Celexa (citalopram hydrobromide) is a selective serotonin reuptake inhibitor (SSRI) prescription medication approved by the FDA for the treatment of major depressive disorder (MDD) in adults. As a well-established antidepressant, it works by increasing serotonin activity in the brain, which helps restore chemical balance and improve mood, energy levels, and interest in daily life. Clinical studies and extensive post-marketing experience have demonstrated its efficacy and generally favorable tolerability profile when used as directed under medical supervision.

Features

• Active ingredient: Citalopram hydrobromide
• Drug class: Selective serotonin reuptake inhibitor (SSRI)
• Available as scored tablets: 10 mg, 20 mg, 40 mg strengths
• Also available as oral solution (10 mg/5 mL)
• Bioavailability: Approximately 80%
• Half-life: Approximately 35 hours
• Time to peak plasma concentration: 2–4 hours post-dose
• Metabolism: Primarily hepatic via CYP3A4 and CYP2C19 enzymes

Benefits

• Effectively reduces symptoms of depression, including low mood, loss of interest, and fatigue
• Helps restore emotional balance and improves overall quality of life
• Generally well-tolerated with a lower incidence of certain side effects compared to older antidepressants
• Once-daily dosing convenience supports treatment adherence
• Non-sedating profile allows for daytime use without significant drowsiness
• Established safety profile with decades of clinical use and monitoring

Common use

Celexa is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It may also be used off-label for other conditions under physician guidance, though such uses lack formal FDA approval. These may include certain anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, or obsessive-compulsive disorder (OCD), when determined appropriate by a healthcare provider based on individual patient assessment and clinical judgment.

Dosage and direction

The recommended starting dosage for most adults is 20 mg once daily, with or without food. Depending on individual response and tolerability, the dosage may be increased to a maximum of 40 mg daily after at least one week. Dose adjustments should only be made under medical supervision. For elderly patients or those with hepatic impairment, the maximum recommended dose is 20 mg daily due to reduced clearance. Tablets should be swallowed whole with water; the oral solution should be measured carefully using the provided device. Therapeutic effect may take 1–4 weeks to become apparent, and full benefits may require several weeks of continuous treatment.

Precautions

Patients should be monitored closely for clinical worsening, suicidality, or unusual changes in behavior, especially during the initial months of therapy or following dosage changes. Celexa may cause activation of mania/hypomania in patients with bipolar disorder. Use with caution in patients with a history of seizures. SSRI treatment may increase the risk of bleeding events, particularly when used concomitantly with NSAIDs, aspirin, or other drugs that affect coagulation. Discontinuation symptoms may occur if stopped abruptly; gradual tapering is recommended under medical supervision. Patients should be advised regarding the potential for impaired judgment, thinking, or motor skills and cautioned about operating hazardous machinery until they know how Celexa affects them.

Contraindications

Celexa is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI treatment due to risk of serotonin syndrome. Concomitant use with pimozide is contraindicated due to dose-dependent QTc prolongation. Contraindicated in patients with known hypersensitivity to citalopram or any component of the formulation. Not recommended for use in patients with congenital long QT syndrome, bradycardia, recent acute myocardial infarction, or uncompensated heart failure due to risk of QTc prolongation.

Possible side effects

Common side effects (≥5% incidence) include: nausea, dry mouth, somnolence, insomnia, increased sweating, fatigue, and ejaculation disorder. Less common but potentially serious adverse reactions include: serotonin syndrome, abnormal bleeding, hyponatremia, angle-closure glaucoma, QT interval prolongation, and activation of mania/hypomania. Sexual dysfunction including decreased libido, orgasm dysfunction, and erectile dysfunction may occur. Weight changes (both gain and loss) have been reported. Most side effects are dose-dependent and may diminish with continued treatment.

Drug interaction

Celexa has significant interactions with MAOIs (risk of serotonin syndrome), other serotonergic drugs, drugs that prolong QT interval (including certain antiarrhythmics, antipsychotics, and antibiotics), and CYP2C19 inhibitors (e.g., omeprazole). Concurrent use with NSAIDs, aspirin, or warfarin may increase bleeding risk. May increase levels of metoprolol and certain tricyclic antidepressants. Use with caution with other CNS depressants. CYP3A4 inducers may decrease citalopram concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is close to the time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling doses to make up for a missed dose is not recommended. Patients should contact their healthcare provider if multiple doses are missed or if they have questions about dosing.

Overdose

Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, sinus tachycardia, and in severe cases, QT prolongation, torsades de pointes, seizures, coma, or serotonin syndrome. There is no specific antidote for citalopram overdose. Management involves supportive care and symptomatic treatment. Gastric lavage may be considered if presented early. ECG monitoring is recommended for at least 24 hours due to risk of QT prolongation. Activated charcoal may be administered if appropriate.

Storage

Store at controlled room temperature 20°C–25°C (68°F–77°F). Keep in original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Properly dispose of any unused medication after the expiration date or when treatment is completed. Do not flush medications down the toilet or pour into drainage unless specifically instructed to do so.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Celexa is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to treatment may vary. Patients should not make any changes to their medication regimen without consulting their prescribing physician. The complete prescribing information should be consulted before initiating therapy.

Reviews

Clinical trials have demonstrated Celexa’s efficacy in treating major depressive disorder, with response rates significantly higher than placebo. Many patients report improved mood, energy, and functionality after several weeks of treatment. Some users note initial side effects that often diminish over time. Healthcare providers generally regard Celexa as a well-tolerated SSRI option with a established efficacy profile. However, individual experiences vary, and some patients may require alternative treatments or dosage adjustments. Patient satisfaction often correlates with adequate dosing duration and appropriate management of side effects.