Celexa is a brand-name prescription medication that’s used to treat depression in adults. Depression is a type of mood disorder in which you have feelings of sadness and can lose interest in things you normally enjoy.

Celexa contains the active drug citalopram, which is a kind of antidepressant. Celexa is part of a drug class called selective serotonin reuptake inhibitors (SSRIs). A class of drugs is a group of medications that work in a similar way.

Celexa comes as a tablet that you swallow once a day.

Celexa isn’t approved for use in children. There haven’t been enough studies for the drug to be recommended for that age group.

Effectiveness

In clinical studies that lasted 4 to 6 weeks, depression symptoms eased more in people who took Celexa. This was compared with people who took a placebo (treatment with no active drug).

Researchers then looked at the people who took Celexa and had their depression symptoms ease to see how the drug worked long term. These people were compared with people who took a placebo. The people in the Celexa group were less likely to have their depression come back again.

Celexa tablets are available as a brand-name medication. They’re also available in a generic form called citalopram. A generic drug is an exact copy of a brand-name medication. Generics tend to cost less than brand-name drugs.

Celexa contains one active drug ingredient: citalopram. This means citalopram is the ingredient that makes Celexa work.

Citalopram also comes as an oral liquid solution and as a tablet that dissolves on your tongue.

Celexa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Celexa. These lists don’t include all possible side effects.

For more information on the possible side effects of Celexa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Vivitrol, you can do so through MedWatch.

More common side effects

The more common side effects of Celexa can include:

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Celexa aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Suicidal thinking and behavior.* Symptoms can include:
    • thoughts of harming yourself
    • worsening depression or anxiety
    • feeling agitated or irritable (easily upset or frustrated)
    • aggressiveness
    • behaviors or feelings that aren’t normal for you
  • Withdrawal symptoms when you stop using the drug. For details, see the “Celexa withdrawal” section below.
  • Hyponatremia (low levels of sodium). Symptoms can include:
    • headache
    • brain fog
    • feeling weak or unsteady
    • fainting
  • Mania or hypomania (racing thoughts or periods of high energy). Symptoms can include:
    • increased energy
    • feeling restless
    • trouble sleeping
    • racing thoughts
  • Bleeding. Symptoms can include:
    • increased bruising
    • nosebleeds
    • blood in urine or stool
  • QT prolongation and torsades de pointes (types of heart rhythm problems). Symptoms can include:
  • Serotonin syndrome (high levels of the chemical serotonin). Symptoms can include:
    • sweating or fever
    • tremor
    • blood pressure changes
    • racing heart
    • feeling agitated
    • dizziness
  • Seizures (changes in the electrical activity of your brain). Symptoms can include:
    • dizziness
    • sudden movement of your arms or legs
    • change in eyesight
    • sudden fear or feeling anxious

Another serious side effect, explained in more detail below in “Side effect details,” is allergic reaction.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Call 911 or the local emergency number.
  • Stay with the person until professional help arrives.
  • Remove any weapons, medications, or other potentially harmful objects.
  • Listen to the person without judgment.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255. During a crisis, people who are hard of hearing should call 1-800-799-4889.

Side effects in children

Celexa isn’t approved for use in children and can increase the risk of suicidal thoughts and behaviors in children.* For details, see “Suicidal thoughts and behaviors” in the “Side effect details” section below.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Celexa. However, there are no studies showing the frequency of allergic reactions in people using Celexa. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Celexa. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Weight gain or weight loss

Changes in appetite may occur while taking Celexa, which can lead to weight gain or weight loss. In clinical studies, weight changes were minimal and occurred in at least 1% of people who took Celexa. In some studies, people who took Celexa lost about 1 lb. In comparison, people who took a placebo (treatment with no active drug) didn’t lose weight.

It’s not known how many people gained weight while taking Celexa or how much weight they gained. And the studies didn’t include a placebo comparison for weight gain.

Keep in mind that depression itself sometimes causes changes in appetite and weight. If you’re taking Celexa and have weight loss or weight gain of more than a few pounds, it’s important to talk with your doctor. They can look at what might be causing the change in your weight and suggest helpful treatments.

Sexual side effects

Sexual problems may occur with Celexa use. Both men and women who take the drug may have a lower sex drive. Men who take Celexa may also have impotence or ejaculation changes (mostly a delay in ejaculating).

In clinical studies, 6% of men who took Celexa had changes in ejaculation, compared with 1% of men who took a placebo. Impotence occurred in 3% of men who took Celexa, compared with less than 1% of men who took a placebo.

