Citalopram

DEA Class;  Rx

Common Brand Names; Celexa

Hypersensitivity

Coadministration with pimozide

• Dry mouth (20%)
• Nausea (21%)
• Somnolence (18%)
• Insomnia (15%)
• Xerostomia (20%)
• Increased sweating (11%)
• Tremor (8%)
• Diarrhea (8%)
• Ejaculation disorder (6%)
• Rhinitis (5%)
• Upper respiratory infection (5%)
• Dyspepsia (5%)
• Fatigue (5%)
• Vomiting (4%)
• Anxiety (4%)
• Anorexia (4%)
• Abdominal pain (3%)
• Agitation (3%)
• Impotence (3%)
• Sinusitis (3%)
• Dysmenorrhea (3%)
• Decreased libido (2%)
• Yawning (2%)
• Arthralgia (2%)
• Myalgia (2%)
• Amenorrhea (>1%)
• Confusion (>1%)
• Cough (>1%)
• Flatulence (>1%)
• Increased saliva (>1%)
• Migraine (>1%)
• Orthostatic hypotension (>1%)
• Paresthesia (>1%)
• Polyuria (>1%)
• Pruritus (>1%)
• Rash (>1%)
• Tachycardia (>1%)
• Weight change (>1%)

Pregnancy: Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn, or PPHN (see Pregnancy)

Neonates exposed to SNRIs/SSRIs late in third trimester: Risk of complications such as feeding difficulties, irritability, and respiratory problems

Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 years)

Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

Risk of hyponatremia, abnormal bleeding (increased if concomitant aspirin, NSAIDs, or anticoagulants, or hemorrhagic diathesis), and impairment of cognitive and motor functions

Risk of serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions have been reported with SSRIs alone or with concomitant use of serotonergic drugs, with drugs that impair metabolism of serotonin, or with antipsychotics or other dopamine antagonists

Activation of mania/hypomania has been reported; use caution when treating patients with history of mania

Increased risk of bone fractures reported with antidepressant use; use caution; consider possibility of fracture it patient presents with bone pain

May cause or exacerbate sexual dysfunction

Use caution when treating patients with history of seizure disorder

Rare cases of hyponatremia and development of SIADH reported with either SSRI or SNRI use

Consider risk of serotonin syndrome if administered concomitantly with other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort

Not recommended in patients with uncompensated heart failure

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy

There are reports of breastfed infants exposed to this drug experiencing irritability, restlessness, excessive somnolence, decreased feeding, and weight loss