Celexa Side Effects: The generic name of Celexa is Citalopram. (See Citalopram side effects) Celexa is in the antidepressant and anti-anxiety class of medications referred to as selective serotonin reuptake inhibitors(SSRI). Prescriptions can be in doses of 10, 20, and 40 mg tablets as well as a liquid solution of 10mg/5ml. Maximum recommended dose is 40 mg daily.  This maximum daily dosage is a new recommendation by the FDA after learning that higher doses previously approved may lead to cardiac arrythmias.

Black Box Warnings: Celexa may lead to an increased the risk of suicide in young persons, from children, through adolescence and into young adulthood. Celexa is not approved for use in children. Persons with depression and other psychiatric disorders have a higher rate of suicide, and all these patients need to be closely monitored and watched for more severe depression, and behavior change or thoughts of suicide. (see manufacturer labeling for details)

Common Celexa Side Effects: Celexa side effects are largely those of the whole group of antidepressant medications referred to as serotonin reuptake inhibitors or SSRIs. These medications all have a lot more similarities than they have differences, and most of the side effects of Celexa are really the typical side effects of all SSRI drugs. Delayed or total inability to have orgasm is the most frequent and bothersome of the side effects of the SSRIs in the experience of most prescribing physicians. Although the package labeling states this incidence is only about 6 percent, it certainly seems much higher in the experience of most clinicians. This is particularly a problem for females, but is also a common side effect for males. Orgasm during sexual intercourse may at times be so difficult or take so long that it just becomes impractical or impossible for some SSRI users. This Celexa side effect usually doesn’t ease over time, and can be so annoying that some patients elect not to continue the medications. Additional frequent SSRI side effects that are also seen as Celexa side effects include weight gain, nausea, decreased libido (sex drive), fatigue, excess sleepiness or difficulty sleeping , and excessive sweating or yawning.

Serious Celexa Side Effects: Suicide and suicidal ideation is the most important serious Celexa side effect, but is not common in adults over the age of 25. More severe symptoms of depression and revealing the mania of previously undiagnosed bipolar disorder are additional very serious Celexa side effects and the other SSRIs. Three additional serious but quite uncommon Celexa side effects include serotonin syndrome, neuroleptic malignant syndrome and extrapyramidal symptoms. Serotonin syndrome typically shows itself with symptoms of confusion, sweating, irregular heart rate, fever and severe muscle pain or stiffness. It can be life threatening, and is usually seen when Celexa is used with a second drug that also increases central nervous system serotonin levels. Potential other drugs include another SSRI or other drug that raises serotonin levels directly and medications that lead to increased serum concentrations of Celexa, typically by competing for the hepatic P450 enzymes that are needed to metabolize the drug.

Very unusual but potentially serious Celexa side effects include epileptic seizures, hyponatremia (low serum sodium levels), protracted erections called priapism, low blood sugar called hypoglycemia, anaphylactic atopic reactions, SIADH, and several neonatal syndromes in newborns in which Celexa is used in pregnancy.

Celexa has a modestly long half-life for an selective serotonin reuptake inhibitor. The longer the half-life of an SSRI the less likely a patient is to have a significant SSRI withdrawal syndrome that affects some patients if the medication is stopped suddenly. The SSRI withdrawal syndrome or discontinuation syndrome is quite common in patients who stop medications like citalopram suddenly. The typical syndrome is fairly minor, and may be called a lightheadedness or odd feeling in the head, like the brain moves a little bit more slowly than the rest of the head. A smaller number of patients complain of sharp electrical type of pains in the head or neck. These sensations typically stop after a few days and usually seem more annoying than severe for many patients, though in a low percentage of Celexa users they are can cause a good deal of distress. Most prescribing clinicians encourage Celexa patients to gradually wean off the medication. This is more important if using near maximum doses, so that patients can lower their chances of symptoms of SSRI discontinuation syndrome.

Contraindications, Cautions and Drug Interactions:  Many drugs have the possibility of drug interaction with Celexa. Celexa is absolutely contraindicated with Non-selective MAO inhibitors, linezolid, primozide, and thioridazine. The list of other drugs with potential for problems when used with Celexa is extensive, and purposely only a few of the more common or important interactions are listed here.  Refer to the manufacturer’s prescribing guidelines for complete details, and for specific medication issues consult your pharmacist or doctor.  Use of lisinopril is to be avoided if possible with the clarithromycins (Biaxin), with class 1a and 3 antiarrhthmics, with methodone, with all of the other SSRIs as well as St. John’s Wort, and with the SNRIs.  Modification of treatment may be needed with carvedilol, the thiazide diuretics, and with any other drugs with serotonergic effects.

Pregnancy and Lactation Class: Pregnancy Category C. Lactation safety unknown.

Special Considerations: As with all SSRIs abrupt discontinuation should be avoided to minimize the SSRI discontinuation syndrome. Most of the side effects of Celexa are common in all or most of the other drugs in the SSRI category.

Off Label Use for Premature Ejaculation:  Physicians often take advantage of Celexa side effects of delayed ejaculation in male patients with premature ejaculation. All of this is not FDA approved use it is fairly common practice to use Celexa or others of the SSRI class of medications with some degree of success. Some men with premature ejaculation when treated with Celexa are able to have more satisfactory duration of stimulation prior to ejaculation. For best help with this most physicians feel that daily use of Celexa is needed rather than simply taking a dose prior to this desired side effect. Justice some men find this a very annoying a Celexa side effect others find taking advantage of the sexual dysfunction Celexa side effects very helpful.

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