Celexa (citalopram hydrobromide) is a selective serotonin reuptake inhibitor (SSRI) antidepressant approved by the FDA for the treatment of major depressive disorder (MDD) in adults. As a well-established pharmacological intervention, it works by increasing serotonin activity in the brain, which helps restore chemical balance and improve mood, energy levels, and interest in daily life. Clinical evidence supports its efficacy in reducing depressive symptoms, with a generally favorable tolerability profile compared to older antidepressant classes. Proper diagnosis and prescription under medical supervision are essential for achieving optimal therapeutic outcomes.

Features

• Active ingredient: citalopram hydrobromide
• Drug class: selective serotonin reuptake inhibitor (SSRI)
• Available in 10 mg, 20 mg, and 40 mg film-coated tablets
• Oral administration, once-daily dosing
• Bioavailability approximately 80%
• Half-life of approximately 35 hours
• Hepatic metabolism via CYP3A4 and CYP2C19 enzymes

Benefits

• Reduces symptoms of depression, including low mood, loss of interest, and fatigue
• Helps restore emotional balance and improves overall sense of well-being
• Lower incidence of anticholinergic and cardiovascular side effects compared to tricyclic antidepressants
• Once-daily dosing supports treatment adherence
• Non-sedating profile for most patients, allowing daytime functionality
• Evidence-based efficacy supported by randomized controlled trials

Common use

Celexa is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It may also be used off-label for other conditions such as generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, though such use should be carefully evaluated and monitored by a healthcare professional. Treatment is typically initiated after a thorough clinical assessment confirms the diagnosis of MDD.

Dosage and direction

The recommended starting dosage for Celexa is 20 mg once daily, with or without food. Depending on individual patient response and tolerability, the dosage may be increased to a maximum of 40 mg per day after a minimum of one week. Dosage adjustments should be made under medical supervision, particularly in special populations such as the elderly or those with hepatic impairment, for whom a maximum dose of 20 mg per day is recommended. Tablets should be swallowed whole and not crushed or chewed.

Precautions

Patients should be monitored for clinical worsening, suicidality, or unusual changes in behavior, especially during the initial few months of therapy or following dosage changes. Celexa may cause activation of mania/hypomania in patients with bipolar disorder; screening for bipolar disorder is recommended prior to initiation. Use with caution in patients with a history of seizures. SSRI use may be associated with hyponatremia, particularly in elderly patients or those taking diuretics. Discontinuation symptoms may occur upon abrupt cessation.

Contraindications

Celexa is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to the risk of serotonin syndrome. Concomitant use with pimozide is contraindicated due to the potential for QT prolongation. It is also contraindicated in individuals with known hypersensitivity to citalopram or any component of the formulation.

Possible side effect

Common side effects (≥5%) include nausea, dry mouth, somnolence, insomnia, increased sweating, fatigue, and ejaculation disorder. Less frequently, patients may experience QT prolongation, serotonin syndrome, abnormal bleeding, angle-closure glaucoma, or hyponatremia. Most side effects are mild to moderate and often diminish with continued treatment.

Drug interaction

Celexa has the potential to interact with other serotonergic drugs (e.g., MAOIs, triptans, tramadol), increasing the risk of serotonin syndrome. It may increase levels of drugs metabolized by CYP2D6 (e.g., metoprolol, risperidone). Concomitant use with drugs that prolong the QT interval should be avoided. Strong CYP3A4 inhibitors may increase citalopram concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended.

Overdose

Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, and rarely, QT prolongation or seizures. In cases of suspected overdose, seek immediate medical attention. Supportive care and symptomatic treatment are mainstays of management; there is no specific antidote.

Storage

Store at room temperature (20°–25°C or 68°–77°F), with excursions permitted between 15°–30°C (59°–86°F). Keep in the original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Celexa is a prescription medication and should be used only under the supervision of a qualified healthcare provider. Individual patient needs and responses may vary. Always follow the guidance of your prescribing physician and refer to the full FDA-approved prescribing information for complete details.

Reviews

Clinical studies and post-marketing surveillance indicate that Celexa is generally well-tolerated and effective for many patients with major depressive disorder. In controlled trials, a significant proportion of patients experienced meaningful improvement in depressive symptoms compared to placebo. Patient-reported outcomes often note improved mood, energy, and daily functioning after several weeks of consistent use. As with all antidepressants, individual experiences may vary, and a subset of patients may not respond adequately or may experience side effects requiring discontinuation or alternative therapy.