Celexa

Generic name: citalopram
Drug class: Selective serotonin reuptake inhibitors

Medically reviewed by A Ras MD.

What is Celexa?

Celexa is a prescription medicine used to treat depression. It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider. Celexa is also used to treat Major Depressive Disorder (MDD), Talk to your healthcare provider if you do not think that your condition is getting better with Celexa treatment.

Description

Celexa contains citalopram, a selective serotonin reuptake inhibitor (SSRI). Citalopram hydrobromide is a racemic bicyclic phthalane structure and is designated (±)-1-(3-dimethylaminopropyl)-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-5-carbonitrile hydrobromide with the following structural formula:

The molecular formula is C20H22BrFN2O and its molecular weight is 405.35.

Citalopram hydrobromide occurs as a fine, white to off-white powder. Citalopram hydrobromide is sparingly soluble in water and soluble in ethanol.

CELEXA tablets are for oral administration and are available as film-coated oval tablets. The strengths reflect citalopram base equivalent content. The 10 mg, 20 mg, and 40 mg strength tablets contain 12.49 mg, 24.98 mg, and 49.96 mg of citalopram hydrobromide, respectively. The 20 mg and 40 mg tablets are scored.

Inactive ingredients: copolyvidone, corn starch, crosscarmellose sodium, glycerin, lactose monohydrate, magnesium stearate, hypromellose, microcrystalline cellulose, polyethylene glycol, and titanium dioxide. Iron oxides are used as coloring agents in the beige (10 mg) and pink (20 mg) tablets.

Mechanism of Action

The mechanism of action of citalopram is unclear, but is presumed to be related to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).

What is the most important information I should know about Celexa?

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

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.

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 and 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 antiinflammatory 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:

headache
weakness or feeling unsteady
confusion, problems concentrating or thinking or memory problems

10. Visual problems.

eye pain
changes in vision
swelling or redness in or around the eye

Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

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

Who should not take Celexa?

Do not take Celexa if you:

are allergic to citalopram or escitalopram or any of the ingredients in Celexa. See the end of this Medication Guide for a complete list of 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 2 weeks of stopping Celexa unless directed to do so by your physician.
Do not start Celexa if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician.

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
confusion
loss of consciousness (pass out)
have a heart problem including congenital long QT syndrome
Do not take Celexa with Orap (pimozide) because taking these two drugs together can cause serious heart problems.

What should I tell my healthcare provider before taking Celexa?

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
Cimetidine
Triptans used to treat migraine headache
Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, amphetamines, or antipsychotics
Tramadol
Over-the-counter supplements such as tryptophan or St. John’s Wort

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 breast-feeding 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.

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.

Ask if you are not sure.

If you take Celexa, you should not take any other medicines that contain citalopram or escitalopram including: Lexapro.

How should I take Celexa?

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.

What should I avoid while taking Celexa?

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.

What are the possible side effects of Celexa?

Celexa may cause serious side effects, including:

See “What is the most important information I should know about Celexa?” above.

Common possible side effects in people who take Celexa include:

Nausea
Sleepiness
Weakness
Dizziness
Feeling anxious
Trouble sleeping
Sexual problems
Sweating
Shaking
Not feeling hungry
Dry mouth
Constipation
Diarrhea
Respiratory Infections
Yawning

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.

Call your doctor for medical advice about side effects. you may report side effects to the FDA at 1800-FDA-1088.

General information about Celexa

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Celexa for a condition for which it was not prescribed. Do not give Celexa to other people, even if they have the same condition. It may harm them.

This Medication Guide summarizes the most important information about Celexa. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about Celexa that is written for healthcare professionals.

For more information about Celexa call 1-800-678-1605.