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Celexa: What is it? Uses, Costs, Benefits, and Doses

Approximately 17.3 million adults, or about 7 percent of Americans over the age of 18, experience major depressive disorder (also known as clinical depression) in a given year, making it one of the most common mental illnesses in the United States. The drugs most commonly used to treat health problems such as depression include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), and new medications in these categories are released every year as demand continues to grow. Celexa, just like lexapro and fluoxetine, one of the most popular drugs used to treat major depressive disorder, is an SSRI that is well tolerated by many people; more than 28 million prescriptions were written for the drug in 2015. Here’s everything you need to know about this commonly prescribed medication

What is Celexa?

Celexa is an antidepressant medication (maoi) categorized in a class of drugs known as SSRIs. Type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs). Celexa was first released in Denmark in 1989, and word of the drug’s effectiveness quickly spread. By 1998, the medication, just like escitalopram, had been approved by the Food and Drug Administration, also known as the FDA, to treat depression and was released to the American public. Today, Celexa is primarily used to treat depression and anxiety. While Celexa is not approved by the FDA to treat anxiety, many doctors and healthcare providers prescribe it for use off-label because the American Psychiatric Association recommends it for panic disorder. The medication has also been found to improve generalized anxiety disorder. Celexa is offered in a generic form under the name citalopram. 

What is Celexa used to treat?

Celexa is used to treat a wide range of mental health disorders, but it is primarily used to treat major depressive disorder, also known as clinical depression, in young adults aged 18 and over. While Celexa is FDA-approved to treat depression, it is also used off-label to treat the following conditions:

  • Bipolar depression/bipolar disorder
  • Repeated episodes of anxiety
  • “Change of life” signs
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder
  • Binge eating disorder
  • Anxiety associated with depression
  • Panic disorder

What is major depressive disorder and what causes it?

Major depressive disorder is characterized by persistent and intense feelings of sadness for extended periods of time. Also called clinical depression, major depressive disorder can affect mood and behavior as well as physical functions like appetite and sleep. Many people suffering from clinical depression find themselves losing interest in activities they once enjoyed, and they find themselves struggling to perform everyday activities. 

In order to be diagnosed with major depressive disorder, individuals must experience at least five of the following symptoms a minimum of once a day for a period of more than two weeks:

  • Feeling sad or irritable most of the day nearly every day
  • Less interested in most activities they once enjoyed
  • Sudden weight loss or weight gain, or change in appetite
  • Trouble falling asleep or sleeping more than usual
  • Feelings of restlessness
  • Unusually tired/lack of energy
  • Feeling worthless or guilty about things that wouldn’t normally cause those feelings
  • Difficulty concentrating, thinking, or making decisions
  • Thinking about self-harm or committing suicide

Exactly what causes major depressive disorder is unknown. Researchers know that genetics and stress can impact brain chemistry and diminish a person’s ability to maintain mood stability. Hormonal changes can also contribute to clinical depression. Drug or alcohol abuse, certain medical conditions, such as cancer or hypothyroidism, and certain types of medications, like steroids, are also believed to trigger episodes of major depressive disorder. 

How does Celexa treat depression?

Celexa works by blocking the reuptake, or reabsorption, of serotonin into nerve cells. This increases the levels of serotonin in your brain, which has been found to help reduce feelings of depression and anxiety in people suffering from these conditions. Celexa and other SSRIs are particularly effective when used in combination with therapy. Because Celexa works to restore balance to your brain chemistry, it generally takes several weeks before patients begin to notice the adverse effects of the medication. While some people begin to notice a decrease in their symptoms in as little as two to three weeks, it may take up to four weeks before your symptoms improve.

How much does Celexa cost?

Celexa is available in 10 mg, 20 mg, and 40 mg oral tablets in both the generic and brand name forms of the drug; the medication is also available in an oral suspension (liquid). The costs of Celexa and citalopram vary slightly between dosages, but Celexa generally costs about ten dollars per pill on average, while citalopram is available for less than 50 cents per pill. The generic form of the medication is covered by nearly all commercial and Medicare drug insurance plans, and pharmacy discount cards can offer savings as well. Manufacturers coupons and patient assistance programs may be available for the brand name version of the drug through the manufacturer’s website. 

Approximate Costs of Celexa and Citalopram

 

Celexa

Citalopram

 

Per Pill

30 Day Supply

Per Pill

30 Day Supply

10 mg oral tablet

$9.57

$287.10

$0.44

$13.28

20 mg oral tablet

$9.97

$299.10

$0.43

$12.86

40 mg oral tablet

$10.40

$312.00

$0.46

$13.74

What are the benefits of using Celexa?

Celexa is a non-habit forming option for people looking to treat their depression with a once-daily medication. Because the generic form of the drug is widely available from a number of manufacturers, Celexa can be obtained inexpensively and is covered by most commercial insurance policies and Medicare in its generic form. For individuals who cannot take pills, Celexa offers an oral suspension (liquid) option that is easy to take. 

How do I know which dose of Celexa I should take?

The available dosages for Celexa and citalopram range from 10 mg to 40 mg. In order to reduce your risk of experiencing side effects, your doctor will likely start you on a low dose of the medication and adjust your dosage over time if needed. Due to risks associated with serotonin syndrome (described below), you should not increase your dose of Celexa or increase your frequency without consulting with your doctor, as serious and potentially fatal complications can occur.

How do I use Celexa to treat depression?

