Citalopram 2025: Price, Dosage, Uses & Comprehensive Side Effects Guide

FDA Boxed Warning: Citalopram carries a boxed warning highlighting serious risks, including increased suicidal thoughts or behaviors in children, teens, and young adults during the initial months of treatment or dose adjustments. Immediate medical attention is essential if drastic mood or behavioral changes occur.

Critical Safety Alerts

• Heart Rhythm Risks: Citalopram may cause QT prolongation or Torsade de Pointes, potentially resulting in sudden cardiac death.
• MAOI Interaction Warning: Avoid combining Citalopram with monoamine oxidase inhibitors (MAOIs) or starting one within two weeks of stopping the other to prevent serotonin syndrome, a life-threatening condition.
• Pimozide Interaction: Concurrent use can lead to serious heart complications.

Essential Facts

• Citalopram is a selective serotonin reuptake inhibitor (SSRI) prescribed primarily for depression.
• Typical adult starting dose (18-60 years): 20 mg once daily; maximum 40 mg/day. For seniors (61+ years), maximum dose is 20 mg/day.
• Common side effects include nausea, drowsiness, dizziness, anxiety, sleep disturbances, sexual dysfunction, sweating, tremors, appetite changes, dry mouth, gastrointestinal issues, respiratory infections, and yawning.

About Citalopram

Available as the brand-name Celexa and generic formulations, Citalopram comes in oral tablets and solutions. Generic options often provide cost savings but may vary in available strengths.

Purpose and Mechanism

Used to alleviate depression symptoms, Citalopram increases serotonin levels in the brain by inhibiting its reuptake, enhancing mood regulation.

Side Effects Overview

While drowsiness is common, side effects vary by age group. Adults may experience nausea, weakness, and anxiety, whereas children might also exhibit increased thirst, agitation, nosebleeds, frequent urination, heavy menstruation, and growth changes.

Serious Side Effects to Watch For

• Suicidal Ideation: Includes thoughts or attempts of self-harm, aggressive behavior, and worsening depression or anxiety.
• Cardiac Issues: Chest pain, irregular heartbeat, fainting, or breathlessness requiring urgent care.
• Serotonin Syndrome: Symptoms such as hallucinations, muscle rigidity, fever, nausea, and confusion demand immediate medical attention.
• Mania and Seizures: Signs include excessive energy, reckless behavior, convulsions, or sudden loss of consciousness.
• Visual Disturbances and Hyponatremia: Eye pain, blurred vision, headaches, confusion, or weakness.

Note: This is not an exhaustive list. Always consult healthcare professionals for personalized advice.

Drug Interactions

Citalopram may interact adversely with various medications, including other serotonergic drugs, heart rhythm modifiers, blood thinners, tricyclic antidepressants, sedatives, and cytochrome P450 2C19 inhibitors. Such interactions can lead to serotonin syndrome, increased bleeding risk, or altered drug metabolism.

Examples of Interacting Medications

• Serotonin-enhancing drugs: buspirone, fentanyl, lithium, triptans, amphetamines, MAOIs, St. John's wort, tramadol.
• Heart rhythm affecting drugs: amiodarone, methadone, moxifloxacin, pimozide, sotalol.
• Blood thinners and NSAIDs: warfarin, ibuprofen, aspirin.
• Sedatives: lorazepam, alprazolam, diazepam, zolpidem.
• CYP2C19 inhibitors: cimetidine, fluvoxamine, omeprazole.

Consult your doctor or pharmacist before combining Citalopram with any other substances.

Important Warnings

Allergic Reactions

Seek emergency help if you experience breathing difficulties, facial swelling, rash, or hives. Do not reuse Citalopram if previously allergic.

Alcohol Use

Avoid alcohol as it can amplify drowsiness and impair cognitive functions.

Health Conditions

• Heart Conditions: Avoid if you have congenital long QT syndrome, recent heart attack, slow heart rate, or severe heart failure.
• Electrolyte Imbalances: Low potassium or magnesium levels increase risk of serious heart rhythm disturbances.
• Kidney and Liver Disease: Dose adjustments or avoidance may be necessary due to altered drug clearance.
• Seizure Disorders: Use cautiously as Citalopram can increase seizure risk.

Pregnancy and Breastfeeding

Citalopram is a category C drug; animal studies show fetal risk, but human data is limited. Discuss risks and benefits with your healthcare provider. It passes into breast milk and may affect infants.

Dosage Guidelines 2024

Dosage depends on age, condition severity, and individual response. Typical dosing:

• Adults 18-60: Start at 20 mg daily; max 40 mg daily.
• Seniors 61+: Max 20 mg daily due to slower metabolism.
• Children: Safety not established; use requires medical discretion.

Special populations like CYP2C19 poor metabolizers and those with liver disease should not exceed 20 mg daily.

Discontinuation

Do not abruptly stop Citalopram; tapering under medical supervision is advised to avoid withdrawal symptoms such as irritability, dizziness, and flu-like symptoms.

Usage Tips

• Can be taken with or without food.
• Tablets may be split or crushed if necessary.
• Store at room temperature away from moisture and heat.
• Carry medication in original packaging during travel.

Monitoring

Regular follow-ups are essential to assess mental health, electrolyte levels, and heart rhythm, especially in patients at risk for QT prolongation.

Alternative Treatments

Several other antidepressants exist; consult your healthcare provider to identify the most suitable option for your condition.

Disclaimer: This information is designed to support, not replace, professional medical advice. Always consult your healthcare provider before starting or modifying treatment.

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