Vol 17 No 3 (2019): Jul-Sep
Take the citalopram packet, or the leaflet inside it, plus any remaining medicine with you.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Celexa only for the indication prescribed.
It is also important information to carry with you in case of emergencies.
You can take it with or without food.
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In the United States, citalopram carries a boxed warning stating it may increase suicidal thinking and behavior in those under age
The length of time a patient was on citalopram, the dose they were on, and how slow the taper was may all have an effect on withdrawal.
Did I wean from it too quickly?
Celexa side effects in more detail.
Do not drive a car or operate machinery until you know how this medication affects you.
See also: Celexa drug interactions in more detail.
Along with its needed effects, citalopram the active ingredient contained in Celexa may cause some unwanted effects.
The usual dose of citalopram is 20mg a day in adults.
Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
The American Journal of Psychiatry.
Categories : Selective serotonin reuptake inhibitors Benzonitriles Fluoroarenes Isobenzofurans Dimethylamino compounds Sigma agonists.
Tell your doctor or prescriber about all prescription, over-the-counter non-prescription , and herbal medications that you are taking.
Q: I was taking citalopram for a while, but stopped.
Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared with placebo in adults aged 65 or older.
Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions.
The body should adjust, but everyone reacts or responds differently, and the amount of time necessary is dependent on the individual.
Citalopram is not approved for use in children.
A meta-analysis, including studies with fluoxetine, paroxetine, sertraline, escitalopram, and citalopram versus placebo, showed SSRIs to be effective in reducing symptoms of premenstrual syndrome, whether taken continuously or just in the luteal phase.
Increased serotonin levels can help improve mood.
Role of community pharmacists in skin cancer screening: A descriptive study of skin cancer risk factors prevalence and photoprotection habits in Barcelona, Catalonia, SpainIt may take several weeks to see a noticeable improvement in your mood.
One study showed, however, when remission of major depressive disorder is achieved, quality of life and sexual satisfaction is reported to be higher in spite of sexual side effects.
Citalopram is also a mild antihistamine , which may be responsible for some of its sedating properties.
You may develop withdrawal symptoms if you stop citalopram abruptly.
Epidemiological studies, primarily in patients aged 50 years or older, have shown an increased risk of bone fractures in patients receiving SSRIs or TCAs.
Citalopram and other SSRIs can induce a mixed state , especially in those with undiagnosed bipolar disorder.
Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.
Some of the dosage forms listed on this page may not apply to the brand name Celexa.
See also: Citalopram side effects in more detail.
In the National Institute for Health and Clinical Excellence ranking of 10 antidepressants for efficacy and cost-effectiveness  citalopram is fifth in effectiveness after mirtazapine , escitalopram , venlafaxine , and sertraline and fourth in cost-effectiveness.
A: Many antidepressants are reported to cause weight gain, especially when used for more than six months.
For its S - enantiomer , see Escitalopram.
Your doctor will likely prescribe a 20 mg dose of citalopram, taken once a day, to start.
Your doctor may start you on a low dose of citalopram and gradually increase your dose, not more often than once a week.
This is not a complete list of the side effects associated with Celexa citalopram.
Acne: Fact vs.
This drug is not typically stopped abruptly.
Do not give Celexa to anyone younger than 18 years old without the advice of a doctor.
Citalopram was approved for medical use in the United States in
Common side effects Common side effects happen in more than 1 in people.
In some cases these can continue even after stopping the medicine.
You should not use Celexa if you are allergic to citalopram or escitalopram Lexapro , or if you also take pimozide.
Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.
Drugs that can cause bleeding or bruising, including antiplatelet drugs like clopidogrel Plavix ; non-steroidal anti-inflammatory drugs NSAIDs such as ibuprofen ; and blood thinners such as warfarin Coumadin , might interact with citalopram.
A serious allergic reaction is an emergency.
The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorderThere have been reports that using this and similar medications in children under 18 years old may cause behavioural and emotional changes such as suicidal thoughts and behaviour.
Citalopram passes into breast milk in small amounts, and has been linked with side effects in very few breastfed babies.
Citalopram may cause a condition known as QT prolongation a fast or irregular heartbeat.
Patients treated with Celexa in controlled trials experienced a weight loss of about 0.
Do not stop taking citalopram without talking to your healthcare provider.
If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.
Take your next dose the next day at the usual time.
I weaned off it slowly, going from 30 to 20 to 10 in about a month.
However, you may have a relapse of depression if you stop taking your antidepressant.
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Can I drive or ride a bike?
These are warning signs of a serious allergic reaction.
Antidepressants like citalopram help to jump start your mood so you feel better.
Tell your doctor if any of these symptoms are severe or do not go away: nausea diarrhea constipation vomiting stomach pain heartburn decreased appetite weight loss frequent urination excessive tiredness yawning weakness uncontrollable shaking of a part of the body muscle or joint pain dry mouth changes in sex drive or ability heavy menstrual periods Some side effects can be serious.
If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Sexual side effects usually pass after the first couple of weeks.
But sometimes people respond better to one antidepressant than to another.
The effect should reverse once you stop taking the medicine.
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Citalopram drug interactions in more detail.
Agreement between units of measure for paediatric antibiotic utilisation surveillance using hospital pharmacy supply dataA: Celexa citalopram is a selective serotonin reuptake inhibitor SSRI most often used to treat major depression associated with mood disorders, typically bipolar disorder.
These medicines are thought to work by increasing the levels of a mood-enhancing chemical called serotonin in the brain.
