In India, Ireland, Russia, Tunisia, Ukraine, the UK, and most of Europe citalopram is approved to treat both the initial phases of depression and to prevent its relapse ; and Panic Disorder (PD) with or without agoraphobia .
In Argentina, Brazil, Estonia, Israel, and South Africa citalopram is approved to treat depression and PD as above, as well as OCD.
In the Dominican Republic Zalopram is approved to treat depression, PD, and OCD as above, and also alcoholism .
In Taiwan citalopram is approved to treat depression and anxiety.
It’s a literal 50% coin-toss that you’ll a positive response within four weeks.
And it’s a two-in-three chance that your depression will stay away.
Based on what I can find in other clinical trials & studies, books, and anecdotal evidence, you’ve got a good 60–70% chance that Celexa will work, keep working, and suck less than MDD and any other antidepressant, except Lexapro.
The data from the clinical trials for hot flashes are pretty encouraging, but anything in stage III tends to be encouraging.
Its main problem with anxiety seems to be the short-term exacerbation of the problem.
Celexa (citalopram HBr) should be administered at an initial dose of 20 mg orally once daily, with an increase to a maximum dose of 40 mg/day at an interval of no less than one week. Doses above 40 mg/day are not recommended due to the risk of QT prolongation. Additionally, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg/day dose over the 40 mg/day dose.
It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Systematic evaluation of Celexa in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment (32 weeks total). In one study, patients were assigned randomly to placebo or to the same dose of Celexa (20–60 mg/day) during maintenance treatment as they had received during the acute stabilization phase, while in the other study, patients were assigned randomly to continuation of Celexa 20 or 40 mg/day, or placebo, for maintenance treatment. In the latter study, the rates of relapse to depression were similar for the two dose groups (see Clinical Trials under CLINICAL PHARMACOLOGY). Based on these limited data, it is not known whether the dose of citalopram needed to maintain euthymia is identical to the dose needed to induce remission. If adverse reactions are bothersome, a decrease in dose to 20 mg/day can be considered.
Start with 20mg a day and give it at least a week.
If 20mg a day isn’t doing it for you go up to 40mg a day.
60mg a day probably won’t work, but as long as you don’t have a history of heart problems, you can give it a shot if you want to.
It should work for at least 8 months at whatever dosage you’re taking.
If you’re taking 40–60mg a day you might be able to get by on 20mg a day if the side effects are a bit harsh.
I can’t find too much fault with Lundbeck’s/Forest’s recommendations. Depending on how bad your depression is and your history with Antidepressants in general or SSRIs in particular, you may want to start at 10mg a day and increase your dosage by 10mg a day until it starts working. But if you feel like whaleshit on the bottom of the ocean, start at 20mg!
Like any SSRI Celexa can take up to a month to fully work. But if it’s not doing anything for you after two or three weeks, especially if you started at 20mg and have been taking 40mg a day for at least two weeks, then it’s time to move on to something else.
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How to Stop Taking Celexa (discontinuation / withdrawal)
Based on the 35 hour half-life your doctor should be recommending that you reduce your dosage by 10–20mg a day every 6–8 days if you need to stop taking it if you need to stop taking it, if not more slowly than that. Make that 10–20mg a day every week just to make things easier on everyone.
Interesting Stuff your Doctor Probably didn’t Tell You about Celexa
For whatever reason, it’s a good med to switch to if the SSRI you’re already taking stops working or sucks too much. A study with Prozac and another with Paxil correspond to the anecdotal evidence I’ve come across. So in addition to being the best first med to try - unless you have specific symptoms that indicate an SSRI isn’t a way to go in the first place - it’s also the best second med to try.
No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.
Drowsiness / fatigue - even when taking stimulants in some circumstances.
Insomnia, instead of or alternating with the drowsiness.
Assorted other minor GI complaints (constipation, diarrhea, etc.)
Generally feeling spacey / out of it
Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.1
All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.
Typical Potential Side Effects
The usual for SSRIs - headache , nausea , dry mouth , sweating , sleepiness or insomnia (sleeping is more likely), constipation or diarrhea (I wish SSRIs would make up their minds about these contradictory side effects), weight gain (if it happens the weight gain can be pretty bad for an SSRI), and assorted sexual dysfunctions . Most everything but the weight gain and bedroom problems usually goes away within a couple of weeks.
