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All You Need to Know About Citalopram Tablets!

About Citalopram Tablets

Citalopram (Citalopram Hydrobromide), an FDA-approved prescription medication, is specifically designed to alleviate depression in adults. It is particularly effective in managing major depressive disorder (MDD). Belonging to a category of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), Citalopram Hydrobromide works by augmenting the levels of serotonin in the brain. Serotonin is a crucial neurotransmitter responsible for regulating mood and emotional stability. Citalopram is available in various strengths, including 10mg, 20mg, and 40mg, catering to different individual needs & treatment plans. So, if you want to buy Citalopram Hydrobromide to treat depression, you need to get a prescription from your healthcare giver.

What Are Citalopram Tablets?

Citalopram Hydrobromide, an SSRI antidepressant, is employed in the medical treatment of depression. It functions by augmenting the levels of serotonin, a neurotransmitter associated with mood regulation, in the brain. This elevation in serotonin helps to alleviate symptoms of depression and improve overall mood. Citalopram is available in tablet form in dosages of 10 mg, 20 mg, and 40 mg, and the dose typically starts at 20 mg per day for adults, with adjustments made based on therapeutic response and side effects.

The medication carries a boxed warning from the FDA, highlighting the increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during initial treatment or when changing doses. Furthermore, Citalopram can cause significant alterations in heart rhythm, such as QT prolongation, necessitating caution in patients with existing heart conditions. Interactions with other medications are a considerable concern with Citalopram. It should not be combined with MAOIs, drugs that increase serotonin (like certain pain relievers and other antidepressants), or medications that influence heart rhythm because of the potential for life-threatening side effects such as serotonin syndrome or severe heart-related effects. Other drugs that may interact with Citalopram include those that increase bleeding risks and those that induce drowsiness.

Given these considerations, it is crucial for patients to have a comprehensive discussion with their healthcare provider about all current medications, over-the-counter drugs, and supplements they are taking. This ensures the safe and effective use of Citalopram, with careful monitoring for any adverse effects or interactions. Regular follow-ups to assess the effectiveness and tolerability of the medication are also vital to achieving the best possible treatment outcomes.

Uses of Citalopram Hydrobromide

  • Citalopram Hydrobromide is used to treat depression.

How to Use Citalopram Hydrobromide Tablets?

Dosage

It is available in the form of an oral tablet and has the following strengths:

  • 10 mg 
  • 20 mg 
  • 40 mg

Recommended Dosage for Different Patients

Adults (18 to 60 Years)

  • Initial dose: 20 mg once daily. Your doctor may adjust the dose, but not more than once weekly.
  • Maximum dose: 40 mg once daily. Do not exceed 40 mg daily to avoid increased risk of QT prolongation.

Children (0 to 17 Years) 

  • Safety and efficacy are not established for individuals under 18 years.

Seniors (61 Years and Older)

  • Maximum dose: 20 mg once daily. Due to potential changes in kidney function, older adults may metabolize the drug more slowly, increasing the risk of side effects. Your doctor may initiate a lower dose or alter the dosing schedule to prevent excessive drug accumulation.

[Note: These recommendations may vary from person to person. Discuss them with your doctor, and they’ll customize your Citalopram Hydrobromide dosage accordingly.]

How to Take It?

  • Read the medication guide and patient information leaflet from your pharmacist. Ask your doctor or pharmacist if you have any questions.
  • Take the medication with or without food as told by your doctor.
  • Usually, take it once daily, either in the morning or evening.
  • Your doctor will decide the right dose based on your condition, age, lab tests, and other medicines you use.
  • Tell your doctor about all the medicines you use, including prescriptions, over-the-counter drugs, and herbs.
  • Your doctor might start you with a low dose to reduce side effects. Follow your doctor’s instructions precisely.
  • Don’t increase the dose or use it more often or longer than prescribed. Taking it regularly helps you get the most benefit.
  • Try to take it at the same time every day to remember.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Citalopram Hydrobromide Work?

Citalopram belongs to a class of antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs). This group of drugs works in a similar way and is commonly used to treat similar conditions. SSRIs function by increasing the levels of a chemical called serotonin in your brain. Higher serotonin levels can help alleviate symptoms of depression.

