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Citalopram

Celexa

RA
UR

Written by R. Author | Reviewed by Uche Ruth

Updated on June 09, 2024

Overview

Citalopram (Celexa) is a first-choice medication for treating depression in adults. This antidepressant belongs to the drug class called selective serotonin reuptake inhibitors (SSRIs). Citalopram (Celexa) is typically taken by mouth once daily. It typically takes a few weeks or longer of consistent treatment to notice an improvement to your mood. Common side effects include nausea and dry mouth. There's a low risk for weight gain, but suddenly stopping the medication can lead to withdrawal symptoms (e.g., upset stomach, trouble sleeping, anxiety).

What is Citalopram (Celexa) used for?

How Citalopram (Celexa) works

Citalopram (Celexa) is a selective serotonin reuptake inhibitor (SSRI). It works by raising the levels of serotonin in your brain. Serotonin is important for regulating your mood.

When does Citalopram (Celexa) start working?

Time passed since treatment started:

time
Pharmacist tips for Citalopram (Celexa)

  • You can take citalopram (Celexa) with or without food. Keep in mind that citalopram (Celexa) commonly causes nausea, especially when you first start the medication and when your dose changes. Taking the medication with food might help lessen this stomach upset.
  • If you get nauseous after you start taking citalopram (Celexa), it should get better as you continue taking the medication. Let your prescriber know if nausea doesn't go away or if it's bothersome. They might lower your citalopram (Celexa) dose or prescribe medications to help with nausea.
  • Don't change your dose or suddenly stop taking citalopram (Celexa) without talking to your psychiatrist first. Otherwise, this could lead to withdrawal symptoms like nausea, headache, and sleep problems. Follow your prescriber's instructions to lower your dose slowly over a period of time to stop the medication completely.
  • Citalopram (Celexa) can make some people have trouble sleeping and other people tired. Take the medication either in the morning or at night depending on how it affects your sleep. Just make sure to be consistent with when you take it (at the same time every day).
  • Avoid alcohol while you're taking citalopram (Celexa). Alcohol can worsen certain side effects like drowsiness or dizziness. It might also worsen your depression symptoms.
  • Don't drive or do anything requiring concentration until you know how citalopram (Celexa) affects you. It's possible for the medication to make you sleepy and lower your ability to think clearly or react fast.
  • Antidepressant medications like citalopram (Celexa) can raise the risk of thoughts about self-harm. Contact your psychiatrist right away if you or your loved ones notice any new or worsening changes in your behavior or mood while you're taking this medication.
  • Tell your psychiatrist, pharmacist, and primary care provider about all the medications you take. Don't start any new medications while you're taking citalopram (Celexa) without talking to your care team first. They can check whether you need any changes to your treatment plan to keep you safe from harmful citalopram (Celexa) interactions.
  • Talk with your psychiatrist or primary care provider about the benefits and risks of taking citalopram (Celexa) during pregnancy. It's not completely clear how safe it is to take medication while pregnant, but a study showed that it doesn't seem to cause major birth defects when it's used during pregnancy.
  • Don't breastfeed your baby while you're taking citalopram (Celexa) without talking to your psychiatrist or primary care provider first. Low amounts of the medication can get into breast milk. This means there's a risk that your baby might have side effects, such as sleepiness, restlessness, and poor feeding.

More tips for citalopram (Celexa) 10 mg/5 mL liquid:

  • Make sure to use an oral syringe or medication dosing cup to measure out your citalopram (Celexa) dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose. Ask your pharmacy for extra oral syringes or dosing cups just in case you lose one.
  • Store the liquid at room temperature in the original bottle it came in from the pharmacy.

What are the risks and warnings for Citalopram (Celexa)?

