Note: This document contains side effect information about citalopram. Some dosage forms listed on this page may not apply to the brand name Celexa.

Summary

Common side effects of Celexa include: drowsiness, ejaculatory disorder, nausea, insomnia, and diaphoresis. Other side effects include: suicidal tendencies, agitation, diarrhea, impotence, sinusitis, anxiety, confusion, exacerbation of depression, lack of concentration, tremor, vomiting, anorexia, and xerostomia. Continue reading for a comprehensive list of adverse effects.

Applies to citalopram: oral solution, oral tablets.

Side effects include:

Nausea, dry mouth, insomnia, sweating, sexual dysfunction (ejaculatory disorder, impotence, decreased libido), tremor, diarrhea, somnolence, dyspepsia, fatigue, upper respiratory tract infection, rhinitis.

For Healthcare Professionals

Applies to citalopram: oral capsule, oral solution, oral tablet.

General

The side effects observed with citalopram (the active ingredient contained in Celexa) in clinical trials were generally reported as mild and transient, occurring most frequently in the first 1 to 2 weeks of therapy, and attenuating subsequently. The most commonly reported side effects were nausea, somnolence, dry mouth, increased sweating, tremor, diarrhea, and ejaculation disorder.^[Ref]

Nervous system

Very common (10% or more): Headache (up to 26.9%), somnolence (up to 17.9%), dizziness (up to 10.3%)

Common (1% to 10%): Amnesia, extrapyramidal disorder, migraine, paresthesia, tremor,

Uncommon (0.1% to 1%): Abnormal gait, ataxia, cerebrovascular accident, convulsions, dystonia, hypoesthesia, involuntary muscle contractions, neuralgia, speech disorder, syncope, hyperkinesia, hypertonia, hypokinesia, dyskinesia, vertigo, transient ischemic attack

Rare (less than 0.1%): Abnormal coordination, dyskinesia, grand mal convulsion, hyperesthesia, stupor

Frequency not reported: Akathisia, movement disorder, serotonin syndrome

Postmarketing reports: Choreoathetosis, myoclonus, neuroleptic malignant syndrome, nystagmus^[Ref]

Potentially life-threatening serotonin syndrome has been reported with SSRIs and SNRIs as monotherapy, but particularly with concomitant use of other serotonergic drugs and drugs that impair the metabolism of serotonin.^[Ref]

Gastrointestinal

Very common (10% or more): Nausea (up to 21.4%), dry mouth (up to 20%)

Common (1% to 10%): Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, increased saliva, taste loss/perversion, vomiting

Uncommon (0.1% to 1%): Abnormal bleeding (predominantly of the mucous membranes), dysphagia, eructation, esophagitis, gastrointestinal bleeding, gastritis, gastroenteritis, gingivitis, hemorrhoids, stomatitis, teeth grinding

Rare (less than 0.1%): Colitis, diverticulitis, duodenal ulcer, gastric ulcer, gastroesophageal reflux, gingival bleeding, glossitis, rectal hemorrhage

Frequency not reported: Gastrointestinal hemorrhage

Postmarketing reports: Pancreatitis^[Ref]

Psychiatric

Very common (10% or more): Insomnia (up to 18.8%)

Common (1% to 10%): Abnormal dreams, aggravated depression, agitation, anxiety, apathy, confusion, depression, impaired concentration, nervousness, suicide attempt, sleep disorder

Uncommon (0.1% to 1%): Aggressive reaction, delusion, depersonalization, drug dependence, emotional lability, euphoria, hallucination, mania, panic reaction, paranoid reaction, paroniria, psychosis, psychotic depression

Rare (less than 0.1%): Catatonic reaction, melancholia, suicide-related events

Frequency not reported: Bruxism, restlessness, panic attack, suicidal ideation/behavior

Postmarketing reports: Delirium, withdrawal syndrome^[Ref]

Other

Very common (10% or more): Asthenia (up to 11.5%)

Common (1% to 10%): Fatigue, fever/pyrexia, tinnitus, asthenia

Rare (less than 0.1%): Facial edema, malaise, rigors

Postmarketing reports: Spontaneous abortion^[Ref]

Dermatologic

Very common (10% or more): Increased sweating (up to 11.3%)

Common (1% to 10%): Rash, pruritus

Uncommon (0.1% to 1%): Abnormal bleeding of the skin, acne, alopecia, dermatitis, dry skin, eczema, flushing, photosensitivity reaction, psoriasis, purpura, skin discoloration, urticaria

Rare (less than 0.1%): Decreased sweating, cellulitis, hypertrichosis, keratitis, melanosis, pruritus ani

Frequency not reported: Angioedema, ecchymosis

Postmarketing reports: Epidermal necrolysis, erythema multiforme^[Ref]

Genitourinary

Common (1% to 10%): Abnormal orgasm/anorgasmia (female), amenorrhea, decreased libido, dysmenorrhea, ejaculation disorders/ejaculation delay, impotence, menstrual disorders, polyuria, ejaculation failure, micturition disorders

Uncommon (0.1% to 1%): Breast enlargement, breast pain, dysuria, galactorrhea, increased libido, menorrhagia, micturition frequency, nonpuerperal lactation, vaginal bleeding, vaginal hemorrhage, urinary incontinence, urinary retention

Rare (less than 0.1%): Hematuria, oliguria

Frequency not reported: Metrorrhagia, priapism^[Ref]

Urinary retention and galactorrhea have been reported with other SSRIs.