You may not have sexual side effects while taking Celexa. But if you do, it’s important to tell your doctor if they’re bothering you. Your doctor may be able to change your dose of Celexa to ease symptoms or recommend a different medication.

Insomnia

Sleep problems may occur while taking Celexa. However, clinical studies found very similar rates of insomnia in people who took Celexa or a placebo. In the Celexa group, 15% of people had insomnia, compared with 14% of the placebo group. In addition, depression may also cause trouble with sleep.

Sleep is an important part of your overall health. If you’re having trouble sleeping during while taking Celexa, share this information with your doctor. They can suggest treatments to help you get a good night’s rest.

Diarrhea

Diarrhea is a possible side effect of taking Celexa, but it may get better over time. Studies found that about 8% of people who took Celexa had diarrhea, compared with 5% of people who took a placebo.

You may also have diarrhea if you stop taking Celexa too quickly. See the “Celexa withdrawal” section below for more details.

If you’re taking Celexa and your diarrhea doesn’t go away or is bothersome, talk with your doctor. They can suggest helpful treatment options.

Hot flashes

Hot flashes are possible when taking Celexa, but they’re not likely to occur. In early studies, less than 1% of people who took Celexa had hot flashes. The studies didn’t include a placebo comparison.

If you have hot flashes during your Celexa treatment and they’re bothersome, talk with your doctor. They can suggest tips on how to be more comfortable.

Constipation

Constipation isn’t likely to occur with Celexa. In studies, more people who took a placebo had constipation than people who took Celexa. Specific statistics aren’t available, but clinical studies found that at least 2% of people who took Celexa had constipation.

However, if you have constipation while using Celexa, talk with your doctor about treatment options.

Sweating

Sweating (including night sweats) may occur when taking Celexa. However, studies showed similar rates of sweating in people who took Celexa (11%) compared with people who took a placebo (9%)

Sweating may also occur if you stop taking the drug too quickly or as a result of certain drug interactions. For more information, see the “Celexa withdrawal” and “Celexa interactions” sections.

If you’re taking Celexa and have sweating that’s bothersome, tell your doctor. They may be able to suggest treatments to help you feel more comfortable.

Suicidal thoughts and behaviors

Worsening depression or suicidal thoughts and behaviors* may occur when taking Celexa. You’re more likely to have these side effects if you’re younger than age 25 years, just started treatment, or your doctor just changed your dosage of Celexa.

Studies have looked at cases of suicide in people younger than age 18 years who took either an antidepressant or a placebo. The results showed 14 more cases of suicide in every 1,000 people who took an antidepressant compared with people who took a placebo. In people ages 18 to 24 years, studies showed 5 more cases of suicide in every 1,000 people who took an antidepressant, compared with people who took a placebo. And in people ages 25 years and older, there were fewer cases of suicide in every 1,000 people who took antidepressants, compared with people who took a placebo.

During your Celexa treatment, it’s vital to watch for changing thoughts and behaviors. Be sure to have friends and loved ones keep an eye out as well. It can take several weeks to notice whether Celexa is helping ease your depression symptoms, so it’s important to have support during this time. If you have thoughts of harming yourself while taking Celexa, tell your doctor right away or call 911.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

The Celexa dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Celexa to treat
  • your age
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Celexa is available as 10-mg, 20-mg, and 40-mg tablets that you swallow.

Dosage for depression

The starting dose of Celexa is 20 mg a day. Your doctor may have you increase your dose to 40 mg a day after at least 1 week of treatment with the starting dose.

A maximum dose of 40 mg a day is recommended because higher doses are more likely to lead to heart-related side effects. These include a heart rhythm problem called QT prolongation.

In certain situations, your doctor may want you to keep taking 20 mg of Celexa a day:

  • You have side effects that bother you when taking 40 mg of Celexa a day.
  • You’re older than age 60 years.
  • You take certain medications such as cimetidine (Tagamet), clopidogrel (Plavix), or omeprazole (Prilosec).
  • Your body is expected to metabolize (break down) the medication differently. This may happen if you’ve had genetic testing done that tells you how your body processes or responds to certain medications.

What if I miss a dose?

If you miss a dose of Celexa, take it as soon as you can. If it’s almost time for your next dose, skip the dose you missed and take your regular dose as scheduled. Don’t make up for your missed dose by taking two doses at once.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Celexa is meant to be used as a long-term treatment. If you and your doctor determine that Celexa is safe and effective for you, you’ll likely take it long term.

