What is Celexa: How to Use, Side Effects, Dosage

What is Celexa: How to Use, Side Effects, Dosage

What is Celexa?

Celexa is used to cure depression. It may improve your energy level and feelings of well-being. Citalopram is known as a selective serotonin reuptake inhibitor (SSRI). This drug works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

Celexa (citalopram HBr) is an orally administered selective serotonin reuptake inhibitor (SSRI) (as told) 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-5-carbonitrile.

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How to use Celexa

Read the Medication Guide and, for sure, the Patient Information Leaflet provided by your pharmacist before you start using citalopram and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this drug with or without food as directed by your doctor, usually once daily in the morning or evening. The dosage is based on your medical situation, response to treatment, age, laboratory tests, and other medications you might be taking. Be sure to tell your doctor about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). The maximum dosage for citalopram is 40 milligrams per day.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you might not get the correct dose.

To reduce your risk of side effects, your doctor may direct you to start taking this drug at a low dose and slowly increase your dose. Follow your doctor's instructions carefully. Do not increase your dose or use this drug more often or for longer than suggested by your doctor. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

It is important to continue taking this medication even if you feel ok. Do not stop taking this drug without talking to your doctor. Some situations may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Report any new or worsening symptoms as soon as possible.

It may take 1 to 4 weeks to feel a benefit from this drug and up to several weeks before you get the full benefit.

Tell your doctor if your condition does not improve or if it gets worse.

Take Celexa exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the drug as directed and tell your doctor if your symptoms do not improve.

Do not stop using Celexa suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Dosage of Celexa

Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, with an increase to a maximum dose of 40 mg/day at an interval of no less than one week. Doses above 40 mg/day are not recommended due to the risk of QT prolongation. Additionally, 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.

Usual Adult Dose for Depression:

Initial dose: 20 mg orally once a day

Maintenance dose: 20 to 40 mg orally once a day

Maximum dose: 40 mg orally per day

Comments:

-The initial dose may be increased if necessary to 40 mg once a day after at least 1 week of therapy.

-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.

-Acute episodes of depression may require several months or more of sustained pharmacologic therapy

Symptoms of overdose

Do not share this medication with others.

Laboratory and/or medical tests (such as EKG) should be done periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Keep all regular medical and psychiatric appointments.

In clinical trials of citalopram, there were reports of citalopram overdose, including overdoses of up to 2000mg, with no associated fatalities. During the post marketing evaluation of citalopram, Celexa overdoses, including overdoses of up to 6000 mg, have been reported. As with other SSRIs, a fatal outcome in a patient who has taken an overdose of citalopram has been rarely reported.

Celexa

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Side effects of Celexa

Nausea, dry mouth, loss of appetite, tiredness, drowsiness, sweating, blurred vision, and yawning may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: shaking (tremor), decreased interest in sex, changes in sexual ability, easy bruising/bleeding.

Get medical help right away if you have any very serious side effects, including: fainting, fast/irregular heartbeat, black stools, vomit that looks like coffee grounds, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Drugs that may interact with Celexa

Drug interactions may change how your drugs work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's confirmation.

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anger (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Citalopram is very similar to escitalopram. Do not use medications containing escitalopram while using citalopram.

This medication might interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Many drugs can interact with citalopram. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

cimetidine;

tryptophan (sometimes called L-tryptophan);

lithium;

a blood thinner (warfarin, Coumadin, Jantoven);

any other antidepressant;

heart medication;

medicine to treat a psychiatric disorder; or

"triptan" migraine headache medicine.

This list is not complete and many other drugs can interact with citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

For whom Celexa might not be safe

Older adults might be more sensitive to the side effects of this drug, especially bleeding, loss of coordination, and QT prolongation (see above). They may also be more likely to improve a type of salt imbalance (hyponatremia), especially if they are also taking "water pills" (diuretics). Loss of coordination can increase the risk of falling.

Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

Warnings of Celexa

Before taking citalopram, tell your doctor or pharmacist if you are allergic to it; or to escitalopram; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using citalopram, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, recent heart attack, QT prolongation in the EKG), family history of specific heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood might also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have situations such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using citalopram safely.

This drug may make you drowsy or blur your sight. Alcohol or marijuana can make you drowsier. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Since untreated mental/mood problems (such as depression, obsessive-compulsive disorder, panic disorder) can be a serious condition, do not stop using this medication unless directed by your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed for you.

Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment.

Store at room temperature away from moisture and heat. Do not store in the bathroom. Keep all medications away from children and pets.

Can you use Celexa while pregnancy?

During pregnancy, this medication should be used only when clearly needed. It might harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Celexa

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