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Celexa (citalopram) is a commonly prescribed antidepressant. While it is generally both safe and effective at relieving the symptoms of depression, there are always things patients need to be aware of.

Selective serotonin reuptake inhibitor (SSRIs) are likely to be the class of antidepressants your doctor will turn to first if you've both agreed that antidepressant therapy is right for you. Citalopram — available under the brand name Celexa — is a popular choice. Though it's specifically FDA-approved for the treatment of depression in adults, Celexa can also be prescribed off-label for other conditions including panic disorder, substance abuse, and premenstrual dysphoric disorder.

What do you need to know about this antidepressant?

How does Celexa (citalopram) work?

Like other SSRIs, Celexa works selectively by increasing the amount of the neurotransmitter serotonin available in your brain. Research has shown that Celexa is a safe and effective treatment for depression. While it works no better than many other antidepressants, SSRIs do have the benefit of typically leading to fewer side effects than older-generation antidepressant medications. 

Many patients taking Celexa will notice a positive difference after a week to four weeks, but it can take up to 12 weeks before the drug reaches its peak efficacy. Knowing this in advance is important — not feeling totally OK right away in no way indicates that your antidepressant isn't working for you. Be patient and keep taking your medication as prescribed.

The dosage of Celexa — and how to take it

Citalopram is available both as oral tablets and liquid drops. The available doses range from 10 mg to 40 mg, and regardless of the dose you are prescribed, you will take Celexa once a day. Patients themselves can decide at what time they would prefer to take their citalopram, but remember to take it at the exact same time each day to make sure the drug is always in your system and therefore working to fight your depression. If you struggle with insomnia, taking your antidepressant in the morning will work best. It does not matter whether you take citalopram with or without food. 

The standard dose of citalpram is, for adults under the age of 60, 20 mg daily. You may be started off at 10 mg, however, and if necessary, your dose can be increased to a maximum of 40 mg a day. (Higher doses have not shown to be more effective, and may be dangerous for your health.) Older adults can be prescribed a maximum dose of 20 mg a day. 

What side effects can you expect while using Celexa (citalopram)?

Celexa, like other SSRIs, has fewer side effects than older antidepressants, something that makes using this antidepressant more tolerable and in turn decreases the risk that you will want to discontinue taking it. However, Celexa is not free of potential side effects.

More common side effects — which plague more than one in 10 users but also often subside as their bodies get used to Celexa — include:

  • Drowsiness
  • Insomnia
  • Dizziness
  • Headache
  • Nausea
  • Constipatpion or diarrhea
  • Excessive sweating
  • Dry mouth

Rare but serious side effects that require emergency medical attention include:

  • Heart attack
  • Hemhorrage — continued bleeding after you sustain a minor injury
  • Serotonin syndrome — a potentially fatal complication of taking medications that increase your serotonin levels
  • Worsened or new suicidal thoughts, which can lead to suicide plans — this is a potential side effect of many antidepressants
While these side effects aren't common, it is important to be aware of the fact that they are possible and to seek urgent medical care if you, or someone else who has recently started taking Celexa, experiences symptoms such as chest pain, uncontrollable bleeding, confusion, shortness of breath, vomiting blood, and acute suicidal thoughts. Also — this is not a joke — look out for painful erections that last for hours and that may occur outside of the context of sexual arousal. 

Warning: Some people become (more) suicidal when they first take Celexa

Young people under the age of 24 who take Celexa are especially likely to suffer from increased suicidal thoughts or the onset of suicidality, which is why the drug has an FDA black box warning. The increased risk of suicide is why the drug isn't approved for use in children and should be prescribed with caution in adolescents and young adults. 

People of any age who first start taking Celexa should be monitored for signs that their depressive symptoms suddenly take a turn for the worse, however. If you are reading this because you have been prescribed this drug, ask your loved ones — especially people who live with you — to keep an eye out.

Who shouldn't take Celexa?

  • Citalopram (Celexa) can't be taken together with antidepressants from the monoamine oxidase inhibitor family, nor should you take it in the first two weeks after stopping a MAOI.
  • Because the drug is prescribed with caution to women who are trying to conceive, pregnant, or breastfeeding, also let your doctor know if any of these things apply to you.
  • As with other drugs, it is also possible that you will have an allergic reaction. If you are already known to have an allergy to any of the components of Celexa, you shouldn't be prescribed this drug. Always let your prescribing physician know what other prescription and over-the-counter medications you use, and whether you have any known drug allergies.

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