Celexa (citalopram hydrobromide) is a widely-used drug for treating depression. It is classified as a serotonin reuptake inhibitor and is also prescribed off-label as a treatment for anxiety and OCD. Citalopram is taken once a day either in the morning or evening. A number of studies have shown that the drug is effective in reversing depression and the reported side effects are minimal.
The few reported side effects from previous clinical studies indicate that besides loss of sex drive, the drug can cause drowsiness, insomnia, nausea and weight gain. Other rare side effects include convulsions, hallucinations and allergic reactions.
Most people are started out on a 20 mg dose but doctors often double the dose when no response is seen.
Now there is a report from the FDA that doctors should not prescribe high doses of Celexa because there is a risk of fatal heart complications. The FDA website indicates that at a dose of more than 40 mg, the drug can cause disturbances in the heart’s electrical activity. The previous label by the manufacturer had indicated that patients could receive up to 60mg, but now the FDA has deleted that dosage. In fact studies show that if a person has not responded to a 40 mg dose of celexa, it is unlikely that he/she will respond to a higher dose. (1)
The FDA highly recommends that patients who have a history of heart problems should not be prescribed celexa. So what about people who have heart disease and are already on celexa?
The FDA says that these individuals should not abruptly stop the drug and see their doctor as soon as possible. At doses below 40 mg, the drug appears to be safe. However anyone experiencing an irregular heart rate, palpitations, and chest pain is best advised to see their doctor as soon as possible. (2)
Why this heart side effect was not reported earlier during initial clinical trials again supports my opinion that often drug companies hide the negative side effects at the cost of profitability.
1. FDA Drug Safety Communication: Abnormal heart rhythms associated with high doses of Celexa (citalopram hydrobromide). FDA U.S. Food and Drug Administration. Web. 23, Aug. 2011