Mental health medication

Provided by You Health for patients

Generic for Celexa® (Citalopram)

In this medication overview
  1. Usage

    How to get the most out of your treatment

  2. Warnings

    Important safety information

  3. Side Effects

    What to look out for when using your treatment

Citalopram is a prescription medicine used to treat depression. (Off-label can be used to treat: obsessive-compulsive disorder, panic disorder, social phobia (also known as social anxiety disorder), posttraumatic stress disorder, eating disorders, premenstrual dysphoric disorder, and alcohol dependence.)

Usage

  1. To get started, follow your provider's dosing instructions
    If you are not already taking citalopram, your provider will likely want you to begin by taking a starting dose for the first 7 days or the first 4 weeks depending on the pill strength prescribed. This may require you to break your pill in half using your hands or an inexpensive pill cutter that can be found at most pharmacies. If your pill splits a bit unevenly, that's okay. Be sure to follow the instructions your provider sent to help your body safely adjust to citalopram.
  2. Missed a dose?
    If you miss a dose of citalopram, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
  3. Use as prescribed
    Do not abruptly stop taking Citalopram without first checking with your healthcare provider, even when you feel better. Abruptly stopping can cause discontinuation symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares. If you choose to stop treatment, guidelines recommend a short taper of your medication between 2 weeks and 4 weeks, reducing your dose in half each week until you are out of medication. Studies have shown that a taper can reduce possible discontinuation symptoms. Your healthcare provider can provide individualized guidance for tapering your medication.
  4. Monitor for improvements
    Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Warnings

SUICIDALITY AND ANTIDEPRESSANT DRUGS
Citalopram and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. Watch for these changes and inform 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 Citalopram is started or when the dose is changed.

IMPORTANT SAFETY INFORMATION

Do not take Citalopram if you:
  • Are allergic to Citalopram, or any of the ingredients in Citalopram
  • Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking and MAOI in the last 14 days
  • Are on methadone
  • Are drinking alcohol
  • Are using or abusing recreation drugs or prescription medications
Before you take Citalopram, tell your healthcare provider if you: have thoughts of suicide or harming yourself have a history of psychiatric or medical problems, including bipolar disorder have taken any medication in the past for your condition, whether effective or not have suffered adverse or side effects from previous medication therapies are receiving any non-medication treatment, such as talk therapy drink alcohol or use/abuse recreational or prescription drugs are pregnant, plan to become pregnant, or are breastfeeding.
Inform your healthcare provider
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Citalopram may affect the way other medicines work, and other medicines may affect the way Citalopram works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Any other serotonergic medications, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Anticoagulant therapy
  • Certain antiarrhythmics: quinidine (Quinidex Extentabs®, Quinaglute®, Quinalan®), procainamide (Procanbid®, Pronestyl®, Pronestyl-SR®), amiodarone (Cordarone®, Pacerone®), sotalol (Betapace®, Sorine®)
  • Certain antipsychotics: chlorpromazine (Thorazine®), thioridazine (Mellaril®)
  • Certain antibiotics: gatifloxacin (Tequin®), moxifloxacin (Avelox®)
  • Methadone
Citalopram is a prescription medicine used to treat depression. (Off-label can be used to treat: obsessive-compulsive disorder, panic disorder, social phobia (also known as social anxiety disorder), posttraumatic stress disorder, eating disorders, premenstrual dysphoric disorder, and alcohol dependence.)
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
Medication disposal

If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.


If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Side effects

Citalopram can cause serious side effects and should be reported to your provider immediately. Rarely reported side effects include:
  • Increased bleeding (gums)
  • Low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • Teeth grinding
  • Seizure
  • Angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • At higher doses may cause abnormal electrical activity of the heart
  • Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of Citalopram are:
  • Diarrhea
  • Nausea
  • Increased sweating
  • Nervousness,
  • Fatigue or feeling sleepy
  • Insomnia
Where to find more side effects information
For more information, read the drug information that comes with your medication, ask your healthcare provider, or ask your pharmacist.