Citalopram (Celexa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Worsening depression, suicidal thoughts, and unusual behavior

  • Risk factors: Age under 24 years old | History of other mental health conditions

Taking citalopram (Celexa) can put you at risk for worsened depression and thoughts of suicide or self-harm. The risk is highest if you're 24 years of age or younger, if you just started taking the medication (during the first few weeks of starting), and if your dose just changed. Get medical help right away if you or anyone around you notices that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, trouble sleeping, feeling angry or irritated, restlessness) while you're taking citalopram (Celexa).

Life-threatening abnormal heart rhythm (QT prolongation)

  • Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation

Citalopram (Celexa) can affect your heart rhythm, which can be serious and life-threatening. More specifically, this medication can lengthen the time period from when the heart pumps and then relaxes. This is known as QT prolongation.

Your risk for QT prolongation and heart rhythm problems is higher if you have certain factors, including having abnormal electrolyte levels, having heart rhythm conditions, or taking other medications that cause heart rhythm problems, among others. To lower your risk, your psychiatrist or primary care provider might recommend that you get an electrocardiogram (EKG) done to make sure your heart rhythm is normal.

Call 911 right away if you feel your chest pounding, chest pain, short of breath, faint, or lightheaded while you're taking citalopram (Celexa). These can be symptoms of an abnormal heart rhythm.

Serotonin syndrome

  • Risk factors: Taking other medications that raise serotonin levels

Some people who took citalopram (Celexa) have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens when there's too much serotonin in the brain.

Your risk for serotonin syndrome is higher if you take citalopram (Celexa) with other medications that can raise your serotonin levels. These medications can include certain antidepressants, mental health medications, and migraine medications. Let your psychiatrist, primary care provider, and pharmacist know about all the medications you take before you start citalopram (Celexa). Also, don't start any new medications without talking to them first.

Get medical help right away if you have any symptoms of serotonin syndrome while you're taking citalopram (Celexa). Symptoms can include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion.

Withdrawal

  • Risk factors: Stopping citalopram (Celexa) suddenly

Suddenly stopping citalopram (Celexa) can cause withdrawal symptoms. You might feel nauseous, anxious, distressed, or dizzy; have flu-like symptoms; or have trouble sleeping. Ask your prescriber if you want to or need to stop taking citalopram (Celexa). Your prescriber will give you specific instructions on how to stop the medication safely over time. Never try to stop citalopram (Celexa) on your own and without your prescriber's guidance.

Higher risk of bleeding

  • Risk factors: Taking blood-thinners or other medications that raise your risk of bleeding

Citalopram (Celexa) can raise your risk of bleeding or bruising. Be careful if you need to take citalopram (Celexa) along with other medications that can put you at greater bleeding risk. These other medications can include aspirin, clopidogrel (Plavix), and blood thinners like warfarin (Coumadin) and apixaban (Eliquis). Get medical help if you have signs of unusual bleeding, such as bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums.

Not for use in bipolar disorder by itself

Depression can be the first sign of bipolar disorder. If you're at risk for bipolar disorder, taking antidepressants like citalopram (Celexa) by themselves can trigger a bipolar manic episode. For this reason, citalopram (Celexa) isn't used to treat bipolar depression.

Your psychiatrist will check whether you have or are at risk for bipolar disorder before you start taking citalopram (Celexa). Talk to your psychiatrist right away if you or your loved ones notice unusual changes in your behavior, such as racing thoughts, restlessness, getting easily distracted, or unusual talkativeness. These can be symptoms of a manic episode.

Glaucoma

  • Risk factors: History of angle-closure glaucoma

Citalopram (Celexa) can lead to or worsen angle-closure glaucoma. Be sure to visit your optometrist for regular eye exams to check your eyes and vision while you're taking this medication. Contact your optometrist or psychiatrist if you notice changes in your vision after you start taking citalopram (Celexa).

Low sodium levels

  • Risk factors: Older people | Taking diuretics (water pills)

Citalopram (Celexa) can cause low sodium levels in the blood. Watch out for symptoms of low sodium levels, such as weakness, headache, trouble concentrating, and confusion. Get medical help right away if you notice these symptoms because having low sodium levels is a medical emergency.

