Celexa (citalopram hydrobromide) is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA for the treatment of major depressive disorder (MDD) in adults. As a well-established antidepressant, it works by increasing serotonin levels in the brain, which helps improve mood, sleep, appetite, and energy levels. Its efficacy and generally favorable side effect profile have made it a first-line option for managing depression. This medication requires a prescription and should be used under strict medical supervision to ensure optimal therapeutic outcomes and minimize risks.

Features

• Active ingredient: citalopram hydrobromide
• Drug class: selective serotonin reuptake inhibitor (SSRI)
• Available in tablet form: 10 mg, 20 mg, 40 mg strengths
• Bioavailability: approximately 80%
• Half-life: approximately 35 hours
• Metabolism: hepatic, primarily via CYP3A4 and CYP2C19 enzymes

Benefits

• Effectively reduces symptoms of major depressive disorder, including low mood and loss of interest
• Helps restore normal sleep patterns and improve energy levels
• May reduce anxiety often associated with depression
• Generally well-tolerated with a lower incidence of certain side effects compared to older antidepressants
• Once-daily dosing supports treatment adherence
• Non-sedating for most patients, allowing daytime functionality

Common use

Celexa is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It is also used off-label for certain anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder, though such use should be carefully evaluated by a healthcare provider. Treatment response typically becomes noticeable within 1-4 weeks, with full therapeutic effects often observed after 6-8 weeks of consistent use.

Dosage and direction

The recommended starting dosage for Celexa is 20 mg once daily, with or without food. Depending on individual patient response and tolerability, the dosage may be increased to a maximum of 40 mg daily after at least one week. Dosage adjustments should be made under medical supervision. For elderly patients or those with hepatic impairment, a maximum dosage of 20 mg daily is recommended. Tablets should be swallowed whole and not crushed or chewed. Abrupt discontinuation should be avoided; instead, gradual tapering under medical guidance is necessary to minimize withdrawal symptoms.

Precautions

• Monitor for worsening depression or emergence of suicidal thoughts, especially in children, adolescents, and young adults
• Use with caution in patients with a history of mania/hypomania or seizure disorders
• May cause hyponatremia; monitor sodium levels in at-risk patients (elderly, those on diuretics)
• Use cautiously in patients with cardiac conditions due to potential QTc prolongation
• May increase risk of bleeding, especially when combined with NSAIDs, aspirin, or anticoagulants
• Inform healthcare provider of all medications and supplements being taken

Contraindications

• Hypersensitivity to citalopram or any component of the formulation
• Use of monoamine oxidase inhibitors (MAOIs) concurrently or within 14 days of discontinuing Celexa
• Use of pimozide
• Patients with congenital long QT syndrome or known QT prolongation
• Uncontrolled narrow-angle glaucoma

Possible side effects

Common side effects (≥1%) include:

• Nausea
• Dry mouth
• Increased sweating
• Somnolence
• Insomnia
• Sexual dysfunction (decreased libido, delayed ejaculation, anorgasmia)

Less common but serious side effects requiring medical attention:

• Serotonin syndrome (agitation, hallucinations, fever, tachycardia, nausea)
• Abnormal bleeding
• Hyponatremia
• QTc prolongation
• Angle-closure glaucoma
• Withdrawal symptoms upon discontinuation

Drug interaction

• MAOIs: risk of serotonin syndrome (contraindicated)
• Other serotonergic drugs: increased risk of serotonin syndrome
• Drugs that prolong QTc interval: additive effects on cardiac repolarization
• CYP2C19 inhibitors (e.g., fluconazole): may increase citalopram levels
• Warfarin: may increase anticoagulant effect
• CNS depressants: additive sedative effects

Missed dose

If a dose is missed, take it as soon as remembered unless it is close to the time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In severe cases, seizures, QT prolongation, and coma may occur. There is no specific antidote; management involves supportive care and symptomatic treatment. Gastric lavage may be considered if presented early. Immediate medical attention is required.

Storage

Store at room temperature (20-25°C or 68-77°F), in a tightly closed container, away from light, moisture, and heat. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Celexa is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual results may vary. Always follow your healthcare provider’s instructions regarding dosage, administration, and monitoring.

Reviews

Clinical studies and patient reports generally indicate that Celexa is effective in reducing symptoms of depression for many individuals. Patients often report improved mood, better sleep, and increased energy levels. Some note initial side effects such as nausea or insomnia, which often diminish with continued use. Healthcare providers appreciate its once-daily dosing and generally favorable tolerability profile. However, individual experiences vary, and not all patients respond equally. Long-term use should be regularly reevaluated by a prescribing physician.