Citalopram (Celexa) Antidepressant

Citalopram (Celexa) belongs to the class of antidepressants

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Citalopram (Celexa) belongs to the class of antidepressants called Selective Serotonin Reuptake Inhibitors (SSRIs). It is available in 10-, 20- or 40-milligram tablets or as an oral solution.

Indications and Usage of Citalopram

Citalopram HBr (Celexa) is used for the treatment of depression.

Contraindications of Citalopram

Concomitant use with Monoamine Oxide Inhibitors (MAOIs) is contraindicated. Serious, sometimes fatal, reactions may occur.

Those with a hypersensitivity to citalopram or any of the inactive ingredients should not use it.


Hyponatremia; activation of mania/hypomania in those with bipolar disorder; use with care in those with a history of seizure disorders; supervise closely during the initial stages of treatment for suicide risk; potential interference with cognitive and motor performance; clinical experience with certain concomitant clinical illnesses is limited and caution should be exercised with these, including those with altered metabolism or hemodynamic response, heart disease or hepatic impairment.

Drug Interactions

Discuss potential drug interactions with your physician if you use any of the following: CNS drugs, alcohol, monoamine oxidase inhibitors, cimetidine, digoxin, lithium, theophylline, sumatriptan, warfarin, carbamazepine, triazolam, ketoconazole, CYP3A4 and 2C19 inhibitors, metoprolol or imipramine and other tricyclics.

Carcinogenesis, Mutagenesis, Impairment of Fertility

There was no evidence of carcinogenesis in mice given 20 times the recommended human dose. There was an increased risk of small intestine carcinoma in rats given 1.3 to 4 times the recommended human dose. Certain in vitro studies found evidence of mutagenicity while others did not.

Rats fed citalopram experienced decreased mating and fertility. It is not known what implication these animal studies have for humans.

Pregnancy and Lactation

Citalopram HBr (Celexa) is a Class C drug. There are no adequate studies of pregnant women using this drug. It should be used during pregnancy only if the potential risk to the fetus is outweighed by the benefit to the mother. Celexa is excreted in breast milk. There have been two reports of infants experiencing excessive somnolence, decreased feeding and weight loss after being breastfed by a mother using citalopram.

Adverse Reactions

At least 2% of patients in placebo-controlled trials experienced the following: dry mouth, increased sweating, tremor, nausea, diarrhea, dyspepsia, vomiting, abdominal pain, fatigue, fever, arthralgia, myalgia, somnolence, insomnia, anxiety, anorexia, agitation, dysmenorrhea, decreased libido, yawning, upper respiratory tract infection, rhinitis, sinusitis, ejaculation disorder or impotence.

Drug Abuse and Dependence

Citalopram HBr (Celexa) is not a controlled substance. Animal studies suggest that it is not likely to be a drug of abuse.

Dosage and Administration

Citalopram HBr (Celexa) should be administered at an initial dose of 20 mg daily, generally with an increase to 40 mg daily.

Increases should occur in 20 mg intervals no closer together than once a week. There is no demonstrated advantage to taking 60 mg over 40 mg. The daily dose may be taken morning or evening, with or without food. The elderly or those with hepatic impairment should begin at 20 mg daily and titrate to 40 mg if no response is obtained. No dosage adjustment is required for those with mild to moderate renal impairment. Caution should be used for those with severe renal impairment. At least 14 days should elapse between stopping an MAOI and beginning citalopram.

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