Important Safety Information

Side Effects

Common side effects of Citalopram Hydrobromide may include:

  • Trouble sleeping
  • Sexual problems
  • Dizziness
  • Weakness
  • Nausea
  • Anxiousness
  • Sweating
  • Shaking
  • Hunger
  • Dry mouth
  • Constipation
  • Diarrhea
  • Respiratory infections
  • Yawning
  • Sleepiness

Serious side effects of Citalopram Hydrobromide include:

  • Attempts or contemplation of suicide
  • Acting impulsively on dangerous urges
  • Displaying aggression or violence
  • Persistent thoughts of suicide or death
  • Intensified feelings of depression or anxiety
  • Restlessness, irritability, or anger
  • Difficulty in sleeping
  • Chest discomfort
  • Irregular heartbeats (fast or slow)
  • Breathlessness
  • Dizziness leading to fainting spells
  • Agitation, hallucinations, or confusion
  • Coordination issues or muscle spasms
  • Rapid heartbeat or fluctuations in blood pressure
  • Sweating or fever
  • Gastrointestinal disturbances such as nausea, vomiting, or diarrhea
  • Muscle stiffness
  • Heightened energy levels
  • Severe insomnia
  • Racing thoughts
  • Engaging in reckless behaviors
  • Grandiose ideas
  • Unusual euphoria or irritability
  • Convulsions
  • Sudden collapses or loss of muscle control
  • Brief lapses in awareness of surroundings
  • Involuntary release of urine or feces
  • Eye discomfort
  • Blurry or double-vision
  • Swelling or redness around the eyes
  • Headaches
  • Weakness or unsteadiness
  • Cognitive issues such as confusion, concentration difficulties, or memory lapses

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

Warnings

  • Heart Rhythm Changes Warning: Citalopram may cause changes in heart rhythm, known as QT prolongation or Torsade de Pointes, which can lead to sudden death.
  • Warning Against Taking This Medication with MAOIs: Do not take a monoamine oxidase inhibitor when you are on Citalopram or within 2 weeks of stopping Citalopram unless your doctor specifically instructs you to do so. Similarly, do not start taking Citalopram within 2 weeks of stopping an MAOI. Using Citalopram and an MAOI too close in time can result in a life-threatening condition known as serotonin syndrome. Symptoms of serotonin syndrome include high fever, stiff muscles, uncontrolled muscle spasms, rapid changes in heart rate or blood pressure, confusion, or fainting.
  • Warning Against Taking Pimozide: Do not take Citalopram if you are taking Pimozide. Combining these medications can lead to serious heart problems.

Boxed Warning

  • Risk of Suicidal Thoughts: Citalopram carries a boxed warning, the most severe cautionary label issued by the Food and Drug Administration (FDA). These warnings are designed to inform healthcare providers and patients about the potentially dangerous effects of the drug. It’s important to note that Citalopram use may heighten the risk of suicidal thoughts or actions in certain children, teenagers, or young adults, particularly during the initial months of treatment or when dosage adjustments are made. Actively monitor for any changes in mood, behavior, actions, thoughts, or feelings, especially if they are sudden or severe, and promptly contact your doctor if you observe any such alterations.

Precautions

  • Allergic Reactions: Citalopram carries a significant allergy warning, as it can trigger severe allergic reactions. Symptoms may be apparent as difficulty breathing, swelling of the face, eyes, tongue, or mouth, and skin reactions such as itchy welts (hives), rash, or blisters, sometimes accompanied by fever or joint pain. 
  • Alcohol: Avoid consuming alcohol while taking this medication. Citalopram has the potential to induce drowsiness and impair cognitive functions such as decision-making, clarity of thought, and reaction times. Drinking alcohol can exacerbate these effects.
  • Heart Conditions: Avoid taking Citalopram if you have any heart issues, including congenital long QT syndrome. This medication could heighten the risk of a dangerous heart rhythm alteration known as QT prolongation, potentially leading to sudden death. Individuals with a slow heart rate, recent heart attack, or severe heart failure should also refrain from using Citalopram.
  • Low Potassium Levels: If you have low potassium levels, steer clear of Citalopram. Combining this medication with low potassium levels may elevate the risk of QT prolongation and subsequent sudden death due to heart rhythm abnormalities.
  • Low Magnesium Levels: Individuals with low magnesium levels should avoid Citalopram. Concurrent use of Citalopram and low magnesium levels may heighten the risk of QT prolongation, potentially leading to sudden death due to abnormal heart rhythms.
  • Kidney Disease: Consult your doctor before using Citalopram if you have kidney disease. This medication may accumulate in the body, causing increased side effects, particularly in those with severe kidney impairment.
  • Liver Disease: Citalopram undergoes liver processing. If you have liver disease, the levels of this medication in your body may rise, leading to heightened side effects. Individuals with liver disease should not exceed a daily dosage of 20 mg of Citalopram.
  • Seizure Disorder History: Individuals with a history of seizure disorder should discuss the use of Citalopram with their doctor, as it may increase the risk of seizures.