It is in a class of medications called selective serotonin reuptake inhibitors, and works by balancing out serotonin, a chemical in the brain.
Availability Prescription only.
Your pharmacist may be able to advise you on managing side effects.
Keep this medication in the container it came in, tightly closed, and out of reach of children.
The side effects listed below are not experienced by everyone who takes this medication.
A very serious allergic reaction to citalopram is rare but seek immediate medical attention if you develop any of these symptoms:.
Lori Poulin, PharmD.
The Journal of Neuropsychiatry and Clinical Neurosciences.
If your doctor determines treatment with citalopram best meets your needs, you may be started on a lower dose and work your way up slowly to get accustomed to the levels of citalopram once again.
Contact your doctor if you experience dizziness or lightheadedness frequently.
Lay summary — Los Angeles Times 2 June
Your doctor can explain the risks and the benefits, and will help you decide which treatment is best for you and your baby.
It is important that this medication be taken exactly as prescribed by your doctor.
However, citalopram has been used off-label for anxiety.
It usually takes 4 to 6 weeks for citalopram to work.
A side effect may be insomnia.
Do not take more or less of it or take it more often than prescribed by your doctor.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug NSAID for pain, arthritis, fever, or swelling.
Information: You can report any suspected side effect to the UK safety scheme.
Citalopram works by increasing the natural brain chemical serotonin, which assists in maintaining metal balance.
Take Celexa exactly as prescribed by your doctor.
If you and your doctor decide to take you off citalopram, your doctor may recommend reducing your dose gradually to help prevent extra side effects.
The half-life of citalopram is about 35 hours.
Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use citalopram only for the indication prescribed.
This class of drugs can cause serious withdrawal side effects if you stop using them suddenly.
Citalopram may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
It is thought to work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
Potentially inappropriate medications among the elderly in primary care in Thailand from three different sets of criteriaMany medications can cause side effects.
The information on this page has been compiled for use by healthcare practitioners and consumers in the United States and therefore neither Everyday Health or its licensor warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.
A pooled analysis of two positive placebo-controlled studies in major depressive disorder".
Sexual Medicine Reviews.
Others: Antihistamines e.
Do not suddenly stop taking citalopram as this can cause withdrawal side effects, some of which could be severe.
Citalopram comes as a tablet and a solution liquid to take by mouth.
Take citalopram once a day.
You should know that your mental health may change in unexpected ways when you take citalopram or other antidepressants even if you are an adult over 24 years of age.
Symptoms of overdose may include the following: dizziness sweating nausea vomiting uncontrollable shaking of a part of the body drowsiness fast, irregular, or pounding heartbeat memory loss confusion seizures coma loss of consciousness fast breathing bluish color around mouth, fingers, or fingernails muscle pain dark-colored urine.
As with other SSRIs, citalopram can cause an increase in serum prolactin level.
Monitor your blood sugar more often for the first few weeks of treatment with citalopram and adjust your diabetes treatment if necessary.
If you are taking any of these medications, speak with your doctor or pharmacist.
If this is the case, continue taking aspirin unless your doctor tells you to stop.
Can I drink alcohol with it?
It usually takes between 4 and 6 weeks before you feel the full benefits.
Some people may experience side effects other than those listed.
A: he problem with citalopram is that it contains two chemicals, the primary active ingredient, and its mirror image that supposedly has no effect on the body.
Symptoms can include: agitation, irritability, dizziness, burning or tingling, sometimes called "brain zaps" anxiety, confusion, headache, tiredness, seizures.
Cut down the amount of alcohol you drink as it can make you feel worse.
Citalopram is considered safe and well tolerated in the therapeutic dose range.
Citalopram may impair your thinking or reactions.
Neither Everyday Health nor its licensor assume any responsibility for any aspect of healthcare administered with the aid of the information provided.
They help control the symptoms of anxiety and are used as part of an overall treatment plan that can include other medications and talk therapy.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles.
Amiodarone Amphetamines e.
American Family Physician.
The group receiving citalopram had a significantly higher improvement rate in managing their anxiety.
I have been on it for 2 years, started at 20mg.
Consult your physician before stopping trazodone.
Symptoms of withdrawal may include:.
In a different study, it was concluded that patients taking citalopram actually experienced a weight loss of 0.
Your doctor may occasionally monitor your heart rate and rhythm with a test called an electrocardiogram.
Tell your health care provider about any negative side effects from prescription drugs.
Celexa 20 mg, pink, elliptical,.
Differences include: citalopram doses are twice as much as those of escitalopram the type and frequency of side effects you may get are different with each medicine citalopram can be used for fewer health problems than escitalopram.
Report any new or worsening symptoms to your doctor.
It is quite typical for many patients to have their dose of citalopram increased to 40mg.
Talk to your doctor if you think you might use recreational drugs while taking citalopram.
You and your doctor will decide what type of treatment is right for you.
Q: I have been taking Citalopram, and have recently come off it.
Your physician may occasionally order an electrocardiogram ECG, EKG to monitor your heart rate and rhythm and blood tests to check your potassium and magnesium levels.
Distinct from some other agents in its class, it exhibits linear pharmacokinetics and minimal drug interaction potential, making it a better choice for the elderly or comorbid patients.
Mianserin Mirtazapine Setiptiline.
Effectiveness of a pharmacist-led quality improvement program to reduce medication errors during hospital dischargeCommon side effects of citalopram include drowsiness, insomnia, nausea, gas, upset stomach, weight changes, urinating more than usual, decreased sex drive, impotence, dry or watery mouth, and yawning.