The Food and Drug Administration (FDA) approves prescription drugs such as Celexa to treat certain conditions. Celexa may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Celexa for depression

Celexa is FDA-approved for the treatment of depression in adults. Early studies of the medication were in people with major depressive disorder (MDD). MDD involves symptoms that interfere with daily life for at least 2 weeks. Examples of these symptoms include:

  • a depressed mood
  • less interest in usual activities
  • appetite changes
  • weight gain or weight loss
  • sleeping more than usual or having trouble falling asleep
  • fatigue (lack of energy)
  • guilty feelings
  • low self-worth
  • trouble thinking or concentrating

In clinical studies that lasted 4 to 6 weeks, depression symptoms eased more in people who took Celexa. This was compared with people who took a placebo (treatment with no active drug).

Researchers then looked at the people who took Celexa and had their depression symptoms ease to see how the drug worked long term. These people were compared with people who took a placebo. The people in the Celexa group were less likely to have their depression come back again.

Celexa for other conditions

In addition to the use listed above, Celexa may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Celexa is used for certain other conditions.

Celexa for anxiety (off-label use)

Celexa doesn’t have FDA approval to treat anxiety. However, some studies suggest selective serotonin reuptake inhibitors (SSRIs) like Celexa may be good treatment options for anxiety. These medications may be an option for people with anxiety who may benefit from taking medication.

Celexa for OCD (off-label use)

SSRIs, including Celexa, are sometimes used off-label for the treatment of obsessive-compulsive disorder (OCD). This is a behavioral health condition in which unwanted thoughts or behaviors keep coming back or repeat over and over.

A review of studies has looked at people with OCD who were treated with Celexa, other SSRIs, or a placebo. People who took Celexa or another SSRI had their symptoms ease more than people who took a placebo.

Treatment of OCD usually requires doses of Celexa that are higher than those used for depression. And it can take longer for people with OCD to notice that Celexa is working.

Although the maximum recommended dose of Celexa for depression is 40 mg, doses of 60 mg have been used to treat OCD. Taking 60 mg of Celexa may increase your risk for heart-related side effects such as dizziness and heart palpitations (feeling of skipped or extra heartbeats).

Celexa for bipolar depression (off-label use)

Although Celexa isn’t FDA-approved for the treatment of bipolar depression, it may be used off-label in some cases. (Bipolar depression is a mental health condition in which you have extreme shifts in your energy and mood.) Celexa and other SSRIs aren’t usually the first choice of treatment for bipolar depression, but these medications may be used with other drugs.

If you have bipolar depression, you may have mania or hypomania (racing thoughts or periods of high energy) when taking Celexa or other antidepressants. For more details, see the “Celexa precautions” section below.

Celexa for PMDD (off-label use)

Celexa may be used off-label to treat premenstrual dysphoric disorder (PMDD), which is a more severe form of premenstrual syndrome (PMS). PMS is a group of physical and mental symptoms women have a week or two before their period.

A review of studies has shown that Celexa and other SSRIs eased symptoms of PMDD better than a placebo. To treat PMDD, your doctor may prescribe doses of Celexa (10 mg to 30 mg) that are lower than those used to treat depression.

Celexa for menopausal symptoms (off-label use)

Celexa may be prescribed off-label for symptoms of menopause, usually at doses smaller than those used for depression. Your doctor may prescribe 10 mg to 30 mg of Celexa to help treat menopause symptoms.

Celexa for IBS (off-label use)

Celexa may be used off-label to treat irritable bowel syndrome (IBS), a condition that affects your intestines. Celexa studies of people with IBS have shown mixed results. IBS symptoms may ease in some people when taking Celexa. Your doctor may prescribe Celexa as part of your treatment plan.

Celexa for PTSD (off-label use)

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur after going through or witnessing a traumatic event. Celexa may be used off-label for the treatment of PTSD, although other antidepressants and medications are often chosen over Celexa.

Due to a lack of evidence, guidelines from The Management of Posttraumatic Stress Disorder Work Group recommend against the use of Celexa if it’s the only medication you’re taking for PTSD. The drug may not fully help treat your symptoms. Also, nondrug treatments such as counseling are generally tried before medication.

More studies are needed to understand the role Celexa may have in treating PTSD.

Celexa for pediatrics (off-label use)

Celexa may be used off-label to treat depression in children.* However, studies haven’t shown that Celexa treats depression in children much better than a placebo.

Other antidepressant medications have FDA-approval for the treatment of major depressive disorder in children and are preferred over Celexa. Examples of these medications include fluoxetine (Prozac) and escitalopram (Lexapro).

