It is very important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for unwanted effects.
Do not take citalopram within 14 days of taking an MAO inhibitor (MAOI) such as isocarboxazid (Marplan®), phenelzine (Nardil®), procarbazine (Matulane®), selegiline (Eldepryl®), or tranylcypromine (Parnate®). Do not take an MAO inhibitor within 14 days of taking citalopram. If you do, you may have extremely high blood pressure or convulsions (seizures). Also, you should not use pimozide (Orap®) while you are taking this citalopram.
For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
This medicine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.
Make sure your doctor knows about all the other medicines you are using. Citalopram may cause serious conditions such as serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions when taken with some medicines. Do not use citalopram with linezolid (Zyvox®), lithium, tryptophan, St. John's wort, or some pain or migraine medicines (e.g., rizatriptan, sumatriptan, tramadol, zolmitriptan, Imitrex®, Maxalt®, Ultram®, or Zomig®). Check with your doctor first before taking any other medicines.
Do not suddenly stop taking this medicine without checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having side effects such as agitation, anxiety, dizziness, a feeling of constant movement of self or surroundings, headache, increased sweating, nausea, trembling or shaking, trouble with sleeping or walking, or unusual tiredness when you stop the medicine.
Citalopram may increase your risk for bleeding problems. Make sure your doctor knows if you are also using other medicines that thin the blood, such as aspirin, NSAID pain or arthritis medicines (e.g., celecoxib, ibuprofen, naproxen, rofecoxib, valdecoxib, Advil®, Aleve®, Celebrex®, Motrin®, or Vioxx®), or warfarin (Coumadin®).
This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or unsteadiness.
It is important to tell your doctor if you are pregnant or planning to become pregnant while using this medicine.
Citalopram has not been shown to add to the effects of alcohol. However, use of alcohol is not recommended in patients who are taking this medicine.
This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.