Citalopram

Citalopram, commonly sold under the brand name Celexa, is a type of prescription medication called a selective serotonin reuptake inhibitor (SSRI) that we use to treat various mental health conditions, including depression.

Serotonin is a natural substance in the brain that produces a feeling of mental wellbeing and helps maintain mental balance. We use SSRIs to help balance the serotonin levels in your brain—increasing those levels can improve your mood. Serotonin is one of the major chemical messengers (neurotransmitters) used to carry a signal from one brain cell to another.

Citalopram produces more serotonin, which can help your brain grow new cells and form stronger connections. This type of drug also blocks neurons from reabsorbing serotonin, which means more serotonin is available to help transmit messages between neurons.

Antidepressants like citalopram may also help grow cells in an important part of your brain that regulates mood. This region of the brain is called the dorsolateral prefrontal cortex (DLPFC). When cells in this region are activated, they can help regulate mood, memories, anxiety, anger, and fear.

We may prescribe citalopram if you’ve been diagnosed with major depressive disorder (MDD), which is also known as clinical depression. If you’re new to this medication or medical treatment for MDD, don’t worry—your Brightside team will work with you through every step to make sure the treatment is right for you.

Some providers may use citalopram to treat other conditions, including:

• Alcoholism
• Eating disorders, including binge eating
• Generalized anxiety disorder (GAD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (PMDD)
• Social phobia or social anxiety disorder

At Brightside, our psychiatric providers specialize in personalizing treatment for each patient. We give you the personal attention and expert advice you deserve and can count on—we explain all your options and use our expertise to find the medication that’s right for you. It’s important to us that you understand how medications work and what to expect so that your treatment is worry-free.

Taking citalopram can help improve your low mood and keep you from feeling sad, empty, or tearful. It can also help with troublesome thoughts that don’t go away on their own.

Citalopram can also help you with:

• Eating more or less than usual
• Fatigue
• Feeling bad about yourself
• Feeling hopeless, worthless or helpless
• Having little energy
• Little interest or pleasure in doing things
• Moving or speaking slowly
• Restless or fidgety
• Sleeping too much
• Suicide or self-harm thinking
• Trouble concentrating

Brightside providers have an in-depth knowledge of the strengths and drawbacks of each medication. You’ll get all the information you need to make an informed choice about your treatment.

We understand that you may have a lot of questions about starting a new medication and whether it will work or help you feel better. You’re not alone; many patients feel the same way.

There are many different factors that influence how well you respond to a medication. Keep in mind that some medications work better for certain people than others, and that’s because each person is different—genetics, age, and gender, among other differences—all affect how someone responds to treatment. Other factors such as underlying health conditions, other medications, and dietary considerations can also play a role in how a medication works.

Remember, your response to citalopram may be different from someone else’s response
At Brightside, we can help you find the right medication to help you feel better.
Before starting any new medication like citalopram, you should get a comprehensive health assessment from a provider who understands your health history. You should only take citalopram if a qualified psychiatric provider prescribed it for you.

It can take three to four weeks before you start feeling the effects of citalopram. We understand that this can feel like a long time, but it’s important to continue taking the medication, even if you don’t feel improvement right away. In some cases, your provider may need to adjust the dosage for you to get the maximum benefit. At Brightside, our board-certified providers will closely monitor your progress to make sure this medication and dosage are right for you.

If you ever have questions about your medication or need to meet with a provider to talk about your treatment—don’t wait. Your board-certified Brightside provider will keep a close eye on your progress and make any appropriate adjustments to ensure your medication and dosage offer you the best results. We also offer telehealth services and provider consultations that can be scheduled within 48 hours.

If you have concerns about how long you’ll need to take citalopram, don’t hesitate to talk to your Brightside provider. The amount of time you take an antidepressant will depend on your treatment plan—which varies based on your symptoms and how you respond to the medication. Some people may only need to take citalopram for a few months, while others may stay on it for several years.

Once you start taking citalopram, you may need to stay on it for a minimum of six months. If this is your first time receiving treatment, you may need to stay on the treatment for six to 12 months. Remember that you may need to take citalopram for a longer amount of time if you need to switch doses or medications. Some people—particularly those with recurrent, persistent, and treatment-resistant depression—may also require longer treatment.

Your Brightside provider will work with you to determine what course of treatment is best for your specific needs. Most importantly, we recommend that you keep taking your medication until your provider says it’s time to stop—even after you start to feel better.