Celexa for agitation associated with dementia (off-label use)

Celexa may be used off-label to treat agitation caused by dementia. Dementia is a group of symptoms that mark a decline in how you communicate, think, and remember things. Some people with dementia may feel agitated, meaning that they’re anxious or restless.

A study looked at people thought to have Alzheimer’s disease, which is a form of dementia. The people were treated with counseling and either citalopram (the active drug in Celexa) or a placebo.

Researchers found that symptoms eased more in the people who took citalopram than in those who took a placebo. Among the different scales researchers used to evaluate people in the study was the modified Alzheimer Disease Cooperative Study — Clinical Global Impression of Change. Based on this scale, 40% of people who took citalopram had a noticed improvement in symptoms compared with 26% of people who took a placebo.

Celexa for sleep (not an appropriate use)

Celexa isn’t approved for the treatment of sleep disorders. These conditions affect how well you sleep on a regular basis. If you’re having trouble sleeping, talk with your doctor to learn about treatment options.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Celexa and children

Celexa isn’t approved for use in children and can increase the risk of suicidal thoughts and behaviors in children.* For details, see “Suicidal thoughts and behaviors” in the “Celexa side effects” section above.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Other drugs are available that can treat depression. Some may be better suited for you than others. If you’re interested in finding an alternative to Celexa, talk with your doctor. They can tell you about other medications that may work well for you.

Other drugs that the Food and Drug Administration (FDA) has approved to treat depression include:

You may wonder how Celexa compares to other medications that are prescribed for similar uses. Here we look at how Celexa and Lexapro are alike and different.

Ingredients

Celexa contains the active drug citalopram. Lexapro contains the active drug escitalopram.

Uses

The Food and Drug Administration (FDA) has approved Celexa to treat depression only in adults. Lexapro is FDA-approved to treat depression in adults as well as children ages 12 to 17 years. Lexapro is also FDA-approved to treat generalized anxiety disorder in adults.

Drug forms and administration

Celexa and Lexapro are both available as tablets that you swallow. Lexapro is also available as an oral liquid solution. Both Celexa and Lexapro are generally taken once a day.

Side effects and risks

Celexa and Lexapro belong to the same class of drugs. (A class of drugs is a group of medications that work in a similar way.) Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Celexa, with Lexapro, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Celexa, with Lexapro, or with both drugs (when taken individually).

  • Can occur with Celexa:
  • Can occur with Lexapro:
    • few unique serious side effects
  • Can occur with both Celexa and Lexapro:

* Celexa and Lexapro have a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Effectiveness

The only condition both Celexa and Lexapro are used to treat is depression.

Separate studies of the two drugs were compared in a larger review of studies. People who took Lexapro were more likely to have their symptoms ease than those who took Celexa.

Costs

Celexa and Lexapro are both brand-name drugs. Both drugs are also available in generic forms. The generic form of Celexa is called citalopram, and the generic form of Lexapro is called escitalopram. Brand-name medications usually cost more than generics.

Brand-name Celexa tablets generally cost less than brand-name Lexapro tablets. Generic Celexa tablets generally cost about the same as generic Lexapro tablets. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Like Lexapro (above), the drug Zoloft has uses similar to those of Celexa. Here’s a comparison of how Celexa and Zoloft are alike and different.

Ingredients

Celexa contains the active drug citalopram. Zoloft contains the active drug sertraline.

Uses

The Food and Drug Administration (FDA) has approved both Celexa and Zoloft to treat depression. Zoloft is also FDA-approved to treat the following:

Celexa is used off-label to treat most of these conditions. See the “Celexa uses” section above to learn more.

Drug forms and administration

Celexa and Zoloft are both available as tablets that you swallow. Zoloft is also available as an oral liquid solution. Both Celexa and Zoloft are usually taken once a day.

Side effects and risks

Celexa and Zoloft belong to the same class of drugs. (A class of drugs is a group of medications that work in a similar way.) Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Celexa, with Zoloft, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Celexa, with Zoloft, or with both drugs (when taken individually).

  • Can occur with Celexa:
    • few unique serious side effects
  • Can occur with Zoloft:
    • symptoms such as fast heart rate, excessive sweating, headaches, nausea, and vomiting when Zoloft oral liquid solution is taken with a drug called disulfiram (Antabuse)
  • Can occur with both Celexa and Zoloft:

* Celexa and Zoloft have a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Effectiveness

The only condition both Celexa and Zoloft are used to treat is depression.

These drugs haven’t been directly compared in clinical studies, but studies have found both Celexa and Zoloft to be effective for treating depression.

Costs

Celexa and Zoloft are both brand-name drugs. Both drugs are also available in generic forms. The generic form of Celexa is called citalopram, and the generic form of Zoloft is called sertraline. Brand-name medications usually cost more than generics.

