Celexa (citalopram HBr)
FDA ALERT Suicidal Thoughts or Actions in Children and Adults
Patients with depression or other mental illnesses often think about or attempt suicide. Closely watch anyone taking antidepressants, especially early in treatment or when the dose is changed. Patients who become irritable or anxious, or have new or increased thoughts of suicide or other changes in mood or behavior (or their care givers) should contact their healthcare professional right away.
Taking antidepressants may increase suicidal thoughts and actions in about 1 out of 50 people 18 years or younger. Although citalopram is prescribed for children, FDA has not approved citalopram for use in children.
Several recent scientific publications report the possibility of an increased risk for suicidal behavior in adults who are being treated with antidepressant medications. Even before these reports became available, FDA began a complete review of all available data to determine whether there is an increased risk of suicidal thinking or behavior in adults being treated with antidepressant medications. It is expected that this review will take a year or longer to complete. In the meantime, FDA is highlighting that adults being treated with antidepressant medication, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior.
This information reflects FDA’s preliminary analysis of data concerning this drug. FDA is considering, but has not reached a final conclusion about, this information.
What is Celexa?
Celexa (citalopram HBr) is a highly selective serotonin reuptake inhibitor (SSRI) that was approved by the FDA for the treatment of depression in July of 1998. It is a widely prescribed medication both in the United States and in many other countries around the world. Celexa was developed by the Danish pharmaceutical firm H. Lundbeck A/S and is marketed in the U.S. by Forest Laboratories.
How is Celexa different from other antidepressants?
Celexa has a chemical structure unrelated to that of other SSRIs. It is a highly selective inhibitor of serotonin reuptake with little or no affinity for other neurotransmitter receptors. Celexa may also cause less drug interactions than some other antidepressants, which could make it a good choice for medically compromised individuals such as the elderly or those with comorbid illness. Additionally, Celexa appears to be safe to use on a long-term basis and may cause less withdrawal than other antidepressants when use is stopped.
Several studies have also revealed other possible applications for this antidepressant. Celexa was shown to be effective in treating post-stroke depression and in alleviating emotional disturbances in elderly consumers with dementia disorders. Like other SSRIs, Celexa may also prove to be effective in the treatment of anxiety disorders such as panic disorder and obsessive-compulsive disorder. It is important to note that these observations are based on a few limited studies. So far, Celexa has only been approved for the treatment of depression in the U.S.
What are the side effects of Celexa?
The side effects most frequently reported with Celexa tend to be those associated with other SSRIs. However, some note these effects to be less extreme. The most commonly reported side effects are increased sweating, sleepiness, nausea, tremor, dry mouth, lack or loss of strength, headache, weight loss or gain, dizziness, and restlessness. Such adverse events usually decrease in intensity and frequency as the depressive state improves. Sexual side effects also occur, and these often do not diminish over time.
Clinical evidence also shows that Celexa is not associated with tachycardia or postural hypotension.
How does Celexa interact with other medications?
Like other SSRIs, Celexa should not be taken with monoamine oxidase inhibitors (MAOIs). Although Celexa is noted for its reduced instances of drug interactions, you should always let your doctor know what other medications you are taking.
What is the standard dosage of Celexa?
It is recommended that Celexa be administered as a single oral dose of 20 mg daily. Depending on individual patient response, this may be increased to a maximum of 60 mg daily for adults or 30 mg daily for the elderly.
For more information please contact the pharmaceutical company listed below.
Forest Pharmaceuticals, Inc.
13600 Shoreline Drive
St. Louis, MO 63045
Free or low-cost medications provided by pharmaceutical companies
Some pharmaceutical companies offer medication assistance programs to low-income individuals and families. These programs typically require a doctor’s consent and proof of financial status. They may also require that you have either no health insurance, or no prescription drug benefit through your health insurance. Please contact the pharmaceutical company directly for specific eligibility requirements and application information.
Celexa Rx Assistance Program: 1-800-851-0758
Reviewed by Jack Gorman, M.D., Chair NAMI Scientific Council, Sept 2002