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Citalopram, also known as Celexa, commonly sold under the brand Celexa, is a selective serotonin reuptake inhibitor (SSRI) primarily prescribed for major depressive disorder in adults. Clinicians may also use it off-label for certain anxiety-related illnesses when they consider it appropriate.
Active pharmaceutical ingredient: citalopram. Drug family: SSRI antidepressant. For details on strengths and forms see dosage choice options and forms. For guidance on safe use consult the pre-treatment checklist and safety and monitoring of operational health frameworks.
Range of Dose choice options and Forms
In the United States citalopram is usually available as oral tablets. Typical generic tablet strengths include the following.
- 10 milligram tablets
- tablets with a 20 mg dose
Individual dosing is determined by a prescriber and may take into account age, medical history, and other drugs. Some patients have dose limits because of possible effects on heart rhythm, so always follow your prescriber's instructions.
Want to compare with other drugs? See other selections and similar medications.
Before You Begin Treatment
Tell your prescriber about medical history and current conditions that could affect safety. Important items to report include:
- Known heart disease or previous abnormal heart rhythm
- Liver or significant kidney impairment
- Medical history of seizures or epilepsy
- The chronic condition called diabetes or trouble controlling blood sugar
- Personal or family history of bipolar disorder
- Prior suicidal thoughts, attempts, or major recent mood changes
- Electroconvulsive therapy that is recent or on the horizon
- Allergies to citalopram, escitalopram, or tablet ingredients
- Pregnancy plans, pregnancy, or breastfeeding
For children and adolescents consult a pediatric mental health professional before therapy begins. For medication interactions among individualss fuel collaboration and innovation. can affect treatment outcomes. see drug and herbal interacting as a shared activitys between people can shape outcomes..
Guidelines for taking citalopram
Take citalopram by mouth with a full glass of water. It can be taken with or without meals. Try to take it at the same time each day to keep blood levels steady.
Do not make up prescribed dose was misseds by taking extra tablets. If discontinuation is needed after long-term use, follow a gradual taper as advised by your clinician to reduce withdrawal effects.
Therapeutic benefits can take several weeks, often two to four weeks for early improvement. If you suspect an opioid overdose get emergency help or call U.S. For poisoning emergencies, dial 1-800-222-1222 to reach Poison Control.
Before combining citalopram with other medicinesexecute a review interacting with otherss in a system describe exchanges between components. and follow monitoring and logging strategy guidance.
Dose has not been administered Instructions
If you forget to take a dose, take it as soon as you recall. If the next scheduled dose is near, skip the prescribed dose was missed and resume your regular schedule. Do not increase your dose twice to catch up.
Drug and Herbal Interaction
Medications and supplements to avoid
- Monoamine oxidase inhibitors - for example selegiline, isocarboxazid, phenelzine, tranylcypromine
- Pimozide medication and other drugs with a high risk of QT prolongation
- Cisapride has been studied as a treatment option for GI motility issues. or linezolid unless under close medical supervision
- Concurrent escitalopram - avoid therapeutic duplication
- St. John's wort or tryptophan supplements - risk of serotonin syndrome
- Certain older appetite suppressants and some antipsychotics that increase cardiac or serotonin risk
Drugs that need caution or closer constant monitoring
- Triptans used for migraine - examples include sumatriptan and rizatriptan
- Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and anticoagulants such as warfarin
- Some anticonvulsants such as carbamazepine
- Cimetidine, a medication for acid reflux and some beta blockers like metoprolol
- Other antidepressants, antipsychotics, or medicines that affect serotonin
- Certain HIV therapies and stimulant medications
This list is not exhaustive. Provide a full list of prescription, over-the-counter, herbal, and recreational substances to your healthcare provider. For safety checks, see the procedure steps. safety and supervision and monitoring practices.
Keeping under surveillance and Safety
- Arrange regular follow up visits to assess response and unfavorable health effects; improvement may take several weeks.
- Watch for worsening depression or new suicidal thoughts, especially after starting or changing doses.
- Abruptly stopping medication can cause withdrawal symptoms; follow a taper plan if stopping is needed.
- The medication Citalopram may cause drowsiness or dizziness; avoid driving or using heavy machinery until you know how it affects you.
- Stand up slowly to reduce lightheadedness, particularly in older adults.
