Celexa

Overview of Celexa Drug

Many people are experiencing various mental disorders, the most common reason is stress. There is a constant feeling of sadness and loss of interest in activities that are related to their life. This mental condition is called depression. Buy Celexa online to fight against this mental condition.

Celexa is a prescription medicine and an antidepressant medication. It is used to treat depression and MDD (major depressive disorder) in adults. Citalopram HBr (hydrobromide) is a generic variant and an active ingredient as well, which is sold under the brand name, Celexa. It is approved by the U.S. FDA (Food and Drug Administration) to treat depression.

Mechanism of Action of Celexa Medication:

The mechanism of this drug is not clear yet. This drug contains Citalopram HBr which belongs to the class of drugs known as SSRIs (selective serotonin reuptake inhibitors). Depression disorder is generally caused due to low levels of neurotransmitters such as serotonin or norepinephrine. 

Serotonin is a neurotransmitter that is responsible for exchanging messages between the central nervous system (CNS) and all over the body. It affects emotion, mood, and sleep in a person. After passing the message, serotonin gets reabsorbed by the nerve cells, which is called reuptake. 

SSRIs are antidepressants, and after taking Celexa, it inhibits or prevents the reuptake of serotonin. This allows more serotonin to transmit the message between the brain and the body. 

Dose and Dosage Strength of Celexa Medicine:

This anti-anxiety medicine is available in the form of an oral tablet and an oral solution. The dosage strength is as follows:-

• 10 mg
• 20 mg
• 40 mg

The initial dose starts with 20 mg, once a day. It can be consumed on an empty stomach or with food. The strength of the dose can adjust after 7 days of the treatment by a healthcare provider.

For patients who are above the age of 60 years (geriatric), the recommended dose is 20 mg.

Uses of Celexa Drug:

1) Prescribed-form Use

• Depression:- It is a prescription-only drug that also acts as an antidepressant. It is mainly used to treat depression, which may vary from mild to severe. 

2) Off-label Use (Non-prescribed)

• Social Anxiety Disorder (SAD):- This medication is used to treat SAD, which is also known as social phobia. It is the condition in which an individual feels fear, embarrassment, and anxiety during social interaction. This causes anxiety due to fear of situations, such as being judged and humiliated by others.
• Obsessive-compulsive disorder:- It is a behavioral disorder in which there is a pattern of unwanted or intrusive thoughts that become obsessions and this leads to repetitive behavior, which is called compulsion.

3) Other Use

• Generalized anxiety disorder (GAD):- It is a condition in which a person gets worried about situations and issues that occur in their daily life.

Side Effects of Celexa:

Common Side effects

• Feeling sleepy (drowsiness)
• Decrease appetite
• Dry mouth
• Nose bleeding
• Blurry vision
• Constipation
• Sweating
• Nausea
• Feeling weak
• Heavy bleeding during menstruation
• Diarrhea
• Sexual problem
• Sore throat
• Lightheaded (woozy)
• Trouble sleeping (insomnia)
• Frequently passing urine
• Feeling Thirsty
• Feeling shaky (tremors)
• Weight loss

Serious Side Effects:

• Palpitation (irregular heartbeat)
• Abnormal muscle movement like twitching and stiffness (seizures)
• Twitching (contraction of muscles)
• Hallucination
• Low coordination
• Feeling fainting (dizziness)
• Unstoppable bleeding from gums, vagina, and nose
• Vomiting
• Allergic reaction
• Difficulty in breathing
• Feeling restless and being talkative
• Confusion
• Forgetfulness (brain fog)
• Depression
• Suicidal thoughts

Note: There is a risk of suicidal thoughts and behavior in adults who are above the age of 25 years. Celexa drug has a boxed warning by the U.S. Food and Drug Administration (FDA). It is not approved for children.

Safety Measures:

• Never abruptly stop taking the medicine due to its withdrawal symptoms like headache, mood swings, difficulty in sleeping, feeling sluggish, etc.
• To prevent nausea, it is recommended to take this drug without food. This is because the absorption of the medicine will not increase after taking food.
• Due to drug interaction, it is advised not to take this drug with other centrally-acting medications.
• Alcohol consumption is not recommended while taking the drug.
• Inform your doctor before symptoms get worse.
• This medicine should not be taken before getting a prescription from a healthcare professional.
• Do not take Celexa, if you have used MAO inhibitor (monoamine oxidase) (used to treat depression) within 14 days. It may cause a fatal reaction.

Check 1: Is this the right indication?

Celexa has one FDA-approved use: major depressive disorder in adults. Prescribers commonly use it off-label for generalized anxiety, panic disorder, OCD and social anxiety, since SSRIs as a class are first-line for these conditions. Off-label use is legal and common, but the label’s dosing and trial data are for depression.

Celexa is not approved for anyone under 18. If the goal is an SSRI with a pediatric anxiety approval, escitalopram (Lexapro) is approved for generalized anxiety from age 7.

For an SSRI that works on anxiety without the dependence risk of benzodiazepines, see Xanax vs. Celexa.

Check 2: Is the dose within the ceiling?

