Jeffrey Panko NP Psychiatry · Patient education
Citalopram
Celexa / Generic tablets and oral solution
A guide for adults taking citalopram.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Tablets and oral solution are usually taken once daily. Age, liver function, heart risk, and interacting medicines can limit the appropriate dose.
What it is used for
Citalopram treats major depression. It is also prescribed off-label for some anxiety disorders or OCD. Off-label use means the FDA has not approved that specific indication.
How it works
It slows serotonin reuptake, leaving more serotonin available between nerve cells. Symptom improvement develops gradually as the nervous system responds to treatment.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Take once daily, with or without food. Use an oral dosing device for liquid.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Do not exceed your prescribed dose; higher exposure increases heart-rhythm risk.
- Consult with your provider before stopping or switching.
When to get help
Emergency symptoms. Get emergency care for a seizure, severe allergic reaction, or sudden eye pain with vision changes. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome and needs urgent assessment.
Prompt medical advice. Contact your provider right away for marked agitation, new hallucinations, or unusually high energy with very little need for sleep.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, diarrhea, or stomach discomfort
- Headache, sweating, or a mild tremor
- Sleep changes or early restlessness
- Changes in sexual desire, arousal, or orgasm
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.
An ECG and electrolyte checks may be needed. Fainting or a rapid, irregular heartbeat needs urgent assessment.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss bipolar symptoms, seizures, glaucoma, liver disease, long-QT syndrome, a slow heartbeat, heart failure, fainting, and low potassium or magnesium.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Do not combine with an MAOI; the waiting period depends on the medication being stopped. Linezolid and IV methylene blue also require special precautions.
Other antidepressants, tramadol, dextromethorphan cough medicines, triptans, lithium, and St. John’s wort may increase serotonin-syndrome risk.
Aspirin, NSAIDs such as ibuprofen, and anticoagulants can add bleeding risk. Review alcohol and other medicines that impair alertness.
Other QT-prolonging medicines add heart-rhythm risk. Omeprazole, cimetidine, and other CYP2C19 inhibitors can increase exposure and may require a lower dose.
Everyday tips
A regular dose time and refill reminder can help prevent missed doses.
Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment after improvement can reduce the chance that symptoms return. Most antidepressants should be reduced gradually to limit withdrawal symptoms.
What if I have sexual side effects?
Changes in desire, arousal, or orgasm are worth discussing. Your provider can review the dose or treatment options; do not stop or skip doses on your own.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.