A: Drowsiness is a side effect of citalopram Celexa.
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Tell your doctor if you drink alcohol or take any medications that cause drowsiness like antihistamines , allergy medications, cough and cold medications, drugs for sleep or anxiety , muscle relaxants, and narcotic pain relievers like codeine.
For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.
This includes aspirin, ibuprofen Advil, Motrin , naproxen Aleve , celecoxib Celebrex , diclofenac, indomethacin, meloxicam, and others.
If you stop taking citalopram, you should wait at least 14 days before you start to take an MAO inhibitor.
Atypical antipsychotics aripiprazole , brexpiprazole , lurasidone , olanzapine , quetiapine , risperidone Buspirone Lithium lithium carbonate , lithium citrate Thyroid hormones triiodothyronine T 3 , levothyroxine T 4.
The FDA requires citalopram to carry a black-box warning because some children, teenagers, and young adults up to 24 years of age who took antidepressants such as citalopram during clinical studies had suicidal thoughts and behavior.
Specifically, common side effects include difficulty becoming aroused, lack of interest in sex, and anorgasmia trouble achieving orgasm.
Cannabis can also make drowsiness worse with citalopram, especially in people who have just started taking it.
Take citalopram exactly as prescribed by your doctor.
If you have a seizure disorder or have had seizures in the past, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Burton Dunaway, PharmD.
Do not use this medicine in larger or smaller amounts or for longer than recommended.
I would contact your health care provider and let them him or her know how you are feeling.
Do not stop taking citalopram without talking to your doctor.
In case of overdose, call the poison control helpline at
Insoluble fibers, including whole grain breads and cereals, can help bulk up your stool if you have diarrhea.
That dose could be increased gradually to 40 mg a day as you adjust to the medication.
Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here.
The most commonly reported side effects were nausea , somnolence, dry mouth, increased sweating, tremor, diarrhea, and ejaculation disorder.
The New England Journal of Medicine.
MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Common side effects include nausea, trouble sleeping, sexual problems, shakiness, feeling tired, and sweating.
Some patients may have significant withdrawal symptoms that last a significant amount of time while others may not have many symptoms.
Other brands: Celexa.
Other uses for this medicine What special precautions should I follow?
Journal of Physiology and Pharmacology.
If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment: chest pain shortness of breath dizziness fainting fast, slow, or irregular heartbeat hallucinating seeing things or hearing voices that do not exist fever excessive sweating confusion coma loss of consciousness loss of coordination stiff or twitching muscles hives or blisters rash itching difficulty breathing or swallowing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness unusual bleeding or bruising headache unsteadiness problems with thinking, concentration, or memory seizures Citalopram may decrease appetite and cause weight loss in children.
For a complete list, consult with your doctor or pharmacist.
Many medical experts believe depression is caused by an imbalance of neurotransmitters such as serotonin.
Citalopram comes in tablet form, in 10, 20, and 40 milligrams mg , or as a liquid solution taken orally.
These factors may affect how you should use this medication.
Overdosage may result in vomiting, sedation, disturbances in heart rhythm, dizziness, sweating, nausea, tremor, and rarely amnesia, confusion, coma, or convulsions.
Some young people have thoughts about suicide when first taking an antidepressant.
Your doctor may increase the dose as appropriate, based on how well it is working for you and whether you are experiencing side effects.
Citalopram may increase the risk of bleeding, especially in patients taking other drugs that increase bleeding risk, such as nonsteroidal anti-inflammatory drugs NSAIDs like ibuprofen, naproxen, and aspirin, as well as warfarin.
The FDA also issued a Safety Announcement in recommending that citalopram not be prescribed at doses greater than 40 milligrams a day because of the increased risk potentially dangerous abnormalities in the electrical activity of the heart changes in heart rhythm.
Assessment of pharmacists’ knowledge, attitude and practice in chain community pharmacies towards their current function and performance in IndonesiaNonetheless, talk with your doctor if you have any history of substance abuse.
Larger, controlled studies need to be evaluated to confirm the positive results of using citalopram for the treatment of anxiety.
Withdrawal symptoms such as nausea, headache, fatigue, and sweating may occur.
There are dietary adjustments that may reduce the frequency diarrhea.
Q: My year-old father is about to begin taking citalopram.
Since a mild depression has returned, my doctor recommended boosting the dose to 40 mg per day.
Browse Drugs and Medicines.
Do not engage in activities that require you to be alert until you know how citalopram affects you.
Could this medication cause this?
Q: My doctor says I am just depressed, but I have the symptoms of bipolar disorder.
Michelle McDermott, PharmD.
Methadone can increase the risk of side effects in people taking citalopram.
Newborn babies may experience withdrawal symptoms or high blood pressure in the lungs if the mother is taking citalopram during the 3 months before the baby is born.
Journal of Toxicology.
Can it make me gain weight?
This information is for educational purposes only, and not meant to provide medical advice, treatment, or diagnosis.
Back to Medicines A to Z.
Evaluation of aminoglycosides utilization in intensive care units of a teaching hospital in southern IranA: Try taking the citalopram at in the morning at first.
If you have questions or concerns about these instructions, talk to your doctor or local pharmacist for help.
It is usually taken once a day, in the morning or in the evening, with or without food.
A: If left untreated, the symptoms associated with discontinuing a selective serotonin reuptake inhibitor SSRI , such as citalopram Celexa , may last anywhere from one to three weeks.
Citalopram does have a risk of withdrawal symptoms when stopping the medication, especially if citalopram is stopped suddenly.
