OriginalDrugs

Celexa (Citalopram HBr)

  • Generic name: Citalopram hydrobromide (nitalapram)
  • Brand names: Celexa, Cipram, Cipramil, Seropram
  • Drug class: Antidepressant, Selective serotonin reuptake inhibitor

What is Citalopram used for?

  • Depression
  • Anxiety
  • Panic attacks
  • Obsessive-compulsive disorder
  • Posttraumatic stress disorder

Strict contraindications

  • Concurrent use with MAO inhibitors or within 2 weeks of discontinuing MAO inhibitors
  • Contraindicated in patients with congenital long QT syndrome or pre-existing QT interval prolongation, bradycardia, hypokalemia or hypomagnesemia4.
  • Concurrent use with other medicines that prolong the QT interval.

Major drug interactions

  • MAO inhibitors - Potentially fatal, concomitant use contraindicated
  • Pimozide - potentially fatal, concomitant use contraindicated

Can you take Citalopram with Aspirin?
Recent research6 found that aspirin may decrease the effectiveness of antidepressant citalopram.

Warning!

High doses of Citalopram cause QT interval prolongation that could lead to development of Torsade de Pointes, a potentially fatal abnormal heart rhythm.

The maximum recommended daily dose of citalopram is 40 mg. A maximum daily dose of 20 mg is recommended for patients:

  • greater than 60 years of age
  • with liver dysfunction
  • with poor CYP2C19 activity
  • taking concomitant CYP2C19 inhibitors (e.g. cimetidine or omeprazole).

How long before Citalopram works?

Every person is different. Usually, it takes about 2-4 weeks before you start feeling any improvement. And it can take up to 6-8 weeks to achieve the full antidepressant effect. If you don’t feel any positive benefit after 6 weeks, then you should talk to your doctor.

How long does Citalopram stay in the system?

The half-life is 35 hours. It takes 7 to 8 days for citalopram to leave the system.

What is the best time of a day to take Citalopram?

There is no "right" time to take citalopram or Celexa. It works best when it is taken at the same time each day, which keeps the constant blood levels. Some people prefer to take citalopram first thing in the morning as it will mess with sleep patterns. Other people become drowsy after citalopram and have to take it in the evening.

References

  • 1. Citalopram Hydrobromide Reference guide from the American Society of Health-System Pharmacists.
  • 2. FDA Celexa Drug Safety Communication.
  • 3. Shaila Misri, Xanthoula Kostaras, Lisa Milis. The use of antidepressants in pregnancy and lactation. BCMJ, Vol. 47, No. 3, April 2005
  • 4. Celexa (citalopram hydrobromide) Tablets and Oral Solution. FDA Safety Information
  • 5. Sivojelezova A, Shuhaiber S, Sarkissian L, Einarson A, Koren G. Citalopram use in pregnancy: prospective comparative evaluation of pregnancy and fetal outcome. Am J Obstet Gynecol. 2005 Dec;193(6):2004-9. PubMed
  • 6. Ghanizadeh A, Hedayati A. Augmentation of citalopram with aspirin for treating major depressive disorder, a double blind randomized placebo controlled clinical trial. Antiinflamm Antiallergy Agents Med Chem. 2014;13(2):108-11. PubMed

Last updated: May, 2015

Advanced Consumer Info

celexa
  • Pregnancy Category: C. Use of citalopram in late pregnancy is associated with increased risk of poor neonatal adaptation syndrome5.
  • Breastfeeding: Low levels of citalopram and its metabolite are detected in breast milk. Only one adverse effect, uneasy sleep, has been reported in one study.
  • Mechanism of action: Citalopram inhibits central nervous system neuron uptake of serotonin. Does not affect norepinephrine.
  • Advantages:
    Citalopram HBr is a very weak inhibitor of all the CYP isoenzymes and therefore has minimal potential for drug interactions.