Citalopram, which may be sold under the brand-name Celexa®, is a selective serotonin reuptake inhibitor (SSRI), principally used to treat depressive illness or anxiety. The Danish company Lundbeck® first developed this drug in the late 1980s, and though the drug proved popular at first, Lundbeck now more aggressively markets a variant of the medication called Lexapro® or Escitalopram. Citalopram is still available and might be more appropriate to use than Lexapro® or other antidepressants for different reasons.
The way that citalopram and other SSRIs work is by blocking overuse of the chemical serotonin, which circulates around the brain. When too much serotonin is used, it can result in declining or anxious mood. By preventing the body from using this chemical too quickly, more is available to help create a more even mood. Having stated this, it’s also important to note that SSRIs may be more or less effective with each individual, though they all theoretically have a similar function. Additionally, sometimes depression or anxiety are better treated by medications that impair reuptake of additional neurotransmitters, like norepinephrine.
The decision to take an antidepressant is always serious, and these medicines shouldn’t be used in the absence of a clearly defined need. They come with a variety of potential adverse effects that can range from mild to very serious. Of most concern is the increased risk of suicidal behavior, especially in the first few months of use. Organizations like the Food and Drug Administration (FDA) find this risk so serious that they use a black box warning to make certain people are aware citalopram could cause suicidality. This risk is highest in teens and young adults, but isn’t entirely absent in other populations.
Drugs like citalopram may need to be avoided if people have certain conditions or take other medications. Pregnant or nursing women shouldn’t use this medicine. Kidney or liver problems may contraindicate its use. It’s also not suggested for people who have seizures or anyone who is currently suspected or in the past has had mood disorders like bipolar. It’s exceptionally important that bipolar disorder be ruled out prior to dispensing citalopram, because its use in bipolar patients can cause manic or hypomanic episodes.
The medication should also not be prescribed if people are taking any other types of antidepressants, especially monoamine oxidase inhibitors (MAOIs) and other SSRIs. Other medications that may conflict include carbamazepine (Tegretol®), most antacids, lithium, ibuprofen, and warfarin. Sometimes drug interaction merely means doses must be adjusted for both medicines.
The serious side effects of citalopram include developing suicidal symptoms, or serotonin syndrome, where too much serotonin causes extreme and emergency illness that may impact muscle, reflex and heart function, and causes symptoms like severe vomiting, high fever, and confusion. Most people who take this medicine are more likely to experience common, benign symptoms like dry mouth, lowered libido, some nausea, sleepiness, weight loss or gain, and mild nasal congestion. Some of these symptoms are only felt briefly and not all people experience them.