Your doctor may be able to give you suggestions on how to cope with withdrawal symptoms and how to taper your dose to help prevent withdrawal.
You should know that having depression or another mental illness greatly increases the risk that you will become suicidal.
With liquid drops of citalopram, 4 drops is equivalent to a 10mg tablet.
Some possible withdrawal symptoms include dizziness, drowsiness, vivid dreams, irritability, nausea, tingling sensations, and headache.
Other conditions that may be a concern when taking citalopram are a history of bipolar or manic-depressive disorder, past suicide attempts, liver disease, seizures, low blood sodium, intestinal ulcers or bleeding problems.
Not approved for use in pediatric patients.
There are tablet cutters available which you may be able to get at your local pharmacy that can help with splitting of tablets to achieve a lower dose.
See also: Celexa side effects in more detail.
At the risk of sounding vain, I am also working on losing weight as I have been for several months now.
Q: What would happen if I stopped taking my citalopram all at once, without easing off it slowly?
Talk to your doctor about any concerns you have about your diagnosis or your use of citalopram.
Last updated on Dec 27,
If possible, use one pharmacy for all your prescription medications and over-the-counter products.
For Healthcare Professionals Applies to citalopram: oral solution, oral tablet.
Derek Dore, PharmD.
Your doctor will probably decrease your dose gradually.
A: Regarding Citalopram and its use in the treatment of depression, the normal starting dose is 20 mg daily.
Citalopram is thought to work by increasing serotonin levels.
A: The main concern with citalopram is that adolescent patients who take it may have suicidal thoughts and behaviors.
A descriptive study of antithrombotic medication patterns in adult patients with recent venous thromboembolismDo not give this medication to anyone else, even if they have the same symptoms as you do.
Do not use Celexa if you have used an MAO inhibitor in the past 14 days.
Follow all directions on your prescription label.
Serotonin, if there is too little, can cause the symptoms of depression.
Daily news summary.
You do take this at bedtime, which is advisable.
Citalopram helps many people recover from depression, and has fewer unwanted side effects than older antidepressants.
It might be best to stop driving and cycling for the first few days of treatment until you know how this medicine makes you feel.
Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist.
Is there any food or drink I need to avoid?
If you start to have problems with your weight while taking citalopram, talk to your doctor or pharmacist.
If you become pregnant while taking citalopram, speak to your doctor.
Citalopram has been linked to a very small increased risk of problems for your unborn baby.
Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Some people experience persistent sexual side effects after they stop taking SSRIs.
If you are thinking about starting citalopram again, it is recommended that you speak with your doctor prior to re-initiating therapy.
According to the prescribing information for citalopram, tapering the dose is preferred over abruptly stopping the medication.
Is this a side effect of this medicine and is there anything to combat it if it is?
But it may be started at a lower dose and increased to a maximum dose of 40mg a day.
If you become pregnant while taking this medication, contact your doctor immediately.
Nonmedicinal ingredients: copolyvidone glycerin, cornstarch, croscarmellose sodium, lactose monohydrate, magnesium stearate, hydroxypropyl methylcellulose, microcrystalline cellulose, polyethylene glycol , and titanium dioxide.
Never take 2 doses at the same time to make up for a forgotten one.
Keep all appointments with your doctor and the laboratory.
This risk can go up if you take diuretics.
Talk to your doctor about your condition, symptoms, and personal and family medical history.
Evidence for effectiveness of citalopram for treating depression in children is uncertain.
The length of time that a person experiences symptoms may vary depending on several patient specific factors.
Either of these prescriptions may be written in liquid form to allow a very slow and gradual tapering down in dosage.
Do not let anyone else take your medication.
Do not stop using citalopram suddenly, or you could have unpleasant withdrawal symptoms.
Some side effects of citalopram may occur that usually do not need medical attention.
Some data suggest citalopram may cause nightmares.
You should not use Celexa if you also take pimozide, as the combination can cause problems with your heart rhythm.
These are called "off-label," "unlabelled," or "unapproved" uses.
Neither Everyday Health nor its licensors endorse drugs, diagnose patients or recommend therapy.
Your doctor may decide to start with a lower dose.
Continue to take citalopram even if you feel well.
Citalopram side effects in more detail.
Impact of an HIV-trained clinical pharmacist intervention on error rates of antiretroviral and opportunistic infection medications in the inpatient settingIf you are experiencing anxiety, consult with your doctor for more information regading citalopram, or to determine if another SSRI may be appropriate for your specific medical condition.
Taking a monoamine oxidase inhibitor MAOI with this drug could be fatal.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Also talk to your doctor if you plan to breastfeed while on citalopram.
Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Citalopram is typically taken in one dose, either in the morning or evening.
See also: Celexa dosage information in more detail.
A multisite randomized controlled study found no benefit and some adverse effects in autistic children from citalopram, raising doubts whether SSRIs are effective for treating repetitive behavior in children with autism.
The use of antidepressants should be monitored closely by your healthcare provider.
Some people feel worse during the first few weeks of treatment before they begin to feel better.
There is no specific time frame that withdrawal from citalopram may last but there are sources that suggest it could last from weeks.
Mandatory continuing education for pharmacists in a developing country: assessment of a three-year cycleIf you do not have a dose-measuring device, ask your pharmacist for one.
This is not a complete list of side effects and others may occur.
If you have a bleeding disorder or a history of bleeding problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Your doctor may occasionally change your dose.
Talk to your doctor about having an eye examination before you start taking this medication.
Take citalopram exactly as it is prescribed for you.