Other Important Precautions

  • Pregnancy: Citalopram is classified as a Category C drug for pregnancy. This classification indicates two key points. One is that animal studies have shown adverse effects on the fetus when the mother uses the drug. Another is that insufficient research has been done in humans to determine the exact effect of the drug on the fetus. If you are pregnant or planning to become pregnant, it is crucial to discuss the use of Citalopram with your doctor. This drug should only be used if the potential benefits outweigh the potential risks to the fetus.
  • Breastfeeding: Citalopram is known to pass into breast milk and may cause side effects in a breastfed child. If you are breastfeeding, consult with your doctor to make an informed decision on whether to continue breastfeeding or discontinue the medication.
  • Use in Children: In children and adolescents, Citalopram may affect appetite or weight. It is important to monitor height and weight regularly during treatment with Citalopram to manage any potential changes effectively.

Contraindications 

  • The close temporal proximity of Citalopram and an MAOI could precipitate a serious condition known as serotonin syndrome, characterized by symptoms such as high fever, uncontrolled muscle spasms, stiffness, sudden fluctuations in heart rate or blood pressure, confusion, or loss of consciousness. 
  • Combining Citalopram and pimozide may lead to severe cardiac issues.

Missed Dose

  • For Citalopram to be effective, it must be present in your body at a consistent level. If you miss a dose, take it as soon as you remember. If it’s just a few hours before your next scheduled dose, skip the missed Citalopram tablets dose and take only the next regularly scheduled dose. Do not take two doses at the same time to make up for a missed dose, as this could lead to dangerous side effects.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose 

An overdose of Citalopram can lead to symptoms of serotonin syndrome, which is a serious medical condition. Symptoms may include:

  • Hallucinations
  • Agitation
  • Confusion
  • Coma
  • Coordination problems
  • Racing heartbeat
  • Muscle twitching
  • Sweating
  • Nausea
  • Fever
  • Vomiting
  • Muscle rigidity
  • Diarrhea

If you experience any of these symptoms, it is crucial to contact your doctor immediately or seek urgent medical attention by going to the nearest emergency department. Prompt treatment is essential.

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

  • Store Citalopram tablets at room temperature, ideally at 77°F (25°C). 
  • Temporarily, the tablets can be kept at temperatures ranging from 59°F to 86°F (15°C to 30°C).
  • Avoid exposing the medication to high temperatures.
  • Do not store Citalopram in moist or damp areas, such as bathrooms, as this can affect the medication.
  • Keep the bottle tightly closed to protect the tablets from air and moisture.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Citalopram Hydrobromide Interactions

Citalopram oral tablets can interact with other medications, vitamins, or herbs you might be using. An interaction occurs when a substance affects how a medication functions, which can be harmful or stop the medication from working properly.

To avoid interactions, it is important that your doctor manages all of your medications carefully. Make sure to inform your doctor about all the medications, vitamins, or herbs you are taking. To learn more about how Citalopram might interact with other substances you are using, consult your doctor or pharmacist. Below is a list of drugs that are known to interact with Citalopram.

Drugs That Increase Serotonin Levels: When taken with other medications that elevate serotonin in your body, Citalopram can lead to a potentially life-threatening condition known as serotonin syndrome. This risk is particularly high when starting a new drug or after increasing the dosage of an existing one. Below are examples of drugs that can cause increased serotonin levels and may interact with Citalopram:

  • Buspirone
  • Lithium
  • Medications for Migraines (Triptans):
    • Almotriptan
    • Sumatriptan
    • Zolmitriptan
  • St. John’s Wort
  • Tramadol
  • Amphetamines:
    • Lisdexamfetamine
    • Amphetamine
    • Dextroamphetamine
  • Linezolid
  • Fentanyl
  • Methylene Blue
  • Monoamine Oxidase Inhibitors (MAOIs):
    • Selegiline
    • Isocarboxazid
    • Tranylcypromine
    • Phenelzine
  • Tricyclic Antidepressants:
    • Imipramine
    • Amitriptyline
    • Nortriptyline

