WARNING

Citalopram is a commonly prescribed antidepressant medication that belongs to the class of selective serotonin reuptake inhibitors (SSRIs). While it can be effective in treating depression and anxiety disorders, it also carries certain risks and side effects:

• Side Effects: Common side effects include nausea, dry mouth, drowsiness, insomnia, and increased sweating. These usually lessen over time as your body adjusts to the medication.
• Suicidal Thoughts: In some cases, especially in younger adults, citalopram and other SSRIs may increase suicidal thoughts, particularly at the start of treatment or when doses are adjusted. This risk should be monitored closely by healthcare providers.
• Serotonin Syndrome: This is a rare but serious condition that can occur when there is too much serotonin in the body. Symptoms include confusion, hallucinations, rapid heartbeat, high blood pressure, fever, sweating, shivering, trembling, muscle twitching, and in severe cases, loss of consciousness or death. It’s crucial to seek immediate medical attention if you experience these symptoms.
• Withdrawal Symptoms: Stopping citalopram suddenly can lead to withdrawal symptoms such as dizziness, nausea, headache, fatigue, and irritability. It’s important to taper off the medication under medical supervision to minimize these effects.
• Interactions with Other Medications: Citalopram can interact with other medications, including other antidepressants, blood thinners, and certain pain medications. These interactions can increase the risk of side effects or reduce the effectiveness of either medication.
• Long-term Effects: There are concerns about potential long-term effects on bone health, although more research is needed to fully understand this risk.
• Birth Defects: There is a slight increase in the risk of certain birth defects when citalopram is taken during pregnancy. The decision to use antidepressants during pregnancy should involve careful consideration and consultation with healthcare providers.

It’s essential to discuss these risks and benefits with a healthcare provider before starting citalopram or any other antidepressant medication. They can help weigh the potential risks against the benefits based on your individual health situation.

Why is this medication prescribed?

Citalopram is prescribed primarily for the treatment of depression and certain anxiety disorders. Here’s why it is prescribed and how it should be used:

• Depression: Citalopram is effective in treating major depressive disorder (MDD), which is characterized by persistent feelings of sadness, loss of interest or pleasure in daily activities, and other symptoms that affect how you feel, think, and handle daily activities.
• Anxiety Disorders: It is also used to treat various anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (social phobia), panic disorder, and obsessive-compulsive disorder (OCD).

How should this medicine be used?

Here’s how citalopram is typically used:

• Dosage: The typical starting dose of citalopram for adults is 20 mg once daily, usually taken in the morning or evening. Your healthcare provider may adjust the dose based on your response to the medication.
• Administration: Citalopram is usually taken orally, with or without food. It’s important to take it exactly as prescribed by your doctor to achieve the best results.
• Duration: Treatment with citalopram is usually long-term, as discontinuing the medication abruptly can lead to withdrawal symptoms. Your doctor will monitor your progress regularly and may adjust your dose as needed.
• Response Time: It may take several weeks before you notice the full benefits of citalopram. It’s important to continue taking it even if you feel well, unless your doctor advises otherwise.
• Special Instructions: If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
• Discontinuation: When stopping citalopram, your doctor will typically taper the dose gradually to reduce the risk of withdrawal symptoms.
• Medical Monitoring: Regular visits to your healthcare provider are important to monitor your progress and adjust the treatment plan as needed.
• Side Effects: Be aware of potential side effects and report any new or worsening symptoms to your doctor promptly.
• Interactions: Inform your doctor about all other medications, supplements, and herbal products you are taking, as they may interact with citalopram.

Always follow your doctor’s instructions carefully regarding the use of citalopram to ensure safe and effective treatment for your condition.

Other uses for this medicine

Besides treating complicated intra-abdominal infections (cIAI) and complicated urinary tract infections (cUTI), Ceftolozane and Tazobactam Injection may also be used for other serious bacterial infections when the infecting organisms are susceptible to this medication. These could include infections like hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and infections caused by multidrug-resistant bacteria such as Pseudomonas aeruginosa.

What special precautions should I follow?

When taking citalopram, it’s important to follow these precautions:

• Suicidal Thoughts: Like other antidepressants, citalopram may increase the risk of suicidal thoughts and behaviors, especially in young adults under 24 years old. Close monitoring is crucial, especially when starting or changing the dosage.
• Serotonin Syndrome: This is a potentially life-threatening condition characterized by agitation, hallucinations, fast heart rate, fever, excessive sweating, shivering, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. It can occur if citalopram is taken with other medications that increase serotonin levels (such as other SSRIs, SNRIs, or MAO inhibitors).
• Withdrawal Symptoms: Abruptly stopping citalopram can lead to withdrawal symptoms such as dizziness, nausea, headache, irritability, and sleep disturbances. It’s important to taper off the medication gradually under medical supervision.
• Drug Interactions: Citalopram can interact with other medications, including certain antibiotics, antifungals, antiarrhythmics, and drugs metabolized by the liver enzymes CYP2C19 and CYP3A4. Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
• Pregnancy and Breastfeeding: The safety of citalopram during pregnancy and breastfeeding is not well-established. It may pose risks to the fetus or newborn, so its use should be carefully considered and monitored by healthcare professionals.
• Medical Conditions: Inform your doctor if you have any medical conditions, particularly liver or kidney problems, seizures, bipolar disorder, or a history of bleeding disorders, as these may affect your ability to take citalopram safely.

