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 activity in the brain, which helps improve mood, sleep, appetite, and energy levels. Clinical studies and extensive post-marketing experience support its efficacy and generally favorable tolerability profile, making it a frequently prescribed option in the management of depression.

Features

• Active ingredient: Citalopram hydrobromide
• Drug class: Selective serotonin reuptake inhibitor (SSRI)
• Available formulations: Oral tablets (10 mg, 20 mg, 40 mg) and oral solution (5 mg/mL)
• FDA-approved for: Major depressive disorder (MDD)
• Prescription status: Rx only

Benefits

• Effectively reduces symptoms of depression, including low mood and loss of interest
• Helps restore energy levels and improve daily functioning
• May alleviate associated anxiety symptoms often present with depression
• Generally well-tolerated with a lower incidence of certain side effects compared to older antidepressants
• Once-daily dosing supports treatment adherence

Common use

Celexa is primarily indicated for the treatment of major depressive disorder (MDD). It is used to manage the core symptoms of depression, which may include persistent sadness, loss of interest or pleasure in activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death or suicide. Treatment is typically initiated after a thorough diagnostic evaluation by a qualified healthcare professional.

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 certain patient populations, such as the elderly or those with hepatic impairment, a lower starting dose of 10 mg daily is recommended. The full therapeutic effect may take several weeks to manifest. Tablets should be swallowed whole and not crushed or chewed.

Precautions

Patients should be monitored for clinical worsening, suicidality, or unusual changes in behavior, especially during the initial few months of therapy or following dosage changes. Celexa may cause activation of mania/hypomania; use with caution in patients with a history of bipolar disorder. Caution is advised in patients with a history of seizures. SSRI use may be associated with hyponatremia, particularly in elderly patients, those taking diuretics, or those who are otherwise volume-depleted. Discontinuation symptoms may occur upon abrupt cessation; gradual dose reduction is recommended.

Contraindications

Celexa is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to the risk of serotonin syndrome. Concomitant use with pimozide is contraindicated due to the potential for QTc prolongation. It is also contraindicated in patients with known hypersensitivity to citalopram or any components of the formulation.

Possible side effect

Common side effects may include nausea, dry mouth, increased sweating, somnolence, insomnia, and fatigue. Sexual dysfunction, including decreased libido, delayed ejaculation, and anorgasmia, has been reported. Other potential side effects include tremor, diarrhea, and anorexia. Most side effects are dose-dependent and may diminish with continued treatment.

Drug interaction

Celexa has the potential to interact with other medications that affect serotonin neurotransmission, increasing the risk of serotonin syndrome. These include other SSRIs, SNRIs, triptans, tramadol, and tryptophan. Concomitant use with drugs that prolong the QTc interval should be avoided. Celexa is a moderate inhibitor of CYP2D6 and may increase plasma concentrations of drugs metabolized by this enzyme (e.g., certain beta-blockers, antiarrhythmics, and antipsychotics). Caution is advised with concomitant use of NSAIDs, aspirin, or other drugs that affect coagulation due to potential increased risk of bleeding.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Doubling the dose to make up for a missed one is not recommended.

Overdose

Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In rare cases, seizures or ECG changes (including QTc prolongation) may occur. There is no specific antidote; management should consist of supportive measures and symptomatic treatment. Gastric lavage may be considered if performed soon after ingestion.

Storage

Store at room temperature (20°C to 25°C/68°F to 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Keep the container tightly closed and protect from light and moisture. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Celexa is a prescription medication and should be used only under the supervision of a qualified healthcare provider. Individual patient needs and responses may vary. Always consult with a healthcare professional for diagnosis and treatment recommendations tailored to your specific medical situation.

Reviews

Clinical trials and post-marketing surveillance indicate that Celexa is generally effective and well-tolerated for the treatment of major depressive disorder. Many patients report significant improvement in depressive symptoms and overall quality of life. As with all antidepressants, individual responses can vary, and a period of dosage adjustment may be necessary to achieve optimal results while managing side effects.