Celexa side effects — what you should know

Celexa (citalopram) helps many people with depression and anxiety, but like any drug it can cause side effects. Here’s a plain, useful rundown of what commonly happens, what’s serious, and simple steps to stay safe.

Common and mild side effects

Most people notice mild effects in the first weeks. Nausea, dry mouth, tiredness or drowsiness, trouble sleeping, sweating, tremor, constipation, and changes in appetite or weight are the usual ones. Sexual problems — lower libido, delayed orgasm, or erectile issues — are also common and can persist. These often improve after a few weeks as your body adjusts. If they don’t, talk to your prescriber; switching medicines or changing dose can help.

Serious risks and red flags

Citalopram can rarely affect the heart’s rhythm. The FDA warns about dose-related QT prolongation — a change on an ECG that can lead to fainting or dangerous arrhythmias. Because of that, doctors usually keep doses under 40 mg/day for most adults and under 20 mg/day for people over 60, or with liver problems, or who take certain other drugs. If you have a history of long QT, low potassium, or take other QT drugs (like some antipsychotics or antibiotics), mention that before starting Celexa.

Watch for signs of serious problems: fainting, fast or irregular heartbeat, severe lightheadedness, or chest pain. Those need urgent care. Also be alert for serotonin syndrome if Celexa is mixed with MAO inhibitors, certain migraine meds (triptans), linezolid, or other serotonergic drugs. Symptoms include high fever, severe agitation, rapid heart rate, muscle stiffness, and confusion — seek emergency help.

Older adults can get low sodium (hyponatremia) with SSRIs, which looks like confusion, weakness, or seizures. Celexa can also increase bleeding risk when combined with blood thinners or NSAIDs. And if you or a family member have suicidal thoughts or sudden mood changes after starting or changing dose, contact your provider right away — especially true for people under 25.

Stopping Celexa suddenly often causes discontinuation symptoms: dizziness, 'electric shock' sensations, irritability, sleep trouble, and flu-like feelings. Don’t quit abruptly — work with your doctor to taper the dose slowly.

Practical tips: take Celexa at the same time each day, avoid heavy drinking, tell every prescriber and pharmacist about it (so they can avoid dangerous combinations), and ask whether you need an ECG if you’re older or on higher doses. Pregnant or breastfeeding? Discuss risks and benefits with your clinician — there can be trade-offs.

If you’re unsure whether a symptom is side effect or something else, call your healthcare provider. Quick communication can prevent small problems from becoming big ones.