Citalopram (Systemic)

Brand Names : Celexa

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For citalopram, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to citalopram. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Studies have not been done in pregnant women. However, studies in animals have shown that citalopram may cause decreased survival rates and slowed growth in offspring when given to the mother in doses many times higher than the usual human dose. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - Citalopram passes into breast milk and may cause unwanted effects, such as drowsiness, decreased feeding, and weight loss in the breast-fed baby. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children - Citalopram must be used with caution in children with depression. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine. More study is needed to be sure citalopram is safe and effective in children.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, citalopram is removed from the body more slowly in older people and an older person may need a lower dose than a younger adult.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking citalopram, it is especially important that your health care professional know if you are taking any of the following:

• Bromocriptine (e.g., Parlodel) or
• Buspirone (e.g., BuSpar) or
• Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], or imipramine [e.g., Tofranil]) or
• Dextromethorphan (cough medicine) or
• Levodopa (e.g., Sinemet) or
• Lithium (e.g., Eskalith) or
• Meperidine (e.g., Demerol) or
• Moclobemide (e.g., Manerix) or
• Nefazodone (e.g., Serzone) or
• Pentazocine (e.g., Talwin) or
• Selective serotonin reuptake inhibitors, other (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) or
• Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
• Tramadol (e.g., Ultram) or
• Trazodone (e.g., Desyrel) or
• Triptans (e.g., Imitrex) or
• Tryptophan or
• Venlafaxine (e.g., Effexor) - Using these medicines with citalopram may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome. This syndrome may cause confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching. If you develop these symptoms, contact your doctor as soon as possible

• Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Do not take citalopram while you are taking or within 2 weeks of taking an MAO inhibitor. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, severe convulsions, or the serotonin syndrome. At least 14 days should pass between stopping treatment with one medicine (citalopram or the MAO inhibitor) and starting treatment with the other

Other medical problems - The presence of other medical problems may affect the use of citalopram. Make sure you tell your doctor if you have any other medical problems, especially:

• Bipolar disorder (history of) - May be activated or

• Diabetes mellitus (sugar diabetes) - Hypoglycemia has occurred rarely in diabetic patients receiving citalopram or

• Kidney disease, severe - Until enough patients have been evaluated, caution is recommended for patients with severe kidney disease or

• Liver disease - Higher blood levels of citalopram may occur, increasing the chance of having unwanted effects. You may need to take a lower dose than a person without kidney or liver disease or

• Mania (history of) - May be activated or

• Seizure disorders (history of) - The risk of having seizures may be increased or