Celexa (citalopram)

Celexa (Cipromil)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.

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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).

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