• Usual start: 20 mg once daily, morning or evening, with or without food
• Increase: to 40 mg after at least one week if needed
• Maximum: 40 mg/day. Higher doses add QT risk without meaningful added benefit for depression, per the FDA.

The 20 mg ceiling. These patients should not exceed 20 mg/day:

Check 3: Is the heart rhythm safe?

This is what sets citalopram apart from most other SSRIs. In 2011, the FDA announced that citalopram causes dose-dependent QT interval prolongation, a change in the heart’s electrical cycle that can trigger a dangerous rhythm called torsade de pointes. In 2012 it revised the advice to the 40 mg cap and the 20 mg groups above. See the FDA safety communication.

Avoid Celexa, or use only with ECG monitoring, with:

• Congenital long QT syndrome
• Slow heart rate (bradycardia)
• Recent heart attack or uncompensated heart failure
• Low potassium or magnesium (correct these before starting)
• Other drugs that prolong QT (e.g., some antipsychotics, some antibiotics like azithromycin and moxifloxacin, ondansetron, methadone, antiarrhythmics)

Report right away: fainting, a racing or pounding heartbeat, or sudden dizziness.

Check 4: What else is on the medication list?

Check 5: Is the patient in a higher-risk group?

• Under 25: closer monitoring for new or worsening suicidal thoughts, especially in the first few months and after dose changes (boxed warning).
• Bipolar disorder: an SSRI alone can trigger mania. Screen for personal or family history before starting.
• Older adults: risk of low sodium (hyponatremia). Watch for headache, confusion, weakness or unsteadiness.
• Narrow-angle glaucoma: SSRIs can trigger an acute angle-closure attack in people with untreated narrow angles.
• Seizure disorder: use with caution.
• Pregnancy: third-trimester exposure is linked to neonatal adaptation problems and a small increased risk of persistent pulmonary hypertension of the newborn (PPHN). This should be weighed against the real risks of untreated depression in pregnancy. It’s a decision for the prescriber and patient together.
• Breastfeeding: citalopram passes into breast milk. Watch the infant for drowsiness and poor feeding.

Check 6: Does the patient know what the first weeks look like?

Most people starting an SSRI expect it to work like a painkiller. It doesn’t.

• Week 1–2: side effects often show up before benefits: nausea, loose stools, sweating, dry mouth, tiredness or trouble sleeping. These usually ease.
• Week 2–4: sleep, energy and appetite often improve first.
• Week 4–8: mood and anxiety improvement becomes clearer. The label’s trials measured response over 4–6 weeks.
• After response: guidelines generally advise continuing for at least 6–12 months after a first episode of depression is in remission, to reduce relapse.

Sexual side effects (lower libido, delayed ejaculation or orgasm) are common with all SSRIs and under-reported. Patients should know they can bring this up.

Citalopram and escitalopram: One molecule, two mirror images

Citalopram is a racemic mixture: equal parts two mirror-image forms of the same molecule, the S-form and the R-form. Nearly all of the antidepressant effect comes from the S-form, which is escitalopram (Lexapro). The R-form contributes little benefit.

That’s why roughly 20 mg of citalopram ≈ 10 mg of escitalopram, and why the two are never taken together. Escitalopram also shows less QT prolongation at usual doses, which is part of why some prescribers prefer it. Compare the two on the Lexapro page.

Stopping Celexa: The FINISH checklist

Celexa isn’t addictive, but stopping suddenly can cause SSRI discontinuation syndrome. Clinicians remember the symptoms with FINISH:

• Flu-like symptoms: fatigue, aches, sweating
• Insomnia and vivid dreams
• Nausea
• Imbalance: dizziness, vertigo
• Sensory disturbances: “brain zaps,” tingling
• Hyperarousal: irritability, anxiety, agitation

Because citalopram’s half-life is long (about 35 hours), symptoms tend to be milder than with paroxetine (Paxil). Still, the label advises a gradual dose reduction rather than stopping abruptly.

FDA Boxed Warning: Suicidal Thoughts and Behaviors. Antidepressants increased the risk of suicidal thoughts and behaviors in children, adolescents and young adults (under 25) in short-term studies. Everyone starting an antidepressant should be watched for worsening depression, unusual changes in behavior, or suicidal thoughts, especially during the first few months and after dose changes. Celexa is not approved for pediatric patients. If you are in the US and in crisis, call or text 988.

FAQ

Is Celexa a controlled substance?

No. Unlike benzodiazepines such as Xanax, citalopram isn’t scheduled by the DEA and doesn’t cause a “high.” It can still cause discontinuation symptoms if stopped suddenly.

Does Celexa cause weight gain?

Modest weight changes are possible in either direction. Short-term, some people lose a little weight from nausea. With long-term use, gradual weight gain is reported in some patients. See Antidepressants That Cause Weight Loss for how SSRIs compare.

Can I take Celexa in the morning or at night?

Either. It’s once daily, with or without food. If it makes you sleepy, take it at night. If it keeps you awake, take it in the morning.

Why won’t my doctor go above 40 mg?

Because of the FDA’s QT warning. Above 40 mg, heart-rhythm risk rises without meaningful extra benefit. If 40 mg isn’t enough, the usual next step is switching or adding a medication, not raising the dose.