and Antidepressant Drugs
- Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Celexa or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
- Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.
- Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Celexa is not approved for use in pediatric patients.