Citalopram

Conditions Treated

Citalopram is used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

Possible Side Effects

What Side Effects Can This Cause?

Citalopram may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• diarrhea
• vomiting
• stomach pain
• drowsiness
• excessive tiredness
• uncontrollable shaking of a part of the body
• excitement
• nervousness
• muscle or joint pain
• dry mouth
• excessive sweating
• changes in sex drive or ability
• loss of appetite

Some side effects can be serious. If you experience either of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• seeing things or hearing voices that do not exist (hallucinating)
• fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
• seizures

Citalopram may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Usage Instructions

How Should This Medication Be Used

Citalopram comes as a tablet and a solution (liquid) to take by mouth. It is usually taken once a day with or without food. Take citalopram at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take citalopram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of citalopram and gradually increase your dose, not more often than once a week. It may take 1 to 4 weeks before you feel the full benefit of citalopram. Continue to take citalopram even if you feel well. If you suddenly stop taking citalopram, you may experience withdrawal symptoms such as mood changes,irritability, agitation, dizziness, numbness or tingling in the hands or feet, anxiety, confusion, headache, tiredness, and difficulty falling asleep or staying asleep. Do not stop taking citalopram without talking to your doctor. Your doctor will probably decrease your dose gradually.

What Dietary Instructions Should I Follow

Unless your doctor tells you otherwise, continue your normal diet.

Are There Any Special Instructions

Before taking citalopram, tell your doctor and pharmacist if you are allergic to citalopram, escitalopram (Lexapro), or any other medications. tell your doctor if you are taking pimozide (Orap) or a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take citalopram. If you stop taking citalopram, you should wait at least 14 days before you start to take an MAO inhibitor. you should know that citalopram is very similar to another SSRI, escitalopram (Lexapro). You should not take these two medications together. tell your doctor and pharmacist what other prescription and nonprescription medications and vitamins you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); other antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); carbamazepine (Tegretol); cimetidine (Tagamet); ketoconazole (Nizoral); linezolid (Zyvox); lithium (Eskalith, Lithobid); medications for anxiety, mental illness, Parkinson's disease, and seizures; medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); metoprolol (Lopressor, Toprol XL); sedatives; sibutramine (Meridia); sleeping pills; tramadol (Ultram); and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor what nutritional supplements and herbal products you are taking, especially products that contain St. John's wort or tryptophan. tell your doctor if you have recently had a heart attack and if you have or have ever had seizures or liver, kidney, or heart disease. you should know that citalopram may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. remember that alcohol can add to the drowsiness caused by this medication.