Depression may feel frustrating, even overwhelming, especially if you’re not on the right treatment. For many people, taking medication is a significant step in allowing them to improve their mental health.

One common medication often used to treat depression is citalopram (often known by the brand name Celexa). On this page, we’ve outlined some important information about the drug.

What is citalopram?

What is citalopram? How does it work?

Citalopram is an antidepressant used to treat depression. Also called Celexa, it may sometimes be used to treat panic attacks, alcohol use disorder, generalized anxiety disorder, panic disorder, premenstrual dysphoric disorder, and postmenopausal flushing, among others. Citalopram belongs to a class of medications called SSRIs, or selective serotonin reuptake inhibitors. SSRIs work by increasing the levels of a neurotransmitter called serotonin in the brain. Serotonin plays a large part in regulating mood and anxiety. Boosting levels of serotonin in the brain may help improve mood, which is linked to improved symptoms of depression and anxiety. 

How should citalopram be used?

Citalopram is often prescribed as tablets ranging in strength from 10mg to 40mg. A standard dose of citalopram is 20mg a day for adults. However, your doctor may start you lower and gradually increase the dose as you continue with the medication depending on how you respond. The maximum dose is generally accepted to be 40mg per day. It may take weeks before you notice the full effects of the drug, but do not stop taking the medication or change doses without first talking to your doctor.

Going off of SSRIs like citalopram too abruptly can cause negative side effects. If your doctor thinks that you are ready to stop taking the medication, they might gradually reduce the dose over several weeks to prevent any negative reactions. 

If you miss a dose, take your medication as soon as you remember. However, do not take it within a few hours of your next dose or take two doses at once as this could cause dangerous side effects. 

What are some possible side effects?

Some common side effects of citalopram include:

• Nausea
• Drowsiness
• Constipation
• Dry mouth
• Stomach pain 
• Change in sexual function 

Some serious (but uncommon side effects) include:

• Chest pain
• Shortness of breath
• Dizziness or fainting 
• Suicidal thoughts or actions
• Problems with thinking, concentration, or memory 

Call 911 or seek emergency care if you notice any severe side effects. You can find a more comprehensive list of side effects here. 

Why do these side effects occur? 

Any medication can potentially lead to side effects, and a person’s likelihood of having side effects depends on many factors, including age, lifestyle, and the type of medication itself. Side effects may occur because drugs often have broad or poorly targeted effects, or the drug target itself may have many downstream effects on the body. Though citalopram targets the neurotransmitter serotonin to improve mood, there are other areas affected by serotonin, and unusual changes in serotonin levels can lead to side effects. As pharmaceutical research develops, newer medicines are often refined to have fewer side effects.

Many non-serious side effects of mental health medications like citalopram go away after a few weeks as your body gets used to the medication. However, if a side effect persists, is intolerable, or severely hinders your ability to go about your daily life, talk to your doctor, because this might be a sign of a deeper problem. 

How do your genes relate to citalopram? 

Genetics can affect your body’s response to medication. Citalopram is metabolized in the liver by CYP2C19 and CYP3A4 enzymes. This means that some people with a certain variation of either gene might metabolize citalopram differently. Being a slow metabolizer means your body may break down the medication more slowly than others, which means the drug sticks around for longer than intended and may lead to side effects. For slow metabolizers, a doctor might opt to prescribe a different medication or prescribe a lower dosage. 

One way to predict whether you’ll have a positive outcome while taking citalopram is by taking a genetic test to determine what genetic variations you have and how they affect medication metabolization. Your DNA can help your doctor rule out less suitable medications and make more informed decisions so that you can get better, faster.

Special Precautions

• Do not take this medication with a monoamine oxidase inhibitor.
• Do not take this medication with pimozide. 
• If citalopram is taken with lithium, fentanyl, buspirone, or some other pain medication, there can be serious side effects. Consult your doctor about medication you’re taking alongside citalopram.
• If you are on blood thinning medication, speak to your doctor before taking citalopram. 
• Avoid consuming alcohol while taking citalopram

If you show signs of an allergic reaction to citalopram (hives, difficulty breathing, rash, swelling), call 911 or go to the nearest emergency department.

Some medications, vitamins, and herbs may interfere with how citalopram works. Make sure to tell your doctor about all other medications you are taking before starting citalopram to avoid negative interactions. For full details, see the FDA’s full list of precautions.

Looking to find the right medication for your mental health? Join Prairie today to connect to expert providers and affordable medication options.