Celexa (Citalopram) - Oral

Warning:

Antidepressants may increase the risk of suicidal thinking and behavior (suicidality). If you’re considering using Celexa (citalopram) or any other antidepressant, it’s important to balance this possible risk with your current medical needs. When on antidepressant therapy, your healthcare provider will work with you to help look for any symptoms over time that may mean that your condition is worsening (e.g., suicidality, unusual behavior). It’s important that the individual on the medication, family members, and/or caregivers thoughtfully and carefully observe any changes and keep communication open with each other and the prescriber.

What Is Celexa?

Celexa (citalopram) is a prescription drug used to treat depression. Citalopram belongs to a drug class called selective serotonin reuptake inhibitor (SSRI).

Celexa selectively blocks neurons from reabsorbing a neurotransmitter called serotonin in the body. Serotonin is also known as the "happy chemical." Celexa increases levels of serotonin in the blood and helps to balance mood.

It is available in both liquid and tablet forms.

Drug Facts

Generic Name: Citalopram

Brand Name(s): Celexa

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antidepressant

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Citalopram

Dosage Form(s): Tablet, solution

What Is Celexa Used For?

Celexa is a prescription drug commonly used to treat mood and anxiety problems. It helps to manage symptoms of depression, also called major depressive disorder (MDD).

The clinical signs of depression can include, but are not limited to:

  • Persistent feelings of sadness, emptiness, or anxiety
  • Feeling worthless, guilty, or hopeless
  • Loss of interest or pleasure in usual activities
  • Low energy or fatigue
  • Abnormal changes in appetite or weight
  • Thoughts of death or suicide or suicidal behavior

However, not everyone with depression experiences all of these symptoms. In addition to low mood, you may only have a few of these symptoms or others that are not listed above.

How to Take Celexa

Take Celexa by mouth once a day in the morning with or without food. You can break citalopram in half with a pill cutter if your healthcare provider tells you to. If you are taking citalopram liquid, use a measuring cup to measure the doses carefully. Ask your pharmacist for a measuring device if you do not have one.

Citalopram increases the risk of a severe heart rhythm condition called QT prolongation. This heart condition causes a fast or irregular heartbeat. Due to this likely risk, while taking Celexa, the maximum recommended dose is usually 40 milligrams (mg) daily.

A lower maximum dose of 20 milligrams per day is advised for certain people. This includes people:

  • Over 60
  • With serious liver problems
  • On any medication that can increase levels of Celexa (like Prilosec [omeprazole])

Do not stop taking your medicine even if you start to feel better. To stop citalopram, your healthcare provider must taper you off. Tapering is a method to prevent withdrawal symptoms; it involves slowly weaning someone off medication.

Citalopram may or may not work for you. Your healthcare provider may switch your medicine to another class of antidepressant called monoamine oxidase inhibitors (MAOIs). When switching to or from MAOIs, allow 14 days between stopping an MAOI and starting citalopram, and vice versa.

Storage

Store Celexa in a dry place at room temperature (77 degrees F).  You may store it between cool and mildly hot temperatures as low as 59 F and as high as 86 degrees F), but only for short periods. Do not store citalopram in your bathroom.

Keep your medicine out of reach of pets and children. Discard all unused and expired medications; do not throw them down the toilet or drain. Ask your pharmacist about the best ways to toss your medicine. Check out local take-back programs near you.

Off-Label Uses

Healthcare providers may prescribe citalopram for off-label uses, meaning for conditions not specifically indicated by the Food and Drug Administration (FDA). Some of those conditions include:

How Long Does Celexa Take to Work?

It takes about one to four hours for Celexa to peak in your body. Depending on the condition, how long it takes to notice the full benefits of Celexa may vary for each individual. For example, people with depression and anxiety disorders may start noticing symptom improvement within one to two weeks. However, its full effects can take longer.

What Are the Side Effects of Celexa?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Celexa can cause several side effects, although some people will have little to no side effects. Let your healthcare provider know if any of these side effects become bothersome or do not go away. Common side effects of citalopram include:

  • Trouble sleeping
  • Yawning
  • Upset stomach
  • Drowsiness
  • Excessive sweating
  • Sexual problems, such as delayed ejaculation, low libido (sex drive), and impotence (erectile dysfunction)
  • Dry mouth
  • Appetite loss or increase or weight changes
  • Fatigue or weakness
  • Respiratory infections
  • Constipation or diarrhea 
  • Shakiness
  • Growth problems in children and teens

Severe Side Effects

In rare cases, people can experience severe side effects related to citalopram. Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.