Studies have shown that antidepressants relieve symptoms of depression about 40-60% of the time and additional treatments (such as therapy and lifestyle improvements) on top of medication often lead to the best outcomes.

To get the best results with medication, it’s important to consistently measure progress during treatment. This is known as Measurement Based Care, and it’s the approach we use at Brightside. It’s common to adjust the dose and/or medication when starting antidepressants until you find just the right fit.

Citalopram is a safe and helpful antidepressant, but it’s important to keep in mind that its effectiveness varies from person to person.

A 10-year review of citalopram studies showed that it was as effective as other antidepressant medications and SSRIs.

According to the U.S. Food and Drug Administration (FDA), trials have shown that citalopram is effective in treating depression. The positive response was seen for up to six months after an initial treatment phase of six to eight weeks.

We know that you may be concerned about the side effects of citalopram, but this medication won’t change your personality. The goal of this treatment is to help you feel better—like yourself again—and restore your mental health. But remember, it doesn’t happen overnight. Keep taking your medication as prescribed, and talk to your provider if you have any questions or concerns.

Citalopram is generally a safe medication when used as prescribed by a board-certified provider. However, it’s important to talk with your Brightside provider about the potential side effects of this medication and to review any side effect warnings from the FDA. Your Brightside team will work to minimize your side effects as much as possible, so you can focus on feeling better and improving your mental wellbeing.

There are some common side effects associated with citalopram, which are temporary and manageable. These can include:

• Change in sex drive or ability
• Constipation
• Decreased appetite
• Diarrhea
• Dry mouth
• Excessive fatigue
• Frequent urination
• Heartburn
• Heavy menstrual periods
• Loss of appetite 
• Muscle or joint pain
• Nausea
• Stomach pain
• Uncontrollable shaking
• Vomiting
• Weakness
• Weight loss
• Yawning

In rare cases, citalopram can also cause severe side effects. Call a provider right away if you experience:

• Chest pain
• Confusion
• Difficulty breathing
• Difficulty concentrating or memory problems
• Difficulty swallowing
• Dizziness
• Excessive sweating
• Excessive itching
• Fainting
• Fast or irregular heartbeat
• Feeling unsteady
• Fever
• Hallucinations
• Headache
• Hives 
• Hoarseness 
• Loss of consciousness
• Rash
• Seizures
• Shortness of breath
• Stiff or twitching muscles
• Swelling of the face, throat, lips, tongue, or eyes
• Swelling of the lower legs, including the ankles and feet
• Unusual bruising or bleeding

At Brightside, your health and safety are our highest priorities. We make sure you get individual attention and guidance to make sure you feel your best.

At Brightside, we prescribe citalopram to help you feel better. And when it does, some people think they’re ready to stop taking it. But, in most cases, citalopram is part of what’s causing those good feelings—stopping your medication could bring symptoms back. That’s why it’s necessary to continue taking it.

If you’re concerned about continuing to take citalopram or you want to make any changes, talk to your provider first. Antidepressants are not physiologically or psychologically addictive, but they can cause a discontinuation syndrome if stopped abruptly.

Discontinuation syndrome is a consequence of abruptly stopping certain types of antidepressants––particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). 

It can include a range of symptoms that may occur in patients who suddenly stop their SSRIs or SNRIs. These are the most common symptoms of discontinuation syndrome:

• Feeling anxious
• Feelings of vertigo
• Odd sensory symptoms, such as tingling feelings in the skin or what some people describe as a “zapping” sensation in the brain
• Trouble sleeping

Talk to your provider before stopping or changing how you take your medication so that they can create a plan that gives your body enough time to adjust. This will keep you feeling well and prevent symptoms from returning.

If you are pregnant or plan to become pregnant, you should talk to your provider before making any changes to your medication. At Brightside, we can also help you weigh the pros and cons of continuing your medication while pregnant.

Some SSRIs like citalopram may contribute to complications such as low birth weight and premature delivery (delivery before 37 weeks of pregnancy). Although there is minimal risk of birth defects, there may be safer ways to manage your symptoms while you’re pregnant.

It’s also important to talk to your provider if you plan to breastfeed, as citalopram can pass into breast milk. You and your provider can come up with a plan to manage your symptoms and feed your baby safely.

Citalopram is not addictive and is not a controlled substance, but if you have concerns about your dependence on this medication, don’t hesitate to talk to your Brightside provider.

You can view the FDA black box warning for citalopram here. If you have questions about whether the black box warning for citalopram applies to you, please talk to your provider.