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Uncommon Potential Side Effects
Tremor , brand new anxiety or exacerbation of existing anxiety , acne , disruption of your menstrual cycle . Given that it works on PMDD and severe hot flashes, those last two shouldn’t be much of a surprise if they happen.
Rectal hemorrhage . Hiccups that won’t stop . Mouse had the unending hiccups. At the time it’s only funny when something like that happens to someone else. A year or two later, or even a couple months, it’s pretty funny no matter whom it happened to.
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Celexa’s Half-Life & How Long Until It Clears Your System
Plasma half-life: 35 hours. It clears your system within 6–8 days.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream2, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what3, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.
Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.
The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.
Name, Address, Serial Number (Generic and Overseas Availability)
Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).
Available as Celexa in:
Overseas Trade and Branded Generic Names
Abgenix - Pakistan
Acelopam - Greece
Actipram - Bolivia, Chile, Paraguay, Peru, Venezuela
Its efficacy, lack of drug-drug interactions with anything involving CYP2D6 & CYP3A4/5 (i.e. half the meds on the planet) and, now that it’s available as a generic practically everywhere, cost, makes it one of, if not the most-prescribed antidepressant on the planet. It’s certainly the most-prescribed, and usually the first-prescribed for MDD wherever it’s available. Unless your symptoms scream something else (e.g. anhedonia and the inability to figure out how to go about getting out of bed, in which case Wellbutrin would probably work better), citalopram should be the first antidepressant you’re prescribed. Unless your insurance covers Lexapro and you’re not taking a drug that interacts with it, you may as well get the med that sometimes works a little faster and sucks a little less.
Currently the only SSRI-classantidepressant that is approved by the FDA for depression and nothing else.17 Although that may change as it is undergoing phase III tests to treat hot flashes in women who experience them frequently long after menopause or during breast cancer therapy. In the latter it manages to do so without messing with tamoxifen, which is critical.
Celexa was part of the cocktail Mouse was on when she went completely manic. The main culprit was Geodon. For an SSRI it wasn’t all that bad for her.
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If you’re still feeling judgmental as well as just mental18, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
Get all judgmental about the Celexa (citalopram) Synopsis
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ქართული ციტომაქსი ანოტაცია Georgian Citomax SPC (Google translates it as “annotation”). If you’re unfamiliar with Georgian or Armenian: your computer did not catch a virus. Unless every other site you looks like they’re written in Georgian or Cambodian when they shouldn’t be.
1 As well as being an indication of half of said conditions.
2 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.
3 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
4 What has to be the most literal drug name on the planet.
6 Finally, a drug company comes right out and says, "It's a mystery how these meds work." Hats off to Arcana Arzneimittel GmbH!
7 You'll have to talk to an Australian intellectual property lawyer to find out how an antidepressant and a Toyota are able to have the same brand name. Actually, I'd appreciate it if someone would talk to an intellectual property lawyer or somebody in Australia who knows why the hell the same brand name is being used for both products.
8 Looks like somebody really does consider Celexa to be a happy pill.
9 The intellectual property laws in South Asia are only slightly better than those in China.
10 Manufactured by, I shit ye not, Panacea Biotec. Whoever named that company has balls of titanium. Especially since most of their products deal with cancer, organ transplants, and assorted supplements. And their logo is easily mistaken for Lundbeck's.
11 Which also sounds like the name of a Cairo gay bar.
13 I bet American drug companies would love it if they could name meds like they can in Greece.
14 Yeah, well wang you too, buddy! No, don't wang me, wang you! Wang you very much! According to Google Wàng (望) translates to "hope", so that's one more incidence of naming drug companies wish they could do in America.
15 Google translates this name to "Easy Tean", which sounds like a pr0n site.
16 I've also seen cytalopram used on academic, government, and pharmaceutical Polish sites. But I've also seen both the standard and Latin INNs, so there doesn't appear to be a consensus on what the generic name is in Poland.
17 Luvox is approved to treat OCD and nothing else, making it the redheaded stepchild of SSRIs.
18 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
If you have any questions not answered here, please see the Crazymeds Celexa discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
Last modified on Monday, 29 December, 2014 at 12:41:50 by JerodPoore
Celexa, and all other drug names on this page and used throughout the site, are a trademark of someone else. Celexa’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot. Know your sources! Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internetis a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.