Brand-name Celexa tablets generally cost about the same as brand-name Zoloft tablets. Generic Celexa tablets generally cost about the same as generic Zoloft tablets. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Stopping Celexa too quickly can make you feel ill. You may have withdrawal symptoms that last days to weeks, which is known as discontinuation syndrome. Symptoms can include:

  • dizziness
  • headache
  • insomnia (trouble sleeping)
  • anxiety
  • feeling restless
  • feeling irritated (easily upset or frustrated)
  • bad mood or mood swings
  • feeling fatigued (having a lack of energy) or sluggish
  • electric shock-like sensations
  • difficulty concentrating or clouded thinking

Memory loss isn‘t an expected symptom of Celexa withdrawal.

If you need to stop taking Celexa, your doctor will help you decrease your dose slowly to help avoid these symptoms. It‘s important you don‘t suddenly stop taking your medication or change your dose without first talking with your doctor.

It’s best to avoid drinking alcohol while taking Celexa. The medication works in part through its activity in the brain and nervous system. So it’s possible that Celexa will make it harder to think clearly and cause drowsiness. Alcohol can also affect the brain and nervous system and make you tired. In addition, drinking alcohol may cloud thinking and impair your ability to drive or operate machinery safely. So drinking alcohol while taking Celexa may put you at risk for harm.

If you drink alcohol, talk with your doctor about the possible risks and whether Celexa is right for you.

Celexa can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Celexa and other medications

Below is a list of medications that can interact with Celexa. This list doesn’t contain all drugs that may interact with Celexa.

Before taking Celexa, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Celexa and tramadol

Taking Celexa and the pain medication tramadol may increase your risk for serotonin syndrome (high levels of the chemical serotonin). For symptoms serotonin syndrome, see the “Celexa side effects” above.

If you’re taking tramadol, tell your doctor before you start using Celexa. They may monitor your side effects during treatment or suggest different medications.

Celexa and medications that can affect the central nervous system

Due to Celexa’s action on the central nervous system (CNS), you should use caution when taking Celexa with other medications that can affect the CNS. (The CNS includes your brain and spinal cord.)

Examples of some drugs that can affect the CNS include:

If you’re taking a drug that acts on your CNS or if you’re not sure, talk with your doctor before you start using Celexa. They may need to monitor your side effects or suggest a different combination of medications.

Celexa and certain depression medications

Using Celexa with certain other antidepressants may increase your risk for serotonin syndrome. (For symptoms of serotonin syndrome, see the “Celexa side effects” section above.)

Monoamine oxidase inhibitors (MAOIs) are one type of these antidepressants, and you shouldn’t use MAOIs within 14 days of stopping Celexa treatment. Other types of these antidepressants include serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs,) and tricyclic antidepressants.

Taking more than one antidepressant at a time can increase your risk of bleeding. To learn more, please see “Celexa and drugs that can increase the risk of bleeding” right below.

If you’re taking an antidepressant, tell your doctor before you start using Celexa. They can review your medications and recommend the right treatment for you.

Celexa and drugs that can increase the risk of bleeding

Celexa can increase the risk of bleeding, especially if you take it with other drugs that can also increase bleeding risk.

Examples of these medications include:

If you’re using any of these drugs, tell your doctor before you take Celexa. They can review your medications and recommend the right treatment for you.

Celexa and certain drugs used for migraine

Drugs known as triptans can be used to treat migraine. Taking a triptan with Celexa can increase the risk of developing serotonin syndrome. (For symptoms of serotonin syndrome, see the “Celexa side effects” section above.)

Examples of triptans include:

  • sumatriptan (Imitrex)
  • frovatriptan (Frova)
  • almotriptan
  • eletriptan (Relpax)

If you need to take a triptan while you’re using Celexa, your doctor will monitor you closely for symptoms of serotonin syndrome.

Celexa and carbamazepine

The medication carbamazepine (Tegretol) may speed up the breakdown of Celexa in the body. But this hasn’t been proven in studies. So in theory, taking carbamazepine with Celexa could cause Celexa to not work correctly.

If you’re taking carbamazepine, let your doctor know before you start taking Celexa. They’ll want to monitor you for side effects of Celexa and whether the medication is helping you.

Celexa and lithium

Taking Celexa and lithium (Lithobid) together may increase the risk of serotonin syndrome. (For symptoms of serotonin syndrome, see the “Celexa side effects” section above.)

If you’re taking lithium, tell your doctor before you start using Celexa. They may monitor you more closely during treatment or suggest different medications.

