Celexa (citalopram)
Celexa is indicated for the relief of symptoms of depression.
Side Effects
Celexa has numerous side effects on several of the body systems
*Nervous System: Dry Mouth, Increased Sweating, Tremor
*Gastrointestinal: Nausea, Diarrhea, Dyspepsia (impairment of the power
of function of digestion), Vomiting, Abdominal Pain
*Body as a whole: Fatigue, Fever
*Musculoskeletal: Arthralgia (pain in a joint), Myalgia(muscle pain)
*Psychiatric Disorders: Somnolence(sleepiness), Insomnia, Anxiety, Anorexia,
Agitation, Dysmenorrhea(painful menstruation periods), Decreased Libido,
Yawning
*Respiratory System: Upper Respiratory Tract Infection, Rhinitis(inflammation
of the mucous membrane of the nose), Sinusitis(inflammation of the sinuses)
*Urogenital: Ejaculation Disorder, Impotence
Precautions and drug interactions:
Celexa should not be taken with the following medications:
*MAOI'S
*Other Antidepressants
*Alcohol
*Cimetidine
*Warfarin
*NSAID's, aspirin, or other drugs work as blood thinners.
Other precautions
Patients with major depressive disorder, both adult and pediatric, may experience
worsening of their depression and/or the emergence of suicidal ideation
and behavior (suicidality), whether or not they are taking antidepressant
medications, and this risk may persist until significant remission occurs.
Discontinuation of Treatment with Celexa
During marketing of Celexa there have been spontaneous reports of adverse
events occurring upon discontinuation of these drugs, particularly when
abrupt, including the following: dysphoric (depressed) mood, irritability,
agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric
shock sensations), anxiety, confusion, headache, lethargy, emotional liability,
insomnia, and hypomania. While these events are generally self-limiting,
there have been reports of serious discontinuation symptoms. Patients should
be monitored for these symptoms when discontinuing treatment with Celexa.
A gradual reduction in the dose rather than abrupt cessation is recommended
whenever possible.
Pregnancy and Nursing Mothers
In animal reproduction studies, Celexa has been shown to have adverse effects
on embryo/fetal and postnatal development. There are no adequate and well-controlled
studies in pregnant women; therefore, Celexa should be used during pregnancy
only if the potential benefit justifies the potential risk to the fetus.
Neonates exposed to Celexa and other SSRIs or SNRIs, late in the third trimester,
have developed complications requiring prolonged hospitalization, respiratory
support and tube feeding. Such complications can arise immediately upon
delivery.
As has been found to occur with many other drugs, Celexa is excreted in
human breast milk.
Pediatric Use
It should be noted that Celexa is not approved for use in treating any indications
in the pediatric population.
Geriatric Use
No overall differences in safety or effectiveness were observed between
these subjects and younger subjects, and other reported clinical experience
has not identified differences in responses between the elderly and younger
patients, but greater sensitivity of some older individuals cannot be ruled
out.
Drug Abuse and Dependence
Celexa is not a controlled substance. Celexa has not been systematically
studied in humans for its potential for abuse, tolerance or physical dependence.
Recommended Dosage
Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerance. 75 mg of amitriptyline HCl a day in divided doses is usually satisfactory. If necessary, this may be increased to a total of 150 mg per day. Increases are made preferably in the late afternoon and/or bedtime doses. A sedative effect may be apparent before the antidepressant effect is noted, but an adequate therapeutic effect may take as long as 30 days to develop.
Overdose
Although there were no reports of fatal Celexa overdose in clinical trials
involving overdoses of up to 2000 mg, postmarketing reports of drug overdoses
involving Celexa have included 12 fatalities, 10 in combination with other
drugs and/or alcohol and 2 with Celexa alone (3920 mg and 2800 mg), as well
as non-fatal overdoses of up to 6000 mg. Symptoms most often accompanying
Celexa overdose, alone or in combination with other drugs and/or alcohol,
included dizziness, sweating, nausea, vomiting, tremor, somnolence(sleepiness),
and sinus tachycardia.(rapid heartbeat)