If you experience any of these symptoms or notice them in a family member who is taking this medication, contact your doctor immediately.
Your doctor is best able to properly evaluate your medical condition and make recommendations based on your specific circumstances.
Others: A Amoxapine Antihistamines e.
Other common side effects are rash, constipation, diarrhea, nausea and vomiting, dry mouth, dizziness, headache, sedation, tremors, ejaculation disorder, rhinitis, and upper respiratory infection.
Families and caregivers should be advised of the need for close observation and communication with the prescriber.
For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action.
Since this medication may increase serotonin levels, in rare cases this may cause a condition known as serotonin syndrome.
It can be taken with or without food.
Citalopram is the generic form of the brand-name antidepressant Celexa, which is used to treat depression.
You should not use citalopram if you also take pimozide, or if you are being treated with methylene blue injection.
This is to help prevent any extra side effects you might get as a reaction to coming off the medicine.
Citalopram should be taken once daily either in the morning or evening, but at the same time every day.
See also: Citalopram dosage information in more detail.
This list is not complete and many other drugs can interact with citalopram.
If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking citalopram for a long time.
Its absorption does not increase when taken with food,  but doing so can help prevent nausea.
These symptoms may be associated with an increased risk of suicidal thinking and behavior.
For more detailed information, consult with your physician or pharmacist for guidance based on your specific condition and current medications.
If you have a history of mania or bipolar disorder, you should be closely monitored by your doctor while taking this medication.
This is not a complete list of the side effects associated with citalopram.
Your doctor may order certain laboratory tests and electrocardiograms EKG; a test to monitor your heart rate and rhythm before you start taking citalopram and during your treatment with this medication.
Although you may start feeling better within a few weeks of treatment, the full effects of the medication may not be evident until several weeks of treatment have passed.
Q: I need to know what the side effects are of stopping the use of citalopram abruptly.
Some people who take citalopram for panic attacks find their anxiety gets worse during the first few weeks of treatment.
Do not take a double dose to make up for a missed one.
A change in weight and appetite is one of the reported side effects of citalopram Celexa.
Citalopram should be weaned down under the supervision of your doctor.
Antidepressant exposure is not associated with an increased risk of spontaneous abortion.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Many other medications may also interact with citalopram, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
Citalopram may be used off-label to treat anxiety , and dysthymia ,  premenstrual dysphoric disorder , body dysmorphic disorder , and obsessive—compulsive disorder.
This article is about the racemic form of the drug.
Q: I have recently stopped taking citalopram.
Common side effects from Celexa citalopram may include nausea, loss of appetite, stomach pain, diarrhea, constipation, drowsiness, tiredness, excitement, nervousness, muscle or joint pain, dry mouth, sweating, changes in sex drive or ability, and shaking of part off the body.
Take the missed dose as soon as you remember it.
Diagnostic and Statistical Manual of Mental Disorders 5th ed.
Q: I take citalopram for depression.
Citalopram is called by the brand name Cipramil.
Every effort has been made to ensure that the information provided by on this page is accurate, up-to-date, and complete, but no guarantee is made to that effect.
Pharmacist intervention to enhance postoperative fluid prescribing practice in an Iraqi hospital through implementation of NICE guidelineFDA alerts for all medications.
Although not all of these side effects may occur, if they do occur they may need medical attention.
For a full list, see the leaflet inside your medicines packet.
Celexa is approved for use to treat depression.
Q: What happens if I stop taking my 40 mg prescription of citalopram completely without weaning off it?
Is citalopram better than other antidepressants?
Alternatively, a patient wishing to stop taking citalopram may visit a compounding pharmacy where his or her prescription may be re-arranged into progressively smaller dosages.
If it becomes necessary for you to stop taking citalopram, ask your doctor to advise you how best to gradually reduce the dose to avoid withdrawal effects.
No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments.
If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Skip the missed dose if it is almost time for your next scheduled dose.
Do not take extra medicine to make up the missed dose.
Atomoxetine Reboxetine Viloxazine.
A: Citalopram Celexa is a selective serotonin reuptake inhibitor used to treat depression and other conditions as determined by your doctor.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:.
A: Citalopram is an antidepressant that belongs to a class of drugs called selective serotonin reuptake inhibitors SSRIs.
In the first six months of taking this, I have gained 20 pounds.
The usual dose of citalopram in children is 10mg a day, but this may be increased to 40mg a day.
Other serious but rare side effects are myocardial infarction, arrhythmia, anemia, lymphadenopathy, and serotonin syndrome.
Close monitoring by a doctor or health care professional and possibly a change in medication may be needed if these symptoms occur.
If symptoms occur, starting the medication at a previous dose and tapering more slowly may help relieve the symptoms of discontinuation.
Do not give this medicine to anyone under 18 years old without medical advice.
You may need to take citalopram during pregnancy if you need it to remain well.
This risk must be balanced with the clinical need.
Coma and death are possible.
Q: I am on citalopram, 10 milligrams at bedtime, bupropion, 75mg at 9 a.
Citalopram may cause other side effects.
In some cases a physician has prescribed low-dose aspirin as part of a heart attack or stroke prevention plan.
This medicine is not approved for use in children.
Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Selective serotonin reuptake inhibitors.
Before taking citalopram, tell your doctor and pharmacist if you are allergic to citalopram, escitalopram Lexapro , any other medications, or any of the ingredients in the citalopram product you are taking.
A: Discontinuation of a medication should only be under the guidance and supervision of a health care provider.
Am I being unreasonable?
Some patients have experienced seizures when stopping this medication abruptly.