Celexa and pimozide

One study showed that taking Celexa and pimozide can increase the risk of a type of heart rhythm problem called QT prolongation. Your doctor should monitor you for changes in heart rhythm if you have to take these drugs together. Be sure to tell them if you have any dizziness or heart palpitations (feeling of skipped or extra heartbeats).

Celexa and ketoconazole

If you take Celexa and ketoconazole together, it may decrease the amount of ketoconazole in your body. It’s important to tell your doctor if you’re taking ketoconazole when you start Celexa treatment. They may monitor your level of ketoconazole or recommend a different medication for you.

Celexa and CYP2C19 inhibitors

Taking drugs called CYP2C19 inhibitors with Celexa may raise the level of Celexa in your system. This can increase the risk for certain side effects such as an irregular heart rhythm (a heartbeat that’s too fast, too slow, or uneven).

Examples of CYP2C19 inhibitors include:

  • cimetidine (Tagamet)
  • omeprazole (Prilosec)
  • clopidogrel (Plavix)

If you’re taking a CYP2C19 inhibitor, tell your doctor before you start using Celexa. They may decrease your dose of Celexa or suggest a different medication for you.

Celexa and herbs and supplements

You should check with your doctor or pharmacist before using any herbal or supplement products while taking Celexa. Taking St. John’s wort or tryptophan may increase your risk for serotonin syndrome, but there aren’t specific studies that prove an interaction.

Serotonin syndrome is a potentially serious condition that requires treatment. For symptoms of serotonin syndrome, see the “Celexa side effects” section above. If you have symptoms of serotonin syndrome, tell your doctor right away.

If you take St. John’s wort or tryptophan, tell your doctor. They may have you pause your use of the supplement during your Celexa treatment.

It’s unclear if Celexa is safe to use during pregnancy. Although there have been studies of Celexa use in pregnant mothers, the drug hasn’t been widely researched.

What the studies say

Studies looked at babies born to pregnant women who were given Celexa during their last trimester (3 months). The babies were more likely to be hospitalized, be fed through a tube, or need breathing support. However, it’s unknown whether these problems were due to Celexa or because the babies had withdrawal syndrome. (Withdrawal syndrome can occur after babies are born and all of a sudden they no longer have Celexa in their system.)

Some studies have shown that Celexa and other selective serotonin reuptake inhibitors (SSRIs) may increase the risk of persistent pulmonary hypertension of the newborn (PPHN). This is a rare but serious condition in which a baby’s lungs don’t expand correctly after birth. However, other studies have shown no link between SSRIs and PPHN.

In addition, research has shown that women who stop taking antidepressants during pregnancy were more likely to have their depression return. This is compared with women who continued to take antidepressants while pregnant.

In animal studies, Celexa didn’t cause harmful side effects when mothers were given doses that were very high compared with those given to humans. However, it’s unknown whether the results in animals can be applied to humans.

Talking with your doctor

If you’re pregnant or are planning to become pregnant, talk with your doctor before taking Celexa. They can discuss the pros of Celexa treatment as well as the possible side effects with you. For some people, the benefits are very clear, and taking the medication makes sense. But for others, a different medication may be a better option.

It’s not known if Celexa is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Celexa.

It’s not known if Celexa is safe to take while breastfeeding. Celexa is present in the breast milk of nursing mothers. Two infants who were breastfed by mothers taking Celexa were reported to have drowsiness, decreased appetite, and weight loss.

If you plan to breastfeed while taking Celexa, first talk with your doctor. They can help you consider the benefits of taking Celexa, other treatment options, and potential side effects to watch for in your child.

As with all medications, the cost of Celexa can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Celexa. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Celexa.

If you’re not sure if you’ll need to get prior authorization for Celexa, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Celexa, or if you need help understanding your insurance coverage, help may be available through your local pharmacy. Talk with your pharmacist about ways to save on your prescription.

You should take Celexa according to your doctor’s or healthcare provider’s instructions.

Celexa comes as a tablet that you take once a day by swallowing it.

When to take

It’s important to take Celexa at about the same time each day. You can take it in the morning or evening.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Celexa with food

You can take Celexa with or without food.

Can Celexa be crushed, split, or chewed?

It’s important to take Celexa as prescribed by your doctor. In some situations, your doctor may adjust your dose, requiring you to split tablets. A pill cutter can make splitting tablets easier. The 20-mg and 40-mg Celexa tablets have score lines to help you split them evenly.

If you have trouble swallowing tablets, talk with your doctor. They may recommend generic forms of Celexa that are available as an oral liquid solution and a tablet that dissolves on your tongue.