Citalopram carries a boxed warning related to the increased risk of suicidal thoughts or behaviors in children, adolescents, and young adults when taking this medication, particularly within the first few months of treatment or after a change in dose. You and your loved ones should be advised to watch for any new or sudden changes in mood, behaviors, thoughts, or actions that may be worrisome.

Citalopram can also cause serotonin syndrome, a potentially life-threatening condition characterized by the build-up of serotonin in the body. Symptoms can include:

  • Mental or behavioral changes, such as agitation or hallucinations
  • Difficulty with coordination
  • Gastrointestinal issues, such as nausea, vomiting, or diarrhea
  • Increased heart rate
  • High or low blood pressure
  • Muscle rigidity or twitching

Other severe side effects of citalopram may include:

  • Allergic reactions: Symptoms may look like breathing difficulties, swelling in the face, tongue, eyes, or lips; skin-related manifestations such as rash, hives, or blisters (with or without fever)
  • QT prolongation and Torsade de Pointes: Symptoms can include chest pain, fast or slow heartbeat, shortness of breath, and dizziness or fainting.
  • Bleeding or bruising: Bleeding risk is enhanced when taking citalopram with blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin.

Additionally, stopping Celexa suddenly can induce withdrawal, which can be severe. Symptoms may include:

  • Flu-like symptoms, like nausea, headache, lightheadedness, chills, and body aches
  • Tingling or prickling feeling in the arms, hands, legs, or feet
  • Electric shock-like sensations
  • Trouble sleeping

Always work with your healthcare provider when planning to go off of any antidepressant treatment. They will help you safely wean off your medication.

Report Side Effects

Celexa may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much of Celexa Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (solution or tablets):
    • For depression:
      • Adults—At first, 20 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 40 mg per day.
      • Older adults—20 mg once a day, taken either in the morning or evening.
      • Children—Use and dose must be determined by your doctor.

Modifications

People who cannot swallow pills, like children, may use the 10 milligram/5 milliliter (mL) oral liquid solution.

If you take other drugs that increase citalopram levels in the blood, like omeprazole, your healthcare provider may adjust your dose to a maximum of 20 milligrams per day. Always tell your healthcare provider what prescription and over-the-counter (OTC) drugs, vitamins, or herbal supplements you take to ensure you can safely take Celexa.

Additionally, a dosage adjustment may be necessary for people older than 60 with liver impairment.

Missed Dose

Take the missed dose as soon as you remember. However, if it is closer to your next dose than the missed dose, skip the missed dose. Instead, go back to your regular dosing frequency. Do not take extra or double up on your dose.

Overdose: What Happens If I Take Too Much Celexa?

Citalopram overdoses cause severe damage to the heart and nerves. Overdose symptoms may include signs of serotonin syndrome, such as a fast or abnormal heartbeat, nausea or vomiting, excessive sweating, and drowsiness. Rarely, it can lead to confusion, convulsions, or coma.

What Happens If I Overdose on Celexa

If you think you or someone else may have overdosed on Celexa, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Celexa, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for unwanted effects.

Do not take citalopram with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid (Zyvox®), methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking citalopram during the 14 days after you stop a MAO inhibitor. Wait 14 days after stopping citalopram before you start taking a MAO inhibitor. If you take them together or do not the proper amount of time, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe seizures.

Do not take pimozide (Orap®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

Citalopram may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use citalopram with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St John's wort, amphetamines, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with citalopram.

Citalopram may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or irregular heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem including QT prolongation or slow heartbeat.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble in sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, including aspirin, nonsteroidal antiinflammatory agents, also called NSAIDs (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or feel unsteady when standing.

The use of alcohol is not recommended in patients who are taking this medicine.

This medicine may cause some people to become drowsy, have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Your doctor may want to monitor your child's weight and height, because this medicine may cause decreased appetite and weight loss in children.

Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have and orgasm in women, inability to have or keep an erection in men, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn't Take Celexa?