In some patients, that shows as a weight loss; others, unfortunately, put on extra pounds as a side effect.
It may take several 4 to 6 weeks for you to start feeling better and see an improvement in your symptoms.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Q: What is the best way to get off of citalopram 10mg?
Also tell your doctor if you are experiencing severe vomiting, diarrhea, or sweating, or if you develop these symptoms at any time during your treatment.
If you develop seizures, contact your doctor or seek medical attention immediately.
Tricyclic and tetracyclic antidepressants.
Medications other than those listed above may interact with this medication.
If you forget doses often, it may help to set an alarm to remind you.
The risk of QT prolongation can be increased if you already have heart problems like a slow heartbeat, recent heart attack , or a family history of certain heart problems including sudden cardiac death.
You can browse Drugs A-Z for a specific prescription or over-the-counter drug or look up drugs based on your specific condition.
Your doctor may want to re-evaluate your symptoms to determine if beginning treatment with citalopram is appropriate for you.
There are anecdotal reports that citalopram, like other antidepressants, has been abused by some people to "get high" or experience a sense of euphoria.
Tell your doctor right away if you become pregnant.
You can drink alcohol while taking citalopram, but it may make you feel sleepy.
However, very rarely, they can be long lasting and may not get better even after stopping the medicine.
It can be harmful for people to take this medication if their doctor has not prescribed it.
Clinical Pharmacology and Therapeutics.
A fatal reaction may occur.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive mentally or physically , more depressed, or have thoughts about suicide or hurting yourself.
Citalopram is also sometimes used to treat eating disorders, alcoholism, panic disorder condition that causes sudden attacks of extreme fear with no apparent cause , premenstrual dysphoric disorder a group of physical and emotional symptoms that occur before the menstrual period each month , and social phobia excessive anxiety about interacting with others.
Take the missed dose as soon as you remember.
If you do not get a good night sleep, this may also lead to the drowsiness.
It may take up to 4 weeks before your symptoms improve.
Common symptoms in these cases include genital anesthesia, erectile dysfunction, anhedonia, decreased libido, premature ejaculation, vaginal lubrication issues, and nipple insensitivity in women.
According to the prescribing information for citalopram, people taking citalopram should let their doctor or health care provider know right away if they are experiencing: irritability; anxiety; agitation; panic attacks; insomnia trouble sleeping ; hostility; aggressiveness; impulsivity; restlessness; hypomania or mania abnormally increased energy and mood ; other unusual changes in behavior; worsening of depression; and thoughts about suicide, which may be detailed and include a plan.
A: Patients taking citalopram should avoid drinking alcohol, which can increase some of the side effects of citalopram.
It is primarily used to treat depression.
If undesirable effects are present from stopping an SSRI too quickly, the dose can be increased again and a slower taper may be necessary.
Your family or other caregivers should also be alert to changes in your mood or symptoms.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach.
For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action.
This class of drugs can cause serious withdrawal side effects if they are stopped suddenly.
You may report them to the FDA.
Alpha-1 blockers e.
It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
Nausea is often caused when the 5HT3 receptors actively absorb free serotonin, as this receptor is present within the digestive tract.
This usually wears off after a few weeks, but speak to your doctor if it bothers you - a lower dose may help reduce your symptoms.
This includes prescription and over-the-counter medicines, vitamins, and herbal products.
Studies show there may be less serotonin in the brains of depressed people.
Can I start taking it again without problems?
The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.
Citalopram will not affect any type of contraception, including the combined pill or emergency contraception.
Treatment with citalopram should be reduced gradually when treatment is finished.
Citalopram and other SSRIs can be used to treat hot flashes.
If you are over 65, discuss with your doctor whether any special monitoring is required.
This is serious but rarely fatal.
Tell your doctor about all your current medicines and any you start or stop using, especially:.
The most common side effects of citalopram are nausea, problems sleeping, tiredness, dry mouth, increased sweating, diarrhea, and dizziness.
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
Check with your doctor before starting to take citalopram if you: have had an allergic reaction to citalopram or any other medicines in the past have a heart problem - citalopram can speed up or change your heartbeat have ever taken any other medicines for depression - some rarely used antidepressants can interact with citalopram to cause very high blood pressure , even when they have been stopped for a few weeks are trying to become pregnant, already pregnant or breastfeeding have an eye condition called glaucoma - citalopram can increase the pressure in your eye have epilepsy or are having electroconvulsive treatment — citalopram may increase your risk of having a seizure If you have diabetes , citalopram can make it more difficult to keep your blood sugar stable.
Side effects can be mild or severe, temporary or permanent.
It is important to speak with your doctor before you stop any medications.
The most common side effects with Celexa include nausea, dry mouth, somnolence, insomnia, increased sweating, tremor, diarrhea, and ejaculation disorder.
A: Celexa citalopram is an antidepressant which is used to treat depression.
International Clinical Psychopharmacology.
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If you have diabetes , citalopram can make it more difficult to keep your blood sugar stable.
Citalopram has one stereocenter , to which a 4-fluoro phenyl group and an N, N -dimethylaminopropyl group bind.
You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased.
Also tell your doctor if you are older than 60 years of age and if you have or have ever had a slow or irregular heartbeat, high blood pressure; bleeding problems; stroke; low levels of magnesium or potassium in your blood, a heart attack, heart failure condition in which the heart cannot pump enough blood to other parts of the body or other heart conditions; seizures; or kidney or liver disease.
You may not notice much improvement in your symptoms for a week or two until citalopram begins to take effect.