Strengths

Capsule

30mg

Ml of oral solution

10mg/5ml

Tablet

10mg
20mg
40mg

Dosages

The typical starting dose is 20 mg by mouth once daily. If needed, your prescriber might raise your dose to 40 mg once daily after a week. The maximum recommended dose is 40 mg daily.

Your dose might be lower if you're an older adult or if you have liver problems.

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Interactions

Citalopram (Celexa) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Citalopram (Celexa). Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Side-effects

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (21%)
  • Dry mouth (20%)
  • Sleepiness (18%)
  • Trouble sleeping (15%)
  • Sweating (11%)
  • Tremor (8%)
  • Diarrhea (8%)
  • Ejaculation problems (6%)

Other Side Effects

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

  • Suicidal thoughts or behaviors
  • Abnormal heart rhythm: chest pounding, short of breath, chest pain, feeling faint or lightheaded
  • Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement
  • Serious bleeding: bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, unusual bleeding from the nose or gums
  • Low sodium levels: nausea, fatigue, headache, confusion, disoriented
  • Seizures

When do Citalopram (Celexa) possible side effects begin and end?

Time passed since treatment started:

Seek immediate medical care if you experience this side effect labelled red. If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

  • Agitation
  • Blurred vision
  • Confusion
  • Fever
  • Increase in the frequency of urination or amount of urine produced
  • Lack of emotion
  • Loss of memory
  • Menstrual changes
  • Skin rash or itching
  • Trouble breathing

Rare

  • Behavior change similar to drunkenness
  • Bleeding gums
  • Breast tenderness or enlargement or unusual secretion of milk (in females)
  • Chills
  • Convulsions (seizures)
  • Diarrhea
  • Difficulty with concentrating
  • Dizziness or fainting
  • Drowsiness
  • Increased hunger
  • Increased thirst
  • Irregular heartbeat
  • Lack of energy
  • Lethargy
  • Nosebleed
  • Overactive reflexes
  • Painful urination
  • Poor coordination
  • Purple or red spots on the skin
  • Rapid weight gain
  • Red or irritated eyes
  • Redness, tenderness, itching, burning, or peeling of the skin
  • Shivering
  • Slow or irregular heartbeat (less than 50 beats per minute)
  • Sore throat
  • Stupor
  • Sweating
  • Swelling of the face, ankles, or hands
  • Talking or acting with excitement you cannot control
  • Trembling, shaking, or twitching
  • Trouble with holding or releasing urine
  • Unusual or sudden body or facial movements or postures
  • Unusual tiredness or weakness

Incidence not known

  • Abdominal or stomach pain
  • Back or leg pains
  • Black, tarry stools
  • Bloating
  • Bloody stools
  • Chest pain
  • Confusion as to time, place, or person
  • Constipation
  • Cough
  • Darkened urine
  • Difficult or fast breathing
  • Difficulty with swallowing
  • Drooling
  • Fast, slow, or irregular heartbeat
  • General body swelling
  • Hive-like swelling on the face, eyelids, lips, tongue, or throat
  • Hives
  • Holding false beliefs that cannot be changed by fact
  • Impaired consciousness, ranging from confusion to coma
  • Indigestion
  • Itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Loss of appetite
  • Loss of bladder control
  • Loss of consciousness
  • Muscle cramps or spasms
  • Muscle tightness
  • Muscle twitching or jerking
  • Painful or prolonged erection of the penis
  • Pale skin
  • Penile erections, frequent or continuing
  • Recurrent fainting
  • Rhythmic movement of the muscles
  • Seeing, hearing, or feeling things that are not there
  • Swelling of the breasts or unusual milk production
  • Tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
  • Tightness in the chest
  • Total body jerking
  • Twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
  • Uncontrolled jerking or twisting movements
  • Unusual excitement
  • Vomiting of blood or material that looks like coffee grounds
  • Yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Decrease in sexual desire or ability
  • Sleepiness or unusual drowsiness