Always follow your doctor’s instructions and never adjust your dosage without consulting them first. They can provide personalized advice based on your medical history and current health status.

What special dietary instructions should I follow?

There are no specific dietary restrictions for citalopram. However, maintaining a healthy diet and avoiding excessive alcohol consumption is generally recommended for overall health and well-being.

What should I do if I forget a dose?

If you miss a dose of citalopram, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

What side effects can this medication cause?

Citalopram, like all medications, can cause side effects. These side effects can vary in severity and frequency among individuals. Common side effects of citalopram include:

• Nausea: Feeling sick to your stomach or the urge to vomit.
• Dry Mouth: A lack of saliva in the mouth, which can make it feel sticky or uncomfortable.
• Drowsiness or Fatigue: Feeling unusually tired or lacking energy.
• Insomnia: Difficulty falling asleep or staying asleep.
• Increased Sweating: Experiencing more sweating than usual, especially at night.
• Tremors: Shaking or trembling, particularly in the hands.
• Loss of Appetite: Decreased desire to eat, which can lead to weight loss.
• Sexual Problems: Such as decreased sexual desire or difficulty achieving orgasm.

Less common side effects may include:

• Headache: Pain or discomfort in the head or scalp.
• Dizziness: Feeling lightheaded or unsteady on your feet.
• Agitation or Anxiety: Feeling restless, nervous, or on edge.
• Digestive Issues: Such as diarrhea or constipation.
• Blurred Vision: Difficulty seeing clearly.
• Muscle Aches or Weakness: Pain or discomfort in muscles, or feeling physically weak.
• Serious Side Effects: While rare, citalopram can cause serious side effects such as serotonin syndrome (symptoms include confusion, hallucinations, rapid heartbeat, high blood pressure, fever, sweating, shivering, trembling, muscle twitching), allergic reactions (rash, itching/swelling, severe dizziness, trouble breathing), and changes in heart rhythm (including QT prolongation).

It’s important to note that not everyone will experience these side effects, and some individuals may experience different or additional side effects. If you notice any unusual symptoms or changes in your health while taking citalopram, it’s important to notify your healthcare provider promptly. They can help determine whether the side effects are manageable or if adjustments to your treatment plan are necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Citalopram:

• Storage: Store citalopram at room temperature, away from moisture and heat. Avoid storing it in the bathroom. Keep the medication in its original packaging or container to protect it from light.
• Disposal: Dispose of any unused citalopram properly according to local regulations or guidelines. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Proper disposal helps prevent accidental ingestion by pets, children, or others.

In case of emergency/overdose

• Emergency: If you suspect an overdose or have accidentally taken too much citalopram, call emergency medical services (911 in the US) or your local poison control center immediately.
• Symptoms of Overdose: Symptoms of citalopram overdose may include dizziness, nausea, vomiting, rapid heartbeat, sweating, tremors, confusion, seizures, and loss of consciousness. Seek medical attention immediately if you or someone else may have overdosed on citalopram.

What other information should I know?

• Regular Monitoring: Your healthcare provider will likely monitor your progress regularly while taking citalopram. This may include assessing your response to the medication and checking for any side effects.
• Follow-Up Appointments: Attend all scheduled appointments with your doctor. This allows them to adjust your treatment plan as needed and address any concerns you may have.
• Avoid Abrupt Discontinuation: Do not stop taking citalopram suddenly without consulting your doctor. Abrupt discontinuation can lead to withdrawal symptoms such as dizziness, nausea, headache, fatigue, and irritability.
• Inform Healthcare Providers: Make sure all healthcare providers (doctors, dentists, pharmacists) are aware that you are taking citalopram. This includes informing them about all other medications, supplements, or herbal products you are using to prevent interactions.
• Patient Education: Educate yourself about citalopram and its potential side effects. Be proactive in monitoring your own health and reporting any new or worsening symptoms to your doctor.
• Lifestyle Considerations: Maintain a healthy lifestyle with regular exercise, a balanced diet, and adequate sleep. Avoid excessive alcohol consumption and smoking, as these can affect how citalopram works.
• Support Systems: If you experience emotional or psychological distress while taking citalopram, seek support from friends, family, or mental health professionals. Therapy or counseling may complement medication in managing depression or anxiety.

Always follow your doctor’s instructions and guidance regarding the use of citalopram to ensure safe and effective treatment for your condition.