Do not give Celexa to anyone under 18 years old without medical advice.
It may take one to four weeks before you notice the full benefit of citalopram, so continue your medication even if you feel well.
An interaction between two medications does not always mean that you must stop taking one of them.
It may take 1 to 4 weeks before you notice the full benefit of citalopram.
Lori Mendoza, PharmD.
Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient studyMany of the SSRIs are also used to treat anxiety.
Some other side effects that are commonly associated with citalopram are nausea, dry mouth, somnolence, sweating, tremor, diarrhea, heartburn, anxiety, anorexia, nervousness, and decreased libido.
If you are thinking of stopping the medication, check with your doctor first.
If you suspect overdose, seek emergency medical attention or call the poison help line at
Trazodone is also used to treat anxiety, insomnia, and chronic pain.
If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Some patients experience worsening symptoms or thoughts of suicide when they first start taking an antidepressant.
Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
Depression: The treatment and management of depression in adults, updated edition ".
Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder MDD and other psychiatric disorders.
If you experience a change in your heartbeat or other symptoms like severe dizziness or fainting, seek medical attention right away.
Cerner Multum, Inc.
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Like all medicines, citalopram can cause side effects in some people, but many people have no side effects or only minor ones.
Avoid activities that require mental alertness, judgment, and physical coordination such as driving a car or performing hazardous tasks until you establish how citalopram affects you.
Edinburgh: Churchill Livingstone.
The estimates of the incidence of untoward sexual experience and performance may underestimate their actual incidence, partly because patients and physicians may be reluctant to discuss this issue.
Citalopram and breastfeeding If your doctor or health visitor says your baby is healthy, citalopram can be used during breastfeeding.
Celexa drug interactions in more detail.
However, these concerns are still disputed as the exact pharmacodynamic effects of citalopram and MDMA have yet to be fully identified.
If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.
A dangerous drug interaction could occur.
Any of these should be reported to a doctor.
Some medicines and citalopram can interfere with each other and increase the chances of you having side effects.
Talk to your pharmacist or check the Medication Guide for a list of the ingredients.
The maximum recommended dose is 40 mg daily.
The side effects observed with citalopram the active ingredient contained in Celexa in clinical trials were generally reported as mild and transient, occurring most frequently in the first 1 to 2 weeks of therapy, and attenuating subsequently.
If your doctor or health visitor says your baby is healthy, citalopram can be used during breastfeeding.
Citalopram can make you feel less hungry, so you may lose weight when you first start taking it.
If you become pregnant while taking citalopram, call your doctor.
Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior.
Adjunctive therapies Atypical antipsychotics aripiprazole , brexpiprazole , lurasidone , olanzapine , quetiapine , risperidone Buspirone Lithium lithium carbonate , lithium citrate Thyroid hormones triiodothyronine T 3 , levothyroxine T 4.
Do not stop using citalopram without first talking to your doctor.
MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, or methylene blue injection.
A: Citalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors SSRIs.
You can report any suspected side effect to the UK safety scheme.
Citalopram is used to treat depression.
Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors SSRIs.
This side effect, if present, should subside as the body adjusts to the medication.
Citalopram theoretically causes side effects by increasing the concentration of serotonin in other parts of the body e.
This may avoid many of the severe withdrawal symptoms associated with citalopram discontinuation.
It should be swallowed whole with water and may be taken with food or on an empty stomach.
Monitor yourself because you may feel some drowsiness at first.
If you are a breast-feeding mother and are taking citalopram, it may affect your baby.
Tryptophan and 5-HTP are precursors to serotonin.
Some of the common side effects of citalopram will gradually improve as your body gets used to it.
Antidepressants, including citalopram, are just one of several approaches to treating depression.
Check with your doctor immediately if any of the following side effects occur while taking citalopram:.
Do not use citalopram if you have used an MAO inhibitor in the past 14 days.
Eat a healthy diet of low-fat foods.
Another small case has been published with only 13 patients, their ages ranged from 18 to 88 years of age, and they all saw significant improvement in their anxiety with the medication.
Toenail Fungus: Treatment Options Table.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.
Evaluation of an interprofessional naloxone didactic and skills session with medical residents and physician assistant learnersDaniel Hargraves, Christopher C. White, Marcia R. Mauger, Aruna Puthota, Harini Pallerla, Patricia Wigle, Sarah L. Brubaker, Jeffrey D. Schlaudecker1591
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Ask your pharmacist any questions you have about refilling your prescription.
Other side effects, such as increased apathy and emotional flattening, may be caused by the decrease in dopamine release associated with increased serotonin.
Taking citalopram with omeprazole may cause higher blood levels of citalopram.
If you are considering coming off this medication, consult with your physician to wean off taper the dose the medication slowly to ensure that these symptoms do not occur.
This rarely occurs but must be monitored.
A: Citalopram is a medication that is used to treat depression, anxiety or panic disorders.
Citalopram is available on prescription as tablets and liquid drops that you put in a drink of water.
Citalopram is licensed in the UK and other European countries  for panic disorder , with or without agoraphobia.
Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation.
It might be best to stop drinking alcohol until you see how the medicine makes you feel.
Talk to your doctor about the possible risks of using this medication for your condition.
Celexa dosage information in more detail.
Speak to your doctor if you are worried.
Citalopram is in a class of antidepressants known as selective serotonin reuptake inhibitors SSRIs , which work on neurotransmitters the chemicals that nerves in the brain use to communicate with each other.
Amoxapine Maprotiline Mianserin Mirtazapine Setiptiline.
