Celexa
Generic Name: Citalopram Hydrobromide
Brand Name: Celexa
Indications
Celexa is indicated for the treatment of depression. Celexa is a selective serotonin reuptake inhibitor (SSRI). This antidepressant medicine has been used safely and effectively by more than 40 million patients worldwide.
Dosage and Administration
Celexa is available for oral administration as 10mg, 20mg, and 40mg tablets and as a 10mg/5ml oral solution.
Normal Dosage: Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, generally with an increase to a dose of 40 mg/day. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Although certain patients may require a dose of 60 mg/day, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg/day dose over the 40 mg/day dose; doses above 40 mg are therefore not ordinarily recommended.
Celexa should be administered once daily, in the morning or evening, with or without food.
Overdose: Symptoms of a Celexa overdose may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.
Drug Description
Celexa® (citalopram HBr) is an orally administer ed selective serotonin reuptake inhibitor (SSRI) with a chemical structure unrelated to that of other SSRIs or of tricyclic, tetracyclic, or other available antidepressant agents. Citalopram HBr is a racemic bicyclic phthalane derivative designated (±)-1-(3-dimethylaminopropyl)-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-5carbonitrile, HBr with the following structural formula:
The molecular formula is C20H22BrFN2O and its molecular weight is 405.35.
Citalopram HBr occurs as a fine, white to off-white powder. Citalopram HBr is sparingly soluble in water and soluble in ethanol.
Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms 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.
Call your doctor at once if you have any of these serious side effects:
- seizure (convulsions);
- tremors, shivering, muscle stiffness or twitching;
- problems with balance or coordination; or
- agitation, confusion, sweating, fast heartbeat.
Other less serious side effects are more likely to occur, such as:
- feeling nervous, restless, or unable to sit still;
- drowsiness, dizziness, trouble concentrating;
- sleep problems (insomnia);
- nausea, gas, upset stomach, loss of appetite;
- weight changes;
- urinating more than usual;
- decreased sex drive, impotence, or difficulty having an orgasm; or
- dry or watery mouth, yawning, or ringing in your ears.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or is especially bothersome.
Precautions
- Do not use citalopram if you are using an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with citalopram. You must wait at least 14 days after stopping an MAO inhibitor before you can take citalopram. After you stop taking citalopram, you must wait at least 14 days before you start taking an MAOI.
- Before taking citalopram, tell your doctor if you are allergic to any drugs, or if you have:
- liver or kidney disease;
- seizures or epilepsy;
- bipolar disorder (manic depression); or
- a history of drug abuse or suicidal thoughts.
- You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
- Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking citalopram, do not stop taking the medication without first talking to your doctor.
Citalopram can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Do not give citalopram to anyone younger than 18 years old without the advice of a doctor.
- Do not take citalopram together with escitalopram (Lexapro), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). Avoid drinking alcohol, which can increase some of the side effects of citalopram.
- Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, other medication for depression or anxiety). They can add to sleepiness caused by citalopram.
Citalopram can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Drug Interactions
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Celexa may cause you to bruise or bleed easily.
Before taking Celexa, tell your doctor if you are using any of the following medicines:
- carbamazepine (Tegretol)
- cimetidine (Tagamet)
- lithium (Lithobid, Eskalith)
- a blood thinner such as warfarin (Coumadin)
- any other antidepressants such as amitriptyline (Elavil), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); or
- almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).
If you are using any of these drugs, you may not be able to use Celexa, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect Celexa. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
