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Antidepressant medications are prescribed to manage depression and various mental or mood disorders. While they can effectively reduce the risk of suicidal thoughts and attempts and offer other significant benefits, it's important to be aware of potential risks. Research indicates that a small percentage of individuals, particularly those under 25, may experience worsening depression, new or intensified mental or mood symptoms, or suicidal thoughts or behaviors when using these medications.

Key safety information includes:

• Discuss thoroughly with your healthcare provider the risks and benefits of antidepressant use, especially if you are under 25, regardless of whether the treatment is for a mental or mood condition.
• Immediately inform your healthcare provider if you observe a deterioration in depression or other psychiatric symptoms, changes in behavior, or any new or worsening mental or mood changes, such as:
  • Suicidal thoughts or behaviors
  • New or increased anxiety or panic attacks
  • Difficulty sleeping
  • Irritability or hostility
  • Impulsive behavior
  • Severe restlessness
  • Rapid speech
• Pay particular attention to these symptoms when starting a new antidepressant or adjusting the dosage.

Staying vigilant and maintaining open communication with your healthcare provider can help manage these risks effectively.

You may experience mild side effects such as nausea, dry mouth, loss of appetite, tiredness, drowsiness, sweating, blurred vision, and yawning. These are common and usually manageable, but if they persist or worsen, consult your healthcare provider.

More serious side effects can include shaking (tremor), decreased interest in sex, changes in sexual ability, and easy bleeding or bruising. It is important to contact your healthcare provider immediately if these occur.

In rare cases, very serious side effects like fainting, fast or irregular heartbeat, black stools, vomit resembling coffee grounds, seizures, eye pain, swelling, redness, widened pupils, or vision changes may occur. Seek medical attention promptly if you experience any of these symptoms.

This medication can increase serotonin levels, potentially leading to serotonin syndrome, a rare but serious condition. Symptoms include fast heartbeat, hallucinations, loss of coordination, severe dizziness, intense nausea, vomiting, diarrhea, muscle twitching, unexplained fever, or unusual agitation. Immediate medical help is crucial if these symptoms develop.

Men may rarely experience a prolonged or painful erection lasting four or more hours, which requires urgent medical care to prevent permanent damage.

A severe allergic reaction to this drug is uncommon, but if you notice symptoms such as rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing, seek emergency medical assistance.

This summary does not include all possible side effects. If you notice other unusual effects, contact your healthcare provider for guidance.

Some medications and substances can interact with this drug, possibly leading to serious side effects.

1. Bleeding Risk: Medicines like antiplatelet drugs (e.g., clopidogrel), NSAIDs (such as ibuprofen and naproxen), and blood thinners (such as dabigatran and warfarin) can increase the likelihood of bleeding or bruising. Aspirin may also raise bleeding risks when combined with this drug. If your doctor has advised you to take low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention, continue taking it unless instructed otherwise. Consult your doctor or pharmacist for more information.

2. MAO Inhibitors: Using MAO inhibitors (such as isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) with this medication can cause a dangerous and possibly life-threatening interaction. Avoid these inhibitors during treatment and for two weeks before and after using this drug. Your doctor will guide you on when to start or stop these medications.

3. Serotonin Syndrome: The risk of serotonin syndrome or toxicity may rise if you take drugs that increase serotonin levels, such as street drugs like MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs like fluoxetine and paroxetine, or SNRIs like duloxetine and venlafaxine), and tryptophan. This risk is higher when starting or increasing doses of these drugs.

4. Drowsiness: Inform your doctor if you are using substances that cause drowsiness, including alcohol, marijuana, antihistamines (e.g., cetirizine, diphenhydramine), sleep or anxiety medications (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, and opioids (e.g., codeine). Some over-the-counter drugs, like those for allergies or colds, may also cause drowsiness—check with your pharmacist for safe use.

5. Heart Rhythm: Many medications, besides citalopram, can affect heart rhythm (QT prolongation), such as amiodarone, pimozide, procainamide, quinidine, and sotalol.

6. Similar Medications: Citalopram is closely related to escitalopram; avoid using escitalopram-containing products while on citalopram.

7. Lab Tests: This medication may interfere with certain medical or lab tests, such as brain scans for Parkinson's disease, potentially causing incorrect results. Ensure all your healthcare providers and lab personnel know you are taking this medication.