Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Citalopram.
Abnormal heart rhythm: Citalopram may cause an abnormal heart rhythm, especially at higher doses. Your doctor may occasionally monitor your heart rate and rhythm with a test called an electrocardiogram. People with a history of a heart rhythm disturbance called QT prolongation should not take Citalopram. If you have Congestive Heart Failure, slow heart rhythm, are at risk of low potassium or magnesium levels because of certain illnesses or medications, or you are taking certain medications that can affect the heart rhythm (e.g., Amiodarone, Sotalol), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed.
Bleeding disorders: Citalopram may increase bruising and cuts may take longer to stop bleeding. If you have a bleeding disorder or a history of bleeding problems, discuss with your doctor how Citalopram may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed.
Diabetes: Citalopram may affect blood sugar levels (hyperglycemia and Hypoglycemia). If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Citalopram may cause drowsiness for some who take it. Avoid activities that require mental alertness, judgment, and physical coordination (such as driving a car or performing hazardous tasks) until you establish how citalopram affects you.
Fractures: There is some evidence that people taking citalopram or other medications in the same class may be at an increased risk of fractures (broken bones) when they first start to take Citalopram and after long term use. If you are a senior, have Osteoporosis, or have other risk factors for bone fractures, take extra care to avoid falling by sitting or lying down if you feel dizzy or lightheaded. Contact your doctor if you experience dizziness or lightheadedness frequently.
Glaucoma: Citalopram may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Citalopram may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Citalopram.
Heart disease: Citalopram may cause decreased heart rate for some people, which may make symptoms of heart disease worse. If you have heart disease, discuss with your doctor how Citalopram may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed.
Kidney function: The effect of citalopram when taken by people with severely decreased kidney function has not been well studied. If you have poor kidney function or severe Kidney Disease, discuss with your doctor how Citalopram may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause Citalopram to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Citalopram may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Citalopram.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Mania or hypomania: Citalopram may cause activation of mania or hypomania. If you have a history of mania or bipolar disorder, you should be closely monitored by your doctor while taking Citalopram.
Seizures: Citalopram may increase the risk of developing seizures, particularly if you have a history of seizures. If you have a seizure disorder or have had seizures in the past, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Citalopram, and whether any special monitoring is needed. If you develop seizures, contact your doctor or seek medical attention immediately.
Serotonin syndrome: Severe reactions are possible when citalopram is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors (medications used to treat depression). These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.
Stopping the medication: Stopping Citalopram suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor first.
Suicidal or agitated behaviour: People taking Citalopram may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves) or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Citalopram. You should be closely monitored by your doctor for emotional and behavioural changes. If you experience any of these symptoms or notice them in a family member who is taking Citalopram, contact your doctor immediately.
Pregnancy: Citalopram should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Citalopram, contact your doctor immediately.
Newborn babies may experience withdrawal symptoms or high blood pressure in the lungs if the mother is taking citalopram during the 3 months before the baby is born.
Breast-feeding: Citalopram passes into breast milk. If you are a breast-feeding mother and are taking citalopram, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children and is not indicated for use in children under the age of 18. There have been reports that using this and similar medications in children under 18 years old may cause behavioural and emotional changes such as suicidal thoughts and behaviour.
Seniors: Because Citalopram is removed from the body by the kidney and liver, seniors may be at increased risk of side effects if they use Citalopram. Your doctor may decide to start with a lower dose. If you are over 65, discuss with your doctor whether any special monitoring is required.
