Citalopram side effects, depression benefit, Celexa by Ray Sahelian, M.D.
April 8 2015

Citalopram is an antidepressant medication that affects neurotransmitters, the chemical transmitters within the brain. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Such uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves. The reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. This anti-depressant is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Citalopram was approved by the FDA in 1998 as the product name Celexa.

Citalopram side effect, is it safe?

The most common citalopram side effects are nausea, vomiting, excessive sweating, headache, tremor, and inability to sleep. A decrease in libido is another potential citalopram side effect.  In 2001 FDA warned that it can cause prolongation of the QT interval and can lead to fatal changes in the heart's rhythm. Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium in the blood.
   Doses greater than 40 milligrams a day can cause changes in the electrical activity of the heart, which can lead to abnormal heart rhythms, including a potentially deadly arrhythmia known as Torsade de Pointes.

Use with 5-HTP
L-5-Hydroxytryptophan augments the neuroendocrine response to a SSRI.
Psychoneuroendocrinology. 2006
A neuroendocrine challenge study was conducted in healthy Asian male subjects. The neuroendocrine response to oral citalopram and l-5HTP was measured primarily as the prolactin and cortisol area under the response curve (or AUC). The study comprised 2 studies: Study 1. A double blind, randomised dose ranging study was conducted with l-5HTP (50-200 mg) to explore the prolactin and/or cortisol dose response and select a dose that provided a threshold neuroendocrine response. Study 2. A randomized comparison of citalopram 20 vs 40 mg was used to assess the effect of these doses on prolactin and cortisol. Based on the results of the dose response assessments with l-5HTP and cortisol, 200 mg l-5HTP was subsequently used in Study 2 to explore the augmentation of the neuroendocrine response to 20 mg citalopram. Citalopram, but not l-5HTP, increased prolactin while 5HTP and citalopram increased cortisol. A 200 mg dose of l-5HTP significantly augmented the prolactin and cortisol response to 20mg oral citalopram. The results of the study suggest that an augmented neuroendocrine challenge may be a suitable marker to demonstrate increased 5-HT-mediated responses when exploring novel agents as improved SSRIs.

Medical use with herbal remedies
Iran Red Crescent Med J. 2013. The Effects of Lavandula Angustifolia Mill Infusion on Depression in Patients Using Citalopram: A comparison Study. This study was carried out to determine the effect of using Lavandula angustifilia infusion on depression in patients taking Citalopram. Lavandula angustifilia infusion has some positive therapeutic effects on depressed patients most importantly decreases mean depression score and might be used alone or as an adjunct to other anti-depressant drugs.

Citalopram for IBS

Treatment with so-called SSRI antidepressants seems to reduce abdominal symptoms and promote overall well being in people with irritable bowel syndrome (IBS). Ciraprolam could be considered in IBS patients who do not respond well enough to a classical treatment approach. The ability to alleviate several IBS symptoms seems unrelated to its effect on depression or anxiety.

Citalopram for Bulimia disorder

Citalopram may be useful in depressed patients with bulimia nervosa.

A Single Dose of the Selective Serotonin Reuptake Inhibitor Citalopram Exacerbates Anxiety in Humans: A Fear-Potentiated Startle Study.
Neuropsychopharmacology. 2006. Mood and Anxiety Disorders Program, National Institute of Mental Health, NIH, Bethesda, MD, USA.
Serotonin reuptake inhibitors may increase symptoms of anxiety immediately following treatment initiation. The present study examined whether acute citalopram increased fear-potentiated startle to predictable and/or unpredictable shocks in healthy subjects. Eighteen healthy subjects each received two treatments, placebo and 20 mg citalopram in a crossover design. Participants were exposed to three conditions including one in which predictable aversive shocks were signaled by a cue, a second in which unpredictable shocks were anticipated, and a third in which no shocks were administered. Changes in aversive states were investigated using acoustic startle stimuli. Citalopram did not affect baseline startle. The sustained startle potentiation in the unpredictable conditions was also increased by citalopram, but only when the drug was given during the first session. These results indicate that a single dose of citalopram is not anxiogenic in itself, but can exacerbate the expression of fear and anxiety.

Questions
Q. I was given citalopram 4 years ago by my GP. How long should I take this citalopram drug, I have never been depressed however suffer a burn-out for already 12 years. I am now 60 years old and my intuition tells me it is time to stop, because the citalopram side effects of sleepiness, tiredness and lack of concentration, head aches, lack of sexual drive have increased in the last 7 months. My medical advisers suggest nothing for they all seem to have no experience with terminating this citalopram drug, or replace it with something less damaging!!! The doses I take every day is 40 mg. Will you please help me please, the only other drug I take is Oxazepam, a relaxant which helps my muscles become less stiff. I also get very uptight, and short of breath and a tightness and pain round my chest without it oxazepam. I have tried to get off the drugs mentioned above individually, however I could not manage to be functional without either. I have lost my job and livelyhood as a result but look forward to take a little part in society again, in the last years I have.
   A. We understand the difficulty and hardship you are experiencing, however it is not our role to give individual advice. We suggest reading the information on the depression page and then discussing with your doctors the best natural option.

Q. I found your website while searching for information on low libido. I have been on and am currently on Citalopram 20 mg for depression. Back in July I had an Angiogram because my family doctor thought I had heart problems after do an EKG. I underwent stress tests at a cardiologists office and was interned that very same evening for the angiogram. That in itself was enough to give me low libido due to the invasive surgery, but ever since that procedure I have had absolutely no libido. That is really depressing me. I have been on the Citalopram for several months but I am wondering if there is anything that I have mentioned here that could be causing it.
   A. Citalopram is an antidepressant medication used to treat depression. Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). Celexa is the brand name for citalopram. This drug influences serotonin levels and serotonin has a major inhibitory effect on sexuality.

Q. Two weeks ago I began taking citalopram which my doctor had prescribed for depression. He started me out on 20 mg a day for six days, then 40 mg thereafter. The citalopram began having a positive effect on the depression after about three or four days but by day six the spasmodic tremors in my neck started getting bad again. When I increased the dose of citalopram to 40 mg the tremors in my neck became constant, violent, and unbearable. I stopped taking the citalopram three nights ago and just today spasming in my neck has begun to subside.