• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is citalopram?
Citalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Citalopram affects chemicals in the brain that may become unbalanced and cause depression. Citalopram is used to treat depression. Citalopram may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of citalopram?

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms 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.

Call your doctor at once if you have any of these serious side effects:

• seizure (convulsions);

• tremors, shivering, muscle stiffness or twitching;

• problems with balance or coordination; or

• agitation, confusion, sweating, fast heartbeat.

Other less serious side effects are more likely to occur, such as:

• feeling nervous, restless, or unable to sit still;

• drowsiness, dizziness, trouble concentrating;

• sleep problems (insomnia);

• nausea, gas, upset stomach, loss of appetite;

• weight changes;

• urinating more than usual;

• decreased sex drive, impotence, or difficulty having an orgasm; or

• dry or watery mouth, yawning, or ringing in your ears.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take citalopram?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication. Try to take the medicine at the same time each day. Follow the directions on your prescription label. To be sure you get the correct dose of liquid citalopram, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

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What is the most important information I should know about citalopram?
Do not take citalopram together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take citalopram. After you stop taking citalopram, you must wait at least 14 days before you start taking an MAOI. You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

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What other drugs will affect citalopram?
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with citalopram may cause you to bruise or bleed easily. Before taking citalopram, tell your doctor if you are using any of the following medicines: carbamazepine (Tegretol); cimetidine (Tagamet);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Citalopram has been assigned to pregnancy category C by the FDA. Citalopram and its metabolites have been shown to cross the placenta. Human spontaneous abortion has been reported by the manufacturer. Neonates exposed to citalopram (and other SSRIs and SNRIs) late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. (Such complications can arise immediately upon delivery.) Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. (These features are consistent with either a direct toxic effect of SSRIs and SNRIs, or possibly a drug discontinuation syndrome.) In some cases, the clinical picture is consistent with serotonin syndrome. The results of a prospective comparative study (n=396 pregnant women) indicate that citalopram use during embryogenesis is not associated with an apparent major teratogenic risk in humans. However, citalopram should be given during pregnancy and particularly during the third trimester, only if the potential benefits outweigh the potential risks to the fetus.

A possible case of citalopram- induced withdrawal effects has been described in an infant which began within the first few days following delivery. Symptoms included apneas, superficial breathing, sleep disorders, and hypotonia which changed to hypertonia before all symptoms gradually subsided and completely disappeared after 3 weeks. The 33- year- old mother had received citalopram 40 mg daily throughout the pregnancy. The results of a cohort study indicate that 30% of neonates who had prolonged exposure to SSRIs in utero experience symptoms, in a dose- response manner, of a neonatal abstinence syndrome (e.g., tremor, gastrointestinal or sleep disturbances, hypertonicity, high- pitched cry) after birth. The authors suggest that infants exposed to SSRIs should be closely monitored for a minimum of 48 hours after birth.

Citalopram is excreted in human milk. Side effects have been reported in two nursing infants. The manufacturer recommends that a decision should be made to discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother.

One study has reported that the relative dose to a suckling infant is similar to that reported for fluoxetine, and higher than that reported for fluvoxamine, paroxetine, or sertraline. Two cases have been reported of infants experiencing excessive somnolence, decreased feeding, and weight loss in relation to breast-feeding from a mother receiving citalopram. Milk/serum concentration ratios based on single pairs of samples from the two patients ranged from 1.16 to 1.88. Based on this, the absolute dose a suckling infant may ingest would be in the range of 4.3 to 17.6 micrograms/kg. The relative dose would be 0.7% to 5.9% of the weight- adjusted maternal dose. In one case the infant was reported to have recovered completely once the infant's mother discontinued the citalopram. According to another case report, the relative infant citalopram dose from breast milk is approximately 9% of the weight- adjusted maternal dose. A study of seven women taking citalopram and their infants has reported that the plasma concentrations of citalopram and demethylcitalopram in the infants were very low or absent and there were no adverse effects.

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Who should NOT use this medication?

• Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor. (See MAO Inhibitors under Cautions and see Interactions.)
• Concurrent pimozide therapy. (See Interactions.)
• Known hypersensitivity to citalopram, escitalopram, or any ingredient in the formulation.

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What does my medication look like?
Citalopram is available with a prescription under the brand name Celexa. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Celexa 20 mg--pink, oval, scored tablets Celexa 40 mg-white, oval, scored tablets Celexa Oral Solution 10 mg per teaspoon (5 mL)-peppermint-flavored solution

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What happens if I overdose?
Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a citalopram overdose may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.

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What should I discuss with my healthcare provider before taking citalopram?
Do not use citalopram if you are using an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with citalopram. You must wait at least 14 days after stopping an MAO inhibitor before you can take citalopram. After you stop taking citalopram, you must wait at least 14 days before you start taking an MAOI. Before taking citalopram, tell your doctor if you are allergic to any drugs, or if you have:

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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