Less common

  • Body aches or pain
  • Change in sense of taste
  • Gas
  • Headache (severe and throbbing)
  • Heartburn
  • Increased sweating
  • Increased yawning
  • Loss of voice
  • Pain in the muscles or joints
  • Sneezing
  • Stuffy or runny nose
  • Tingling, burning, or prickly feelings on the skin
  • Tooth grinding
  • Unusual increase or decrease in weight
  • Watering of the mouth

Incidence not known

  • Bruising
  • Inability to sit still
  • Large, flat, blue or purplish patches in the skin
  • Need to keep moving

Common Concerns

Citalopram (Celexa) can start to work within 2 weeks for some people. But in general, it can take about 1 to 2 months to feel the full effects of the medication for treating depression. Be aware that you might have side effects, like nausea and sleep problems, before your mood improves. But don't get discouraged and make sure to continue taking the medication as prescribed. Keep in mind that each person can have a different experience with citalopram (Celexa). Contact your prescriber if you're not sure whether citalopram (Celexa) is working for you.
How you feel after you start taking citalopram (Celexa) can differ from person to person. It also might depend on your citalopram (Celexa) dose and how serious your depression is. In general, you might notice feeling more energetic or having a more positive mood after a couple weeks of taking citalopram (Celexa). But it can take a few months to feel the full benefits of the medication. At the same time, it's common to have side effects from citalopram (Celexa), like nausea or dizziness, before you feel noticeable benefit from the medication. Talk with your psychiatrist or primary care provider if you have more questions about what it might feel like to take citalopram (Celexa).
Citalopram (Celexa) has a few serious side effects and risks that you should be aware of. All antidepressants, including citalopram (Celexa), have a risk for worsening depression and thoughts of suicide. The risk is highest if you're 24 years old or younger, just starting the medication, or changing the dose. In addition, taking citalopram (Celexa) can put you at risk for a rare, but serious condition called serotonin syndrome if you're also taking other medications that can raise your serotonin levels, such as other antidepressants and certain migraine medications. Lastly, taking citalopram (Celexa) can rarely lead to a serious irregular heart rhythm problem called QT prolongation. Your primary care provider or psychiatrist will regularly follow up with you to check for your risk of these serious side effects and make adjustments to your treatment, if needed.
It's possible to experience weight changes, such as weight gain, while you're taking citalopram (Celexa). But in general, there's a low risk for weight gain, especially compared to some other SSRIs like paroxetine (Paxil). In fact, in clinical studies, some people reported a little weight loss (about 1 pound) after they started taking citalopram (Celexa). Talk with your psychiatrist or primary care provider if you experience unexpected weight changes after you start treatment with this medication.
Yes, citalopram (Celexa) can make you tired. But it's also possible for the medication make it harder to fall asleep. Pay attention to how citalopram (Celexa) affects your sleep, especially when you start the medication and when your dose changes. Contact your psychiatrist or primary care provider if citalopram (Celexa) is making you too sleepy or interrupting your sleep. They might recommend to try changing the time of day you take the medication, or they might lower your dose.
There isn't a set amount of time that you can continue to take citalopram (Celexa). Your psychiatrist or primary care provider will probably recommend that you continue taking the medication as long as it's helping your depression and as long as you're not having any significant side effects. Your prescriber might try to slowly lower your dose to see whether your depression is well controlled. There might be a point where you can stop taking citalopram (Celexa) if your depression seems manageable without medication.
Yes, citalopram (Celexa) is an selective serotonin reuptake inhibitor (SSRI). It works by raising the levels of serotonin in your brain to regulate and improve your mood. As with many of the other SSRIs, citalopram (Celexa) is a first-choice medication for treating depression.
No, citalopram (Celexa) isn't a controlled substance. It doesn't have a risk of addiction, misuse, or dependence.

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