Do not use citalopram if you are:

  • Hypersensitive to citalopram or any part of its formulation. This can increase the chances of having an allergic reaction.
  • Currently on an MAOI or within 14 days of stopping the MAOI. Combining MAOI and Celexa can cause severe effects like serotonin syndrome. Therefore, you must not take these two drugs within 14 days of each other.
  • Born with a heart condition like long QT syndrome. Citalopram may cause more harm to the heart.

 What Other Medications Interact With Celexa?

Some medications do not mix well with citalopram. The combination may cause severe bleeding, serotonin syndrome, nerve damage, and heart damage (e.g., QT prolongation). Do not take the following drugs with Celexa:

  • Lexapro (escitalopram)
  • MAOIs, such as Zyvox (linezolid), Azilect (rasagiline), Zelapar (selegiline), and ProvayBlue (methylene blue)
  • Other serotonergic drugs, such as triptans, tricyclic antidepressants, tramadol, amphetamines, and St. John's Wort. Ask your healthcare provider if you are unsure whether you are taking another serotonergic medication.

Be cautious when taking NSAIDs, aspirin, or warfarin–these drugs increase the risk of bleeding when used along with Celexa. Before starting Celexa, tell your healthcare provider if you take any of these medications.

Examples of NSAIDs include:

What Medications Are Similar?

Other selective serotonin reuptake inhibitors like Celexa used to treat depression are:

Lexapro is similar, but not identical, to Celexa. Both medications have a more negligible effect on the liver. Where drug-drug interactions are a concern, Lexapro and Celexa are usually the drugs of choice.

Zoloft causes more stomach problems and insomnia than Celexa, whereas Paxil is associated with more weight gain and sexual dysfunction. Prozac has similar side effects to Celexa but less harmful side effects on the heart.

This is a list of drugs also prescribed for depression. It is NOT a list of drugs recommended to take with Celexa. In fact, you should not take these drugs together. Talk to your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Celexa used for?

    Celexa is approved to treat depression. However, it has also been used off-label for various other mental health disorders, including anxiety, eating disorders, and obsessive-compulsive disorder.

  • What should I do if I miss a dose of Celexa?

    Take the missed dose once you remember. If it is too close to the next dose, skip the missed dose. Return to your usual dosing time. Do not take extra or double doses.

  • What are some common side effects of Celexa?

    Common side effects may include insomnia, yawning, nausea, drowsiness, excessive sweating, loss of appetite, fatigue or weakness, respiratory infections, and constipation or diarrhea, among others. However, it is important to remember that not everyone will experience these side effects. Some people may have few to no side effects from taking it. Call your healthcare provider if these side effects bother you or do not go away.

  • How do I stop taking Celexa?

    Do not stop taking Celexa without talking to your healthcare provider. You must be tapered off this medication to prevent drug withdrawal and rebound symptoms from occurring. This means that your healthcare provider will come up with a plan to slowly lower your dose until you no longer need to take it.

How Can I Stay Healthy While Taking Celexa?

Depression is a severe mental health condition that can affect one's day-to-day activities. You may have trouble sleeping, lose your appetite, or feel persistent sadness or loneliness as you figure out how to manage this condition.

Getting your symptoms under control usually requires a multi-faceted strategy. While antidepressants can be part of that treatment plan, they are generally not the only piece. Other forms of therapy include psychotherapy, like cognitive-behavioral therapy, and can be used in addition to medication for further benefits.

It's also important to remember that antidepressants can take some time to work. You may start to feel better in one to two weeks, but it can take six to 12 weeks to take full effect. That being said, each person's response to medication is different, so this may vary between individuals. Sometimes, finding the right medication can take trial and error.

Be open and honest with your healthcare provider as you figure out if Celexa is the right option for you. Don't hesitate to let them know about any bothersome side effects or if you don't notice any improvement in your symptoms.

Notify them immediately if your depressive symptoms worsen or you notice any unusual changes in your mood, behavior, or thoughts.

When to Seek Emergency Help

If you think you may be in a position to harm yourself or someone else, call 911 or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through the Substance Abuse and Mental Health Service Administration (SAMHSA) National Hotline at 1-800-662-HELP (4357).

If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.