Using Celexa to Prevent Migraines

This antidepressant may be prescribed off-label to help thwart migraine attacks

In This Article

Citalopram (brand name Celexa) is a type of antidepressant called a selective serotonin reuptake inhibitor, or SSRI, that is used to treat major depressive disorder. In some cases, a doctor will prescribe Celexa or another citalopram option to prevent migraines. This is considered an off-label use, meaning it has not been approved by the U.S. Food and Drug Administration (FDA). Often, the drug is prescribed for people who suffer from both migraines and depression.

How It Works

Citalopram, like all SSRIs, works by making more of the neurotransmitter serotonin available between nerve cells. Higher levels of serotonin have been shown to ease depression.

The rate of depression in people with migraines is higher than in the general population, but it is not clear whether migraines cause depression or vice versa.

Scientists believe that both migraine and depression might be associated with similar brain chemicals, but this has not been proven.

Furthermore, there is no robust scientific data confirming the effectiveness of Celexa or any other formulation of citalopram for preventing migraines. In fact, a 2015 review found that SSRIs—including Celexa—were no more effective than placebo or amitriptyline (a tricyclic antidepressant) in reducing headache frequency in patients with chronic tension-type headaches or migraines.

Still, if you do have depression and migraines, it may be worth a try.

Formulation and Uses

Citalopram, whether the generic drug or Celexa, is available in tablet and liquid form and can be taken with or without food.

In addition to possibly preventing migraines, citalopram has been found to be helpful for obsessive-compulsive disorder, panic disorder, social phobia (also known as social anxiety disorder), post-traumatic stress disorder, eating disorders, premenstrual dysphoric disorder, and alcohol dependence.

There is no clinical data available on the use of citalopram in children and adolescents, although it is sometimes used off-label in these populations to treat depression and anxiety.

Dosing

Citalopram tablets come in dosages of 20mg and 40mg; the liquid form delivers 10mg per 5mL.

In general, patients are started on a dose of 20mg once a day. Your doctor may eventually decide to increase the dosage, with 40mg being the maximum dose in most cases.

Citalopram, like all SSRIs, can take several weeks to reach its full effect. Always take it at the same time every day, and never alter your dose without your doctor's permission. If you forget to take a dose, take it as soon as you remember, but don't take a double dose to make up for the missed one.

Take as Prescribed

Follow the instructions provided to you and never stop taking this or any SSRI on your own. Your doctor can advise you on how to slowly taper your dosage over time to prevent serious withdrawal side effects, such as dizziness, nausea, headaches, and a prickling or tingling sensation in the skin.

Adverse Effects

Citalopram, like all SSRIs, can have side effects. The most common ones include:

  • Headache
  • Nausea
  • Diarrhea
  • Dry mouth
  • Increased sweating
  • Feeling nervous or restless
  • Feeling sleepy or having trouble sleeping (insomnia)

These will often improve over the first week or two as you continue to take the medication.

Sexual side effects, such as problems with libido, orgasm, or ejaculation, are also common and don't usually subside until the medication is discontinued.

Rare and/or serious side effects include:

  • Increased bleeding (e.g., gums may bleed more easily)
  • Low sodium blood levels: Symptoms may include headache, weakness, and difficulties with memory and concentration.
  • Angle closure glaucoma: Symptoms may include eye pain, changes in vision, swelling or redness in or around the eye.

Serotonin Syndrome: A Life-Threatening Complication

Serotonin syndrome is a serious condition that's caused by elevated serotonin concentrations in your system. This can be caused by an overdose of an SSRI or by taking a combination of drugs that increase serotonin levels.

Symptoms of serotonin syndrome include:

  • Slow or fast pulse
  • Fever
  • Headache
  • Muscle rigidity
  • Confusion
  • Profuse sweating
  • Tremor
  • Dilated pupils
  • Poor coordination
  • Rapid breathing
  • Irregular heartbeat
  • High blood pressure
  • Shivering

In the most severe cases, serotonin syndrome can cause seizures and a loss of consciousness.

If you suspect you or a loved one may have serotonin syndrome, call your doctor or head to the emergency room immediately.

Warning

Citalopram is used to treat depression, but there is a risk that it can actually exacerbate the disorder—and the risk of suicide—especially in children, teenagers, and young adults under age 24. For this reason, there is a black box warning on the patient information that comes with the prescription.

Patients, their families, and caregivers should be alert to any changes in mood, such as restlessness, irritability, aggressiveness, insomnia, and suicidal thoughts, particularly during the first few weeks of treatment.

Interactions

Migraine medications called triptans, including Zomig (zolmitriptan) and Maxalt (rizatriptan), may increase the risk of serotonin syndrome when taken with citalopram, so make sure to tell your doctor if you take a triptan.

Other drugs that may interact dangerously with citalopram include:

Citalopram may also increase the effects of other medications that can cause bleeding, such as aspirin and Coumadin (warfarin).

Contraindications

Citalopram is a category C pregnancy drug, which means there haven’t been enough studies done in humans to be certain how the drug might affect a fetus.

Citalopram passes into breast milk and may cause side effects in a child who is breastfed.

Talk to your doctor if you’re pregnant, planning to become pregnant, or are breastfeeding, so you can weigh the risks and benefits of taking Celexa or a generic form of citalopram.

A Word From Verywell

If your doctor offers Celexa (citalopram) as a way to prevent your migraines—whether you have depression or not—be sure to tell him your complete medical history, as well as provide him with a list of all your medications, including over-the-counter drugs and supplements. This is the best way to ensure that any safety concerns can be addressed.

Was this page helpful?

Article Sources