Citalopram is a selective serotonin reuptake inhibitor found under the brand name Celexa. It is most often prescribed to treat depression. Less frequently, it is prescribed to treat eating disorders, panic disorder, premenstrual dysphoric disorder (PMDD), social phobia, and alcoholism.
How Citalopram Works
SSRIs stabilize mood in the long-term by preventing serotonin, an important neurotransmitter, from being reabsorbed by surrounding neurons quickly. When there is more serotonin available to help neurons transmit messages, mood begins to elevate and eventually stabilizes over time.
Citalopram can take between one and four weeks to work completely, so it is important to be patient while waiting for mood to lift. However, if there is no improvement after this time or side effects are too intense, then the person should speak to their doctor about changing the dose or medication.
This medication typically comes in tablet form, in increments of 10 mg, 20 mg, or 40 mg. The dose is taken orally, once per day. How much citalopram a person should take is based on what the medication is prescribed for. Typically, Celexa is used to treat depression, and the initial dose to treat this condition is 20 mg, but this can be adjusted as needed to stabilize mood. Sometimes, citalopram is administered as an oral solution.
What Citalopram Should Do
By regulating mood, citalopram helps to relieve symptoms of depression and, less commonly, symptoms of anxiety or other mental health conditions. Ideally, this will improve overall quality of life. Additionally, when treating alcoholism, citalopram reduces the amount of alcohol that some people wish to consume and can reduce some of alcohol’s intoxicating effects. It is occasionally prescribed to help people who successfully detoxed from alcohol abuse to maintain their abstinence.
Side Effects from Citalopram or Celexa
Since Celexa interacts with brain chemistry, it can lead to side effects. These are rare, although if they begin to interfere with the quality of a person’s life, the dose may need to be adjusted, or the individual may need to switch to a different medication.
Side effects include:
- Abdominal pain or cramps
- Nausea or vomiting
- Diarrhea or constipation
- Indigestion or heartburn
- Decreased appetite
- Weight loss
- Excessive exhaustion or tiredness
- Physical weakness
- Shaking or trembling that is uncontrollable
- Muscle or joint pain
- Dry mouth
Additionally, people who are younger than 24 years old are at an increased risk of developing suicidal ideation or actions while taking citalopram. It is important to inform a doctor immediately if these thoughts occur.
People who have undiagnosed or misdiagnosed bipolar disorder are more likely to experience a manic episode when taking citalopram.
It is important for medical professionals to screen their patients for bipolar disorder before prescribing any treatment for depression.
Long-Term Use of Citalopram
While some people who take citalopram for a long time may develop physical dependence on or tolerance to the medication, there are no recorded long-term problems with this drug. Some medical conditions may be exacerbated by taking citalopram, especially if these conditions were undiagnosed. One condition, called QT prolongation, can cause problems with existing heart conditions, but it is not otherwise harmful.
Is Celexa Addictive?
There is some anecdotal evidence that antidepressants have been abused, but this is generally among people who struggle with pre-existing substance abuse or polydrug abuse problems. SSRIs like citalopram are not considered addictive, and they typically do not enhance the effects of intoxicating substances. In fact, citalopram is employed occasionally in long-term treatment of alcohol use disorder because it decreases cravings for CNS depressants.
Withdrawal from the Medication
Although citalopram is not linked to addiction, it can lead to dependence and tolerance over time. When a person develops a dependence on an SSRI, their brain will have trouble regulating serotonin levels without the substance. If they stop taking citalopram, they may experience withdrawal symptoms. Some of these symptoms include:
- Mood swings
- Agitation or anxiety
- Numbness in the extremities
- The sensation of electric shocks in the hands or feet
- Tremors or shaking
- Trouble falling or staying asleep
When a person wants to stop taking citalopram, they should work with their doctor to gradually taper off the drug rather than quitting suddenly.
When a person overdoses on SSRIs like citalopram, the condition is called serotonin syndrome. This is because too much serotonin leads to a series of side effects, some of which can clear up on their own, but some are extremely dangerous. Serotonin syndrome can be caused by taking too much citalopram or by combining antidepressants, especially older and more potent antidepressants like tricyclic or MAO inhibitors, with citalopram.
Symptoms of serotonin syndrome include:
- Loss of coordination, leading to falling
- Extreme agitation or restlessness
- Nausea and vomiting
- Uncontrollable muscle twitches or spasms
- Rapid heartbeat
- High blood pressure
Alternatives to Citalopram
SSRIs like citalopram are the first, and most effective, medications used to treat depression. If citalopram does not work, there are many other types of SSRIs that may help. If SSRIs do not work, other types of antidepressants may work. These include serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclics, tetracyclics, and MAO inhibitors. These medications are more potent and act on more neurotransmitters than just serotonin; this increases their chances of elevating mood, but it also increases the risk of side effects. These drugs are also more likely to interact with other prescriptions, and MAO inhibitors require dietary restrictions.
After a person detoxes from alcohol abuse, there is one other, more common maintenance medication: naltrexone. This medication blocks the intoxicating effects of alcohol and also reduces the cravings for the substance. Neither citalopram nor naltrexone are appropriate medications during the detox process; however, once a person has ended their physical dependence on alcohol, either citalopram or naltrexone may help them maintain their sobriety during and after a rehabilitation program.
In some instances, citalopram may be prescribed to stabilize mood when a person is overcoming other substance use disorders. This is because mood disorders like depression and substance abuse are closely linked; a person who struggles with one has an increased risk of struggling with the other. Small doses of antidepressants may help to moderate some emotional withdrawal symptoms and can even help underlying mental health conditions improve.