Drugs That Affect Heart Rhythm: Citalopram should not be used in conjunction with other medications that influence your heart rhythm. Combining Citalopram with these drugs can increase your risk of experiencing dangerous changes in heart rhythm. Examples of drugs that can affect heart rhythm and may interact with Citalopram include:

  • Chlorpromazine
  • Amiodarone
  • Methadone
  • Quinidine
  • Thioridazine
  • Pentamidine
  • Moxifloxacin
  • Procainamide
  • Sotalol
  • Pimozide

Drugs That Increase Bleeding Risk: Citalopram, like other antidepressants, may increase your risk of bleeding or bruising. This risk is heightened if you are also taking medications known to increase bleeding. Here are examples of other drugs that can elevate your bleeding risk:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
    • Ibuprofen
    • Ketorolac
    • Naproxen
  • Aspirin
  • Blood Thinners:
    • Enoxaparin
    • Heparin
    • Warfarin
    • Dalteparin

Tricyclic Antidepressants (TCAs): Caution is advised when using Citalopram in combination with tricyclic antidepressants (TCAs). This interaction can lead to higher levels of TCA in your body, increasing the risk of side effects. Examples of tricyclic antidepressants include:

  • Nortriptyline
  • Imipramine
  • Amitriptyline

Drugs That Cause Sedation or Drowsiness: Taking Citalopram may amplify the effects of medications that cause sedation or drowsiness. This can increase your risk of excessive sleepiness or reduced alertness. Here are some examples of drugs known for their sedative effects that may interact with Citalopram:

  • Diazepam
  • Lorazepam
  • Alprazolam
  • Midazolam
  • Zolpidem
  • Temazepam

Cytochrome P450 2C19 Inhibitors: Cytochrome P450 2C19 is an enzyme in your body that helps metabolize various drugs, including Citalopram. Some medications can inhibit or slow down the activity of this enzyme. When Citalopram is taken with drugs that inhibit Cytochrome P450 2C19, it can lead to higher levels of Citalopram in your body, potentially increasing the risk of side effects. Examples of drugs that inhibit Cytochrome P450 2C19 include:

  • Chloramphenicol
  • Clopidogrel
  • Fluvoxamine
  • Cimetidine
  • Modafinil
  • Omeprazole

[Note: This isn’t a complete list, and there could be other drugs that interact with Citalopram Hydrobromide. Tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Citalopram Hydrobromide Alternatives

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

What does Citalopram do to the brain?

Citalopram is a type of medication known as a selective serotonin reuptake inhibitor (SSRI). It is believed to work by boosting serotonin levels in the brain. This increase happens because Citalopram stops the nerve cells in the brain from reabsorbing serotonin once it has been released, which helps more serotonin to be available. This action is thought to contribute to enhancing mood and emotion. Citalopram is commonly prescribed along with talking therapies to treat various mental health conditions.

How do we know if Citalopram is working?

You may not see immediate effects from Citalopram, as it typically takes 4 to 6 weeks to start noticing improvements in your symptoms. The most significant results often appear within 8 to 12 weeks. If you do not feel better after 3 months, or if your symptoms worsen, it’s important to communicate this to your doctor. They can help you assess the effectiveness of the treatment and consider any necessary adjustments to your medication regimen.

Can I stay on Citalopram for life?

Whether you can stay on Citalopram for life depends on your individual circumstances and the advice of your doctor. Typically, once you start feeling better, it is common to continue taking Citalopram for several more months to ensure the stability of your improvements. Most doctors suggest that antidepressants like Citalopram should be taken for at least 6 months to a year after symptoms have improved. This duration helps prevent the recurrence of depression. Stopping the medication too early can lead to a relapse. Long-term use beyond this period may be considered based on your health needs, under close medical supervision.

Who cannot take Citalopram?

Certain people should avoid taking Citalopram due to potential health risks:

  • Individuals with heart issues – Citalopram may cause a faster heartbeat or an irregular heartbeat (arrhythmia), which can be dangerous for those with pre-existing heart conditions.
  • Those who are pregnant or trying to become pregnant and breastfeeding mothers – The effects of Citalopram on the fetus or newborn through breastfeeding are a concern, so it’s important to discuss potential risks with a doctor.
  • People with glaucoma – Citalopram can increase the pressure inside the eye, which could worsen this condition.

If you fall into any of these categories, it’s crucial to consult with your healthcare provider before starting Citalopram to discuss safe and effective alternatives.

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