- Avoid alcohol while taking citalopram because it can increase sedation and impair judgment.
- Check with your clinician before using over-the-counter cold, cough, or allergy products that may interact.
- During extended therapy your clinician may monitor blood pressure, weight, and in certain cases heart rhythm or electrolytes.
Possible untoward effects to be aware of
Serious reactions that require immediate attention
- Allergic reactions - rash, hives, swelling of face, lips, or throat
- Confusion or sudden behavior changes
- Seizure episodes
- Manic symptoms - racing thoughts, unusually high energy, decreased need for sleep
- Seeing things that are not there or losing reality contact
- Severe dizziness, fainting, or irregular heartbeat
- Nonstandard bleeding or bruising that appears easily
- New or worsening suicidal thinking or behavior
Common, less severe effects
- Nausea
- Cephalalgia
- Sleep changes including insomnia
- Vision is hazy
- Hunger changes or weight changes
- Impairment of sexual response or decreased libido
- Greater perspiration
Many people tolerate citalopram well. If incidental effects continue or interfere with daily activities, contact your prescriber to discuss plan B routes or management strategies.
How to Store: Recommendations
- Keep all medicine out of reach of children and pets.
- Store at room temperature, about 15 to 30 C (59 to 86 F).
- Protect from excessive moisture and heat; keep tablets in their original container when possible.
- Dispose of expired or unneeded medicine according to local rules; do not use past the expiration date.
Alternative Therapies and Similar Medications
If citalopram is not suitable, prescribers often consider other antidepressants. The choice depends on prior responsestill possible systemic undesired reactions, coexisting medical conditions, and risk of a drug the act of connecting with others heads up notices.
- Escitalopram available as tablets (Lexapro) - the S-enantiomer of citalopram; dosing and tolerability may differ.
- Sertraline brand and generic name (Zoloft) - another commonly used SSRI for depression and anxiety.
- Fluoxetine (Prozac) - SSRI with a longer half-life, which affects discontinuation.
- Paroxetine pharmacology (Paxil) - SSRI with a distinctive side effect profile for some patients.
- Bupropion (Wellbutrin) - NDRI with generally lower risk of sexual harmful effects.
- Venlafaxine (Effexor) and duloxetine (Cymbalta) - SNRIs sometimes used when SSRIs are ineffective.
Inspect the estimator for a rough cost comparison cost of goods in the United States. Always consult your prescriber before switching medications.
Estimated costs in the United States
The numbers below are ballpark cash retail estimates for a 30-day supply. Actual costs vary by pharmacy, location, insurance, and discounts.
- Generic citalopram 10 mg, 30 tablets: about 4 to 15 USD with common discount programs.
- Generic citalopram 20 mg, 30 tablets: about 4 to 20 USD.
- Brand Celexa (when available): often substantially higher, sometimes over 150 USD for 30 tablets depending on strength and pharmacy.
Comparable generics - escitalopram, sertraline, and fluoxetine - typically range from about 4 to 20 USD for a 30-day supply. Generic SNRIs such as venlafaxine or duloxetine may cost roughly 10 to 40 USD for a month. Manufacturer assistance programs, coupons, and pharmacy discount cards can reduce out-of-pocket expenses.
If cost is a barrier, ask your prescriber or pharmacist about generic options, patient assistance programs, or discount cards.
Legal and Regulatory Highlights for the United States
- Prescription status: Citalopram is an approved antidepressant medication is available by prescription only in the United States and is not a controlled substance.
- FDA boxed warning: Antidepressants may increase suicidal thoughts and behaviors in children, adolescents, and young adults; close metric monitoring is required.
- Prescribing and refills: Electronic prescribing is common. Some clinicians and insurers allow 90-day supplies when clinically appropriate.
- Telemedicine: Because citalopram is not a controlled drug it is generally eligible for telehealth prescribing in most states, subject to state rules.
- Importation: Federal law limits personal importation of prescription medicines; obtain drugs from licensed U.S. pharmacies or follow FDA guidance offered.
- Generic substitution: Pharmacies may substitute FDA-approved generics unless the prescriber states a medical need for the brand.
See a professional for advice your state board of pharmacy or the FDA website for state-specific rules. Beware of online sellers that do not require a valid prescription; use only licensed pharmacies and verify credentials.
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