Celexa is taken once a day and can be taken with or without food. The medication should be taken at the same time every day in order to keep your brain chemistry balanced. Celexa is available in 10 mg, 20 mg, and 40 mg oral tablets and in an oral suspension; the maximum dose is 40 mg per day. If using the liquid form of the drug, make sure you measure your dose with the included measuring spoon or device rather than a household spoon in order to ensure that you receive the correct dose. 
 
It can be tempting to stop taking Celexa if you start feeling better, but it is very important that you continue taking the medication even if you feel well. Do not stop taking Celexa without consulting your doctor. If you and your doctor do decide that you no longer need Celexa, your dose should gradually be reduced by your doctor rather than cutting the medication out “cold turkey.” Just as use of Celexa should not be stopped abruptly, your dosage should only increase under a doctor’s supervision. Do not increase your dose without a doctor’s approval or take it more often or for longer than prescribed.

Are there any side effects I should be aware of?

Celexa is a popular medication, but it does carry with it the risk of numerous side effects and can cause allergic reactions, including some that are potentially serious. In order to reduce your risk of side effects, your doctor may choose to have you start taking Celexa at a low dose and gradually increase your dosage over time.  Common side effects of Celexa include:

  • Problems with memory or concentration
  • Headache
  • Drowsiness
  • Dry mouth
  • Increased sweating
  • Numbness or tingling
  • Increased appetite, nausea, diarrhea or gas
  • Fast heartbeats (qt prolongation)
  • Feeling shaky
  • Sleep problems (insomnia), feeling tired
  • Cold symptoms such as a stuffy nose, sneezing, sore throat
  • Changes in weight
  • Difficulty having an orgasm

 
Less common, but serious side effects associated with Celexa include:

  • Shaking (tremor)
  • Decreased interest in sex
  • Changes in sexual ability
  • Easy bruising/bleeding
  • Hyponatremia

 
In rare cases, Celexa may cause the following very serious side effects. Get medical help right away if you experience any of the following:

  • Fainting
  • Fast/irregular heartbeat
  • Black stools
  • Vomit that looks like coffee grounds 
  • Seizures
  • Eye pain/swelling/redness
  • Widened pupils
  • Vision changes (such as seeing rainbows around lights at night)

 
Taking Celexa can cause an increase in serotonin levels and, in very rare cases, can cause a very serious condition called serotonin syndrome/toxicity. Serotonin syndrome occurs when there is too much serotonin in the brain, causing excessive nerve cell activity which can sometimes be fatal. The condition most commonly occurs when two or more medications that influence serotonin are taken together, and it is more likely to occur when you first start taking a new medicine or increase your dose. Symptoms are often seen within hours of taking a new medication or increasing your dose and may include:

  • Confusion
  • Agitation or restlessness
  • Dilated pupils
  • Headache
  • Changes in blood pressure and/or temperature
  • Nausea and/or vomiting
  • Diarrhea
  • Rapid heart rate
  • Tremor
  • Loss of muscle coordination or twitching muscles
  • Shivering and goosebumps
  • Heavy sweating

 
Serotonin syndrome can be life threatening in severe cases. Seek medical attention immediately if you experience:

  • High fever
  • Seizures
  • Irregular heartbeat
  • Unconsciousness

Is Celexa considered safe for pregnant or breastfeeding women?

Celexa should not be taken during pregnancy unless no other options exist for treating depression in the patient, as SSRIs can cause serious lung problems and other complications in developing fetuses. Women who take Celexa during the last three months of pregnancy can cause withdrawal symptoms in newborn infants, who may develop feeding/breathing difficulties, seizures, muscle stiffness, and constant crying. Nursing mothers can pass Celexa to their babies through breast milk, so it is not recommended for use in women who are breastfeeding. However, untreated mood disorders can be serious and sometimes fatal, so you should not stop taking this medication during pregnancy unless your doctor advises you to do so.

What drug interactions do I need to be aware of?

Numerous drugs interact with Celexa, so it is important that you give your doctor your complete medical history and advise him or her of all the medications you are currently taking, including prescription drugs, over the counter medications, vitamins, supplements, and herbs. Medications that should be avoided when taking Celexa include:
Blood thinner, as this can cause an increased risk of bleeding, especially stomach bleeding 
Non-steroidal anti-inflammatory drugs (NSAIDS) such as Aleve and Advil, which can also increase your risk of bleeding
Other drugs that interact with serotonin, as these can increase your risk for serotonin syndrome

Who should not take Celexa?

There are some groups of people who should not take Celexa under any circumstances, as use in these groups has been found to cause potentially fatal complications. People who should not take Celexa include:
People who have taken MAO inhibitors in the past 14 days, including isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine, or people who have received a methylene blue injection. A fatal reaction can occur when these medications are combined with Celexa.
Individuals who take pimozide should not take Celexa, as this drug interaction can cause a potentially fatal issue with your heart rhythm. 
Children under the age of 18. Celexa is not approved for use in children due to the higher risk of side effects in children, including suicidal thoughts.

How do I know if Celexa is right for me?

If you are looking for a depression medication that is effective, affordable, and  non-habit-forming, Celexa may be right for you. Celexa may take up to four weeks to take full effect, so patients suffering from severe symptoms may require the addition of a fast-acting drug in the meantime to provide relief. Celexa may be helpful for individuals who have difficulty swallowing pills, as it is offered in a liquid form as well as an oral tablet.
 

Published March 27th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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