Celexa is used to treat depression in adults. Depression is a type of mood disorder in which you have feelings of sadness and can lose interest in things you normally enjoy. Depression is caused by certain chemicals being out of balance in the body and brain. These chemicals include serotonin and dopamine.

Major depressive disorder (MDD) is a type of long-term depression in which you often have feelings of depression that last for long periods of time.

Celexa works by increasing the level of serotonin in the central nervous system (CNS) and creating a better balance of the chemicals in your body and brain. (The CNS includes your brain and spinal cord.) If you have MDD, Celexa may help improve your mood, sleep, feelings, and enjoyment of daily activities.

How long does it take to work?

You may notice your symptoms of depression ease after taking Celexa for a couple of weeks. In some cases, it may be closer to a month to see changes in how you feel.

Celexa is usually taken long term (months to years). So it can take time for you to notice the drug’s full benefit after you first start to take Celexa or use a higher dose.

Here are answers to some frequently asked questions about Celexa.

Does Celexa cause hair loss?

It’s not known if Celexa can cause hair loss. Although hair loss was observed in a case report from 2019, this side effect wasn’t reported in clinical trials of Celexa. (A case report is a record of one person’s experience.)

A 2018 study looked at many different antidepressants and found that the use of some antidepressants caused a greater risk of hair loss than others. Celexa was neither the most nor least likely to cause hair loss.

If you have concerns about losing your hair, talk with your doctor. They can review your medications and explore possible reasons for your hair loss.

Can Celexa be used to treat agitation caused by dementia?

Maybe. Dementia is a group of symptoms that mark a decline in how you communicate, think, and remember things. Some people with dementia may feel agitated, meaning that they’re anxious or restless. Celexa may be prescribed to treat agitation caused by dementia. However, the Food and Drug Administration (FDA) hasn’t approved this use, so the use would be considered off-label.

For study results of Celexa for agitation caused by dementia, see the “Celexa uses” section above.

If you or a loved one has dementia and are thinking about taking Celexa, talk with your doctor. They can help you weigh the pros and cons of the medication and decide on the best treatment options.

Can I take pain medications like Tylenol while I’m using Celexa?

Yes. You can take over-the-counter pain relievers such as Tylenol during your Celexa treatment.

However, Celexa, like other antidepressants, may increase your risk of bleeding. So if you’re taking Celexa, be sure to check with your doctor before taking any pain medication. This includes nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve). These medications may also increase your risk of bleeding.

Can I take Xanax for anxiety if I take Celexa?

Yes. If you’re taking Celexa, you can also use medications known as benzodiazepines to treat anxiety. Some benzodiazepines include:

  • alprazolam (Xanax)
  • lorazepam (Ativan)
  • clonazepam (Klonopin)

However, you should be cautious about driving or operating machinery until you know how these drugs affect you. Both Celexa and benzodiazepines can affect your central nervous system and cause drowsiness, clouded thinking, or dizziness. So taking these medications together may increase your risk for these side effects.

If you’re taking Celexa and have questions about treatments for anxiety, talk with your doctor.

If I have trouble sleeping while I’m taking Celexa, can I take supplements like melatonin?

It’s best to talk with your doctor first. Studies haven’t been done to see how Celexa interacts with supplements such as melatonin. Celexa itself can make you drowsy or fatigued (lacking energy).

Before taking other medications or supplements, be sure to talk with your doctor and understand how Celexa is affecting you.

Can I use Celexa if I have heart problems?

Yes. However, if you have heart problems, your doctor may monitor you more closely or choose other medications to treat your depression. This is because Celexa can increase the risk of palpitations (feeling of skipped or extra heartbeats), abnormal heart rhythms, and bleeding.

And if you’re taking other drugs that can cause heart-related side effects, your doctor may recommend a medication other than Celexa. So before you start Celexa treatment, be sure to share a list of all of your medications and supplements with your doctor.

This drug comes with several precautions.

FDA warning: Suicide and antidepressant drugs

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

According to short-term studies, antidepressants such as Celexa may increase the risk of suicidal thinking and behavior in people younger than age 25 years. This includes children, adolescents, and young adults. (Celexa isn’t approved to treat children.) Keep in mind that depression and some other psychiatric disorders can also increase your risk for suicidal thoughts and behavior.

If you’re taking Celexa and notice a change in your mood or behavior, or have thoughts about harming yourself, tell your doctor right away. Your loved ones should watch for these signs, too. It’s important to stay in touch with your doctor throughout your treatment so they can track your progress and response to the medication.

