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Celexa® for depression and anxiety disorders

Celexa® (Citalopram) is approved by the FDA to treat depression, but it is also prescribed to treat certain anxiety disorders and other illnesses. Citalopram (si TAL o pram) is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). They alter the levels of the neurotransmitter serotonin in the brain, which, like other neurotransmitters, helps brain cells communicate with one another.

Celexa® has been used for many years as an effective medication for relief from symptoms of depression. People with moderate to severe depression can often benefit from antidepressants, which can bring relatively quick symptom relief. Psychotherapy, in combination with medication, can help people with depression learn more effective ways to deal with life’s problems.

Celexa® is also commonly prescribed for panic disorder, OCD, PTSD, and social phobia. (but usually not for Generalized Anxiety Disorder). Anxiety disorders are generally treated with medication, specific types of psychotherapy, or both. Medications for anxiety disorders include antidepressants, anti-anxiety drugs, and beta-blockers to control some of the physical symptoms. Medication will not cure anxiety disorders, but it can keep them under control while the person receives psychotherapy.

Celexa® is sometimes used as a treatment for bipolar disorder, however many authorities on this disorder caution against treatment with antidepressants, which may induce hypomania and cycling. People being treated for depression with antidepressants who find that their symptoms are worsening may want to discuss with their doctor the possibility that they may have bipolar depression.

How to take this medication
Citalopram can be taken as a tablet or as a liquid. It is usually taken once a day with or without food. It is important to follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of citalopram and gradually increase your dose, not more than once a week.

It may take up to four weeks before you feel the full benefit of citalopram. Continue to take it even if you feel well and do not stop taking it without talking to your doctor. Stopping the medication suddenly can cause side effects. Your doctor will slowly decrease your dose.

What are possible side effects?
Citalopram may cause side effects. Some people experience only minor side effects, some find that side effects go away after a few days or weeks, some people have no side effects.

Citalopram may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. Alcohol can add to the drowsiness caused by this medication.

Tell your healthcare professional if you are or may be pregnant, and if you are or are planning to breast-feed your baby.

The most common side effects of Celexa® include nausea, drowsiness, dry mouth, changes in sex drive or ability, insomnia, sweating, tremor, diarrhea. As with most SSRIs, weight gain is a possibility. Other side effects may include diarrhea, vomiting and nervousness. Tell your doctor if any of these symptoms are severe or do not go away.

The following symptoms are uncommon, but if you experience any of them call your doctor immediately: Rare side effects may include blurred vision, confusion, fever, problems with urination, loss of memory, menstrual changes, skin rash or itching, trouble in breathing, mood changes, swelling, irregular heartbeat, thoughts of suicide, hyperactivity or agitation or seizure. Report any other unusual symptom to your doctor.

Drug interactions
Do not take citalopram if you are taking monoamine oxidase (MAO) inhibitors, including phenelzine (Nardil) and tranylcypromine (Parnate), or have stopped taking them within the past two weeks. Citalopram is very similar to another SSRI, escitalopram (Lexapro) and they should not be taken together.

If you take migraine headache medicines, ask your doctor if your medicine is a triptan. Taking Celexa® and a triptan together can result in a life-threatening condition called serotonin syndrome. Celexa® may cause bleeding problems, especially if taken with aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen), or other drugs that affect bleeding.

Other options
Generic versions of Celexa® are available. Some doctors caution that generics are not identical. One version manufactured in South Asia is regarded by some professionals to be inferior to others, especially if the patient is switching from Celexa® to this generic. They recommend the generic citalopram sold at Safeway, RiteAid and Cosco.

Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for depression and anxiety disorders. Check with your insurance company to find out. If you don’t have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Forest Laboratories, the manufacturer of Celexa®, has introduced a successor, called Lexapro, as a treatment for both depression and generalized anxiety disorder (GAD). Its patent for Celexa® expired in 2005, allowing other manufacturers to produce generic versions at a lower price.

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