The good effects of citalopram may, after a while, improve your sex life as your mood lifts and you become interested in life and relationships again.
You should not breast-feed while you are using Celexa.
Not all possible interactions are listed here.
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There has only been one major controlled study for this use, which consisted of 34 geriatric patients.
Celexa 20 mg, pink, elliptical, film coated.
Celexa citalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors SSRIs.
I would really appreciate some help, and perhaps a rough estimate as to how long the symptoms go on for?
It can be potentially dangerous to take citalopram with: stimulants like MDMA ecstasy or cocaine hallucinogens like LSD novel psychoactive substances which used to be known as legal highs like mephedrone.
Citalopram may cause side effects.
Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
Do not use citalopram if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Selective serotonin reuptake inhibitor SSRI .
Journal of Clinical Psychopharmacology.
Less common side effects include bruxism , vomiting , cardiac arrhythmia , blood pressure changes, dilated pupils, anxiety , mood swings , headache , and dizziness.
There are many causes of irritability.
Report any changes in vision to your doctor as soon as possible while you are taking this medication.
It is not recommended to abruptly discontinue the use of any antidepressant medication and should only be discontinued under the direction of a physician.
Children who do take citalopram may be more sensitive to its side effects especially appetite and weight loss.
A: Citalopram Celexa is an antidepressant that belongs to a class of drugs called selective serotonin reuptake inhibitors SSRIs.
Researchers have found, however, that the drug has little potential for abuse.
As well, some forms of this medication may not be used for all of the conditions discussed here.
Tapering down the dose of citalopram slowly before completely stopping can help minimize withdrawal symptoms.
You should discuss the risks and benefits of using citalopram if you are breast-feeding.
Some of the possible negative effects include: men getting painful erections and problems getting an erection and ejaculating women having some vaginal bleeding and might not reach orgasm the same way as before a lower sex drive Sexual side effects usually pass after the first couple of weeks.
Many of these side effects can be managed, and some may go away on their own over time.
Citalopram is one of a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.
Some doctors choose to switch a patient to Prozac fluoxetine when discontinuing citalopram as fluoxetine has a much longer half-life i.
Some side effects may not be reported.
1659Pharmacists and Medicare’s Annual Wellness Visit: implications for pharmacy education and interprofessional primary careIn addition to depression , citalopram is also used for treating:.
If you are a senior, have osteoporosis, or have other risk factors for bone fractures, take extra care to avoid falling by sitting or lying down if you feel dizzy or lightheaded.
You may have unpleasant side effects if you stop taking this medication suddenly.
If you have congestive heart failure, slow heart rhythm, are at risk of low potassium or magnesium levels because of certain illnesses or medications, or you are taking certain medications that can affect the heart rhythm e.
Do not stop or change the amount of medication you take without first talking to your health care provider.
Alcohol can make the side effects of citalopram worse.
This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects.
However, you should not flush this medication down the toilet.
Call your doctor for medical advice about side effects.
The Journal of Clinical Psychiatry.
Your doctor will closely monitor both.
Older adults can also be more sensitive to the side effects of this drug, especially bleeding, loss of coordination, and QT prolongation.
Leslie Ako-Mbo, PharmD.
These side effects may go away during treatment as your body adjusts to the medicine.
They may want to review your treatment.
Taking citalopram with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death.
Contact your doctor if you experience these side effects and they are severe or bothersome.
Many drugs can interact with citalopram.
Do not suddenly stop taking citalopram without consulting your physician.
In most people, these side effects decrease over time but you should not discontinue this medication without the supervision of your physician.
Is it safe to take it for a long time?
You should not take these two medications together.
If you miss a dose, skip the missed dose and continue with your regular dosing schedule.
Read Next Citalopram Reviews.
Slowly add fiber to your diet either by taking supplements or eating high-fiber foods.
About this Medication.
Desyrel Trazodone increases the activity of serotonin in the brain which may become unbalanced and cause depression.
However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.
The prevalence of PSSD is unknown, and there is no established treatment.
Take citalopram exactly as directed.
Breastfeeding will also benefit both you and your baby.
Take citalopram at around the same time every day.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Celexa citalopram is an antidepressant that affects chemicals in the brain that can cause depression.
Eczema : Prescription Medication Options Table.
Common side effects of Celexa include: drowsiness, ejaculatory disorder, nausea, insomnia, and diaphoresis.
Store it at room temperature and away from excess heat and moisture not in the bathroom.
Be careful if you drive or do anything that requires you to be alert.
It was first marketed in the US in
Celexa 10 mg, beige, oval, film coated.
Do not use Celexa if you have used a MAO inhibitor in the past 14 days such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine or have received a methylene blue injection.
Insomnia is one of the more common side effects associated with citalopram.
Celexa is used to treat depression.
Do not use medications containing escitalopram Lexapro while using citalopram, since these drugs are very similar.
Cannabis with citalopram can give you a fast heartbeat.
A: According to the FDA approved drug information, diarrhea is not a side effect of trazodone or citalopram.
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation.
It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
The main side effects, in the studies for anxiety, were dry mouth, nausea, and fatigue, but most people tolerated it well.
Citalopram can be taken by adults and children over the age of 12 years.
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health.
This would allow less serotonin in and out of the transporters, thus decreasing the likelihood of neurotoxic effects.
This risk is higher if you or anyone in your family has or has ever had bipolar disorder mood that changes from depressed to abnormally excited or mania frenzied, abnormally excited mood , or has thought about or attempted suicide.