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Antidepressant medications, such as citalopram (Celexa), are prescribed to manage various mental health conditions, including depression. While these medications can offer significant benefits, it is crucial to be aware of specific safety information and warnings:

• Worsening Depression and Suicidal Thoughts: Antidepressants may increase the risk of worsening depression and suicidal thoughts, particularly in individuals aged 24 and younger. Be vigilant for symptoms such as new or worsening anxiety, panic attacks, irritability, anger, and restlessness, especially when starting or modifying the dosage. Immediate medical attention is necessary if suicidal thoughts or unusual behavior occur.

• Heart Rhythm Concerns (QT Prolongation): Citalopram can cause a potentially life-threatening heart rhythm issue known as QT prolongation. Those with low potassium or magnesium levels, existing heart conditions, or those taking other QT-prolonging medications are at increased risk. Regular monitoring and consultation with your healthcare provider are advised.

• Serotonin Syndrome: There is a rare risk of serotonin syndrome, a potentially serious condition caused by excessive serotonin levels. This risk is heightened when taking other medications that increase serotonin. Seek immediate medical attention if symptoms occur.

• Withdrawal Symptoms: Abruptly discontinuing citalopram can lead to withdrawal symptoms such as nausea, dizziness, anxiety, and flu-like symptoms. Never stop taking the medication without consulting your healthcare provider, who can guide a safe discontinuation plan.

• Increased Bleeding Risk: Citalopram may elevate the risk of bleeding, particularly if taken with other medications like aspirin or blood thinners. Look out for signs of unusual bleeding and seek medical help if these occur.

• Not Suitable for Bipolar Disorder Alone: Citalopram should not be used as the sole treatment for bipolar disorder, as it may trigger a manic episode. Consultation with a healthcare provider is crucial for appropriate treatment.

• Glaucoma Warning: Citalopram can contribute to or exacerbate angle-closure glaucoma. Regular eye exams are recommended, and any changes in vision should be promptly reported to an optometrist or psychiatrist.

• Low Sodium Levels: This medication may cause low sodium levels, especially in older individuals or those taking diuretics. Symptoms like weakness, headache, or confusion require immediate medical attention.

• Contraindications: Citalopram should not be used in conjunction with or within 14 days of taking MAOIs, linezolid, methylene blue, or pimozide due to serious health risks. Always consult with your healthcare provider regarding any contraindications.

It is essential to discuss all potential risks and benefits with your healthcare provider before starting or modifying treatment with citalopram.

Common side effects:

• nausea
• dry mouth
• sleepiness
• trouble sleeping
• sweating
• diarrhea
• tremors
• changes in appetite
• indigestion
• anxiety
• upper respiratory tract infections
• low sex drive
• ejaculation problems
• erectile dysfunction

Less common but important to monitor:

• suicidal thoughts or behaviors
• abnormal heart rhythms
• serotonin syndrome
• serious bleeding
• low sodium levels

Serious side effects:

• seizures
• very serious allergic reactions
• prolonged erection lasting more than four hours

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, Selegiline, and others)
• Serotonergic drugs (Fluoxetine, paroxetine, Duloxetine, Venlafaxine, St. John's wort)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Antiplatelet drugs (Clopidogrel)
• NSAIDs (Ibuprofen, Naproxen)
• Anticoagulants (Dabigatran, Warfarin)
• Aspirin
• Alcohol
• Antihistamines (Cetirizine, diphenhydramine)
• Drugs for sleep or anxiety (Alprazolam, Diazepam, Zolpidem)
• Muscle relaxants
• Opioid pain relievers (codeine)
• Drugs affecting heart rhythm (Amiodarone, Sotalol)
• Escitalopram