Citalopram

How to use

Citalopram should be taken orally, once a day, usually in the morning or the evening. You can take this medication with or without food. Follow the directions of your doctor exactly, even if this differs from the usually recommended dosage. Your doctor will determine the dose most effective for you, depending on your condition and response to treatment. It is usually prudent to start treatment at a low dose and then gradually increase it. Take this medication regularly to enjoy its full benefits and try to take it a approximately the same time each day. Keep taking this medication even if you feel well. Some conditions may grow worse if treatment is stopped abruptly. Talk to your doctor if you want to stop taking this medication so he can decrease your dosage gradually.

If you have been taking Citalopram for a long time or in high dosages, you may experience withdrawal symtpoms when you stop treatment. These symptoms may include:

• Nervousness
• Headache
• Numbness
• Tingling
• Trouble sleeping
• Nightmares

Reduce your dosage gradually to prevent these withdrawal reactions from occurring. If you do experience any of the above symptoms, you should contact your doctor straightaway.

Overdose

If you suspect you have taken too much of Citalopram, you should contact your local poison control center or the emergency medical services immediately.

Missed dose

If you miss a dose of Citalopram, take it as soon as you remember. If it is nearly time for your next dosage, skip the missed dose, then resume your usual schedule. Do not double up on this medication to make up for a missed dose.

Notes

When taking Citalopram, you should go for regular medical and psychiatric check-ups to chart your progress and make sure you do not suffer from any negative side effects. Make sure you do not miss any of these appointments.

Do not share this medication with others, since they may have a problem that is not effectively treated by Citalopram. 

Storage

Store Citalopram at room temperature between 59 and 86 degrees F (15-30 degrees C ) and away from light and moisture. KEEP THIS AND ALL MEDICATIONS OUT OF REACH OF CHILDREN.

Important note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician or  other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate or effective for you. Consult your healthcare professional before using this drug.

Precautions

Before taking Citalopram, let your doctor know if you have or ever had any of the following medical conditions:

• Any allergies
• Personal or family history of psychiatric disorders (e.g. bipolar/manic-depressive disorder)
• Personal or family history of suicide attempts
• Bleeding problems
• Liver diseases
• Seizures
• Severe kidney diseases
• Stomach bleeding
• Severe loss of body water (dehydration)
• Low sodium in the blood (hyponatremia)

If you have any of the above conditions, you may not be able to take Citalopram or you may need a dosage adjustment.

Citalopram may cause dizziness or drowsiness. It is therefore not recommended to drive or operate heavy machinery until you are sure you can perform these activities safely.

Caution is advised when elderly people take this medication as they may be more sensitive to the side effects of Citalopram. The elderly are more likely to lose too much salt (hyponatremia), especially if they are taking this medication in combination with diuretics.

Citalopram is classes as Pregnancy Category C, which means it may cause harm to an unborn baby. It is not recommended to take this medication while pregnant. However, depression can be a dangerous disease if left untreated, so talk to your doctor if you are currently pregnant or planning to become pregnant during treatment and he will weigh up the risks and benefits of taking this medication.

Babies born to mothers who used Citalopram during the last 3 months of pregnancy, may in rare cases develop withdrawal symptoms, such as:

• Feeding or breathing difficulties
• Seizures
• Muscle stiffness
• Constant crying

Inform your doctor promptly if you notice any of the above symptoms in your baby.

Citalopram passes into breast milk and may harm a nursing infant. It is not recommended to take this medication while breastfeeding. Talk to your doctor first.

Drug Interactions

 
Before taking Citalopram, inform your doctor of all other prescription and non-prescription medication you use, including:

• MAO inhibitors (e.g. Furazolidone, Isocarboxazid, Linezolid, Moclobemide, Phenelzine, Procarbazine, Rasagiline, Selegiline, Tranylcypromine) for 2 weeks before treatment, during treatment, or for 2 weeks after your last dose of Citalopram
• Pimozide
• Tryptophan
• Weight loss medication (e.g. Sibutramine, Phentermine)
• Cimetidine
• Metoprolol
• Diuretics such as Furosemide
• Medication that can cause bleeding or bruising (e.g. Aspirin, antiplatelet drugs such as Clopidogrel, NSAIDs such as Ibuprofen or blood thinners such as Heparin or Warfarin
• Buspirone
• Dextromethorphan
• Lithium
• Meperidine
• Propoxyphene
• Phentermine
• Other SSRIs (e.g. Paroxetine)
• SNRIs (e.g. Duloxetine)
• Tryptophan
• St. John's wort
• Medication used to treat migraines such as triptans and Dihydroergotamine
• Street drugs such as MDMA or ecstasy
• Amphetamines
• Certain antihistamines (e.g. Diphenhydramine)
• Anti-seizure drugs (e.g. Carbamazepine)
• Medicine for sleep or anxiety (e.g. Lorazepam, Zolpidem)
• Muscle relaxants
• Narcotic pain relievers (e.g. Codeine)
• Psychiatric medicines (e.g. Chlorpromazine, Quetiapine, Nortriptyline, Trazodone)
• Medication containing ingredients that make you drowsy

This is only a partial list and there may be other medication that interacts with Citalopram. Let your doctor know of all other prescription and non-prescription medication you use, including herbal pills, vitamins, minerals, dietary supplements and medication prescribed by other doctors. Do not start or stop taking any medication without your doctor's approval.

The following common side effects of Citalopram may occur:

• Nausea
• Dry mouth
• Trouble sleeping
• Loss of appetite
• Weakness
• Tiredness
• Drowsiness
• Dizziness
• Increased sweating
• Blurred vision
• Yawning

Notify your doctor straightaway if any of these side effects persist or worsen.

Inform your doctor immediately if you experience any of the following unlikely but serious side effects:

• Unusual or severe mental or mood changes (e.g. nervousness, unusual high energy/excitement, rare thoughts of suicide)
• Shakiness (tremor)
• Decreased interest in sex
• Changes in sexual ability

Tell your doctor straightaway if you notice any of these rare but very serious side effects:

• Stomach pain
• Fainting
• Bloody, black or tarry stools
• Vomit that looks like coffee grounds
• Easy bruising or bleeding
• Muscle weakness or cramps
• Seizures
• Fast, irregular or pounding heartbeat
• Difficulty urinating
• Change in the amount of urine

In rare cases, Citalopram may cause a very serious condition called Serotonin Syndrome. This risk increases if you mix this medication with others, such as:

• Triptans used to treat migraine headaches (e.g. Sumatriptan, Eletriptan)
• Certain antidepressants including other SSRIs (e.g. Fluoxetine, Paroxetine)
• SNRIs (e.g. Vnlafaxine)
• Lthium
• Tamadol
• Typtophan
• A certain medication to treat obesity (Sibutramine)

Before taking Citalopram, inform your doctor if you are also taking any of the above medications. Seek emergency medical help if you develop any of the following symptoms:

• Hallucinations
• Restlessness
• Loss of coordination
• Fast heartbeat
• Severe dizziness
• Unexplained fever
• Severe nausea, vomiting or diarrhea
• Twitchy muscles

In rare cases, some men may experience a painful or prolonged erection (that lasts more than 4 hours). If this happens, stop taking Citalopram immediately and seek emergency medical attention to prevent permanent damage.

It is rare to suffer an allergic reaction to this medication. However, seek emergency medical attention if you notice any of the following symptoms:

• Rash
• Itching or swelling (especially of the face, tongue or throat)
• Severe dizziness
• Trouble breathing

This is only a partial list of possible side effects and others may occur. Inform your doctor straightaway of any other side effects you encounter, especially if they are bothersome.