Other precautions

Before taking Celexa, talk with your doctor about your health history. Celexa may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Seizures. If you have a history of seizures, taking Celexa may increase your risk for seizures.However, studies haven’t shown a direct link between Celexa and seizures. If you’ve had a seizure in the past, tell your doctor before taking Celexa. They can help find the right treatment for you.
  • QT prolongation and torsades de pointes. If you have a heart rhythm condition such as QT prolongation or torsades de pointes, taking Celexa may cause heart-related side effects. These can include dizziness and fainting. During your Celexa treatment, your doctor will monitor you closely for side effects. And in some cases, they may choose to prescribe a different medication for your depression.
  • Bipolar depression. Taking Celexa when you have bipolar depression may increase your risk for mania or hypomania (racing thoughts or periods of high energy). Bipolar depression is a mental health condition in which you have extreme shifts in energy and mood. Before you take Celexa, your doctor may screen you for bipolar depression. To learn more, see the “Celexa uses” section above.
  • Angle-closure glaucoma. Celexa can cause your pupils to expand, and this can cause an attack of angle-closure glaucoma if you already have the condition. Before you take Celexa, your doctor may want you to be screened for this type of glaucoma. Based on the results, they can suggest whether Celexa or another medication is right for you.
  • Bleeding problems. Celexa can increase your risk for bleeding, especially when you take other medications that also increase this risk. (To learn more, see the “Celexa interactions” section above.) If you have a bleeding problem, tell your doctor before taking Celexa so they can review your medications.
  • Low sodium levels. If you have hyponatremia (low sodium levels), taking Celexa may lower these levels further. So during your Celexa treatment, your doctor will likely monitor your sodium levels to help make sure they’re in a healthy range.
  • Pregnancy. It’s unclear if Celexa is safe to use during pregnancy. For more information, please see the “Celexa and pregnancy” section above.
  • Breastfeeding. It’s not known if Celexa is safe to take while breastfeeding. For more information, please see the “Celexa and breastfeeding” section above.

Note: For more information about the potential negative effects of Celexa, see the “Celexa side effects” section above.

Using more than the recommended dosage of Celexa can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • dizziness
  • sweating
  • tachycardia (fast heart rate)
  • confusion
  • sleepiness
  • changes in heart rhythm

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Celexa from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Celexa tablets at room temperature (77°F/25°C) in a tightly sealed container away from light. Avoid keeping this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Celexa and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

The Food and Drug Administration (FDA) has approved Celexa for the treatment of depression in adults (ages 18 years and older). There are several off-label uses of Celexa that have varying levels of evidence behind them.

Mechanism of action

Celexa is a selective serotonin reuptake inhibitor (SSRI) that blocks neuronal reuptake of serotonin in the central nervous system, increasing available serotonin concentrations. Celexa exists as a racemic mixture, and most of its serotonin-related activity is thought to be due to its S-enantiomer (S-citalopram or “escitalopram“). Celexa has little impact on dopamine and norepinephrine receptors.

Pharmacokinetics and metabolism

Celexa reaches peak blood concentrations about 4 hours after dosing. Steady-state concentrations are expected after about 1 week. Elimination half-life is about 35 hours.

In clinical trials, Celexa had longer half-lives in older adults and was found in higher concentrations in this population. For these reasons, a maximum dose of 20 mg/day is recommended in patients older than age 60 years.

Hepatic metabolism is the primary mechanism for Celexa’s breakdown and subsequent elimination. The maximum recommended dose of Celexa in people with liver impairment is 20 mg/day.

Celexa is metabolized primarily by CYP2C19 and in part by CYP3A4. Most clinically significant changes occur through augmentation of the CYP2C19 pathway. Poor metabolizers of CYP2C19 should receive a maximum dose of 20 mg of Celexa due to increased risk for QT prolongation and torsades de pointes with increased drug concentrations observed in people with certain polymorphisms.

Contraindications

Patients taking Celexa should avoid monoamine oxidase inhibitors (MAOIs). At least 2 weeks should elapse after a person stops Celexa prior to taking an MAOI. The two treatments should not overlap at any time as this increases the risk of serotonin syndrome.

Concomitant use of pimozide and Celexa places the patient at risk for serious cardiac side effects such as QT prolongation or arrhythmias.

Celexa is contraindicated in people who have had a hypersensitivity (allergic) reaction to citalopram or any inactive ingredients in Celexa in the past.

Storage

Celexa should be stored at room temperature 77°F (25°C). However, excursions from 59°F to 86°F (15°C to 30°C) are allowed.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.