The estimates of the incidence of untoward sexual experience and performance may underestimate their actual incidence, partly because patients and physicians may be reluctant to discuss this issue. In placebo-controlled clinical trials, ejaculation disorder (primarily ejaculation delay) was reported as a treatment-emergent side effect at an incidence of 6% and at least twice the incidence in placebo-treated male patients.^[Ref]

Respiratory

Common (1% to 10%): Coughing, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, yawning

Uncommon (0.1% to 1%): Bronchitis, dyspnea, epistaxis, pneumonia

Rare (less than 0.1%): Asthma, bronchospasm, hiccups, increased sputum, laryngitis, pneumonitis, pulmonary embolism^[Ref]

Cardiovascular

Common (1% to 10%): Chest pain, hypotension, palpitations, postural hypotension, tachycardia

Uncommon (0.1% to 1%): Angina pectoris, atrial fibrillation, bradycardia, cardiac failure, edema (extremities), extrasystoles, hematomas, hot flushes, hypertension, myocardial infarction, myocardial ischemia

Rare (less than 0.1%): Bundle branch block, cardiac arrest, phlebitis, QT prolongation, torsades de pointes

Frequency not reported: Ventricular arrhythmia, orthostatic hypotension

Postmarketing reports: Thrombosis^[Ref]

This drug has been associated with a dose-related QT-interval prolongation; there have been reports of QT-interval prolongation and ventricular arrhythmia, including torsade de pointes, particularly in females, patients with hypokalemia, or with pre-existing QT-interval prolongation, or other cardiac disease.^[Ref]

Musculoskeletal

Epidemiological studies, primarily in patients aged 50 years or older, have shown an increased risk of bone fractures in patients receiving SSRIs or TCAs.^[Ref]

Common (1% to 10%): Arthralgia, back pain, myalgia

Uncommon (0.1% to 1%): Arthritis, leg cramps, muscle weakness, skeletal pain

Rare (less than 0.1%): Bursitis, osteoporosis

Postmarketing reports: Rhabdomyolysis^[Ref]

Metabolic

Common (1% to 10%): Anorexia, decreased/increased weight, decreased/increased appetite

Uncommon (0.1% to 1%): Abnormal glucose tolerance, thirst

Rare (less than 0.1%): Alcohol intolerance, dehydration, hypokalemia, hyponatremia, hypoglycemia, obesity^[Ref]

Ocular

Common (1% to 10%): Abnormal accommodation

Uncommon (0.1% to 1%): Abnormal vision, conjunctivitis, dry eyes, eye pain, mydriasis

Rare (less than 0.1%): Abnormal lacrimation, cataract, diplopia, photophobia, ptosis

Frequency not reported: Visual disturbance, acute narrow angle glaucoma

Postmarketing reports: Angle-closure glaucoma^[Ref]

Hepatic

Common (1% to 10%): Increased alkaline phosphatase

Uncommon (0.1% to 1%): Increased ALT, GGT, and AST

Rare (less than 0.1%): Bilirubinemia, cholelithiasis, cholecystitis, hepatitis, jaundice

Frequency not reported: Abnormal liver function test

Postmarketing reports: Cholestatic hepatitis, hepatic necrosis^[Ref]

Immunologic

Common (1% to 10%): Influenza-like symptoms

Rare (less than 0.1%): Hay fever^[Ref]

Hematologic

Uncommon (0.1% to 1%): Anemia, leukopenia, leukocytosis, lymphadenopathy

Rare (less than 0.1%): Coagulation disorder, granulocytopenia, hemorrhage, hypochromic anemia, lymphocytosis, lymphopenia

Frequency not reported: Thrombocytopenia

Postmarketing reports: Decreased prothrombin, hemolytic anemia^[Ref]

Endocrine

Rare (less than 0.1%): Goiter, hypothyroidism

Frequency not reported: Inappropriate ADH secretion

Postmarketing reports: Prolactinemia^[Ref]

Renal

Rare (less than 0.1%): Pyelonephritis, renal calculus, renal pain

Postmarketing reports: Acute renal failure^[Ref]

Hypersensitivity

Frequency not reported: Anaphylactic reaction, hypersensitivity not otherwise specified

Postmarketing reports: Allergic reaction^[Ref]