Citalopram Side Effects

Citalopram Side Effects

Citalopram is an antidepressant drug that belongs to the selective serotonin reuptake inhibitor (SSRI) class. It can be prescribed for patients suffering from major depression, anxiety, dysthymia, autism, trichotillomania, panic disorder, agoraphobia, PMDD, hot flushes, post-stroke pathological crying, post-traumatic stress disorder, body dysmorphic disorder, somatoform pain disorder, social phobia, dementia, migraines prevention, OCD, binge-eating disorder, anorexia, bulimia, fibromyalgia, diabetic neuropathy, alcoholism, premature ejaculation (off-label use). This antidepressant can also be used to prevent depression relapse.

Side effects

Citalopram does not usually cause very aggravating side effects. However, up to 21% of patients who take this drug may experience some adverse effects. The most common side effects of Citalopram are:

  • Dry mouth
  • Increased salivation
  • Increased appetite
  • Loss of appetite
  • Anorexia
  • Taste perversion
  • Nausea
  • Vomiting
  • Eructation
  • Heartburn
  • Dyspepsia
  • Stomach pain
  • Flatulence
  • Diarrhea
  • Constipation
  • Headache
  • Migraine
  • Dizziness
  • Orthostatic lightheadedness
  • Drowsiness
  • Vivid dreaming
  • Insomnia
  • Fatigue
  • Weakness
  • Asthenia
  • Restlessness
  • Mood swings
  • Increased apathy
  • Anxiety
  • Irritability
  • Hostility
  • Trembling
  • Paresthesia
  • Decreased concentration
  • Decreased coordination
  • Abnormal accommodation
  • Dilated pupils
  • Excessive yawning
  • Weight changes (weight gain or loss)
  • Increased sweating
  • Frequent urination
  • Polyuria
  • Decreased sexual drive or ability
  • Increased or decreased libido
  • Erectile dysfunction
  • Ejaculation problems (premature or delayed ejaculation)
  • Anorgasmia or delayed orgasm
  • Painful menstrual cramps
  • Absent menstrual period (amenorrhea)
  • Dysmenorrhea

The more infrequent side effects of Citalopram include:

  • Thirst
  • Dry eyes
  • Conjunctivitis
  • Vision changes (blurred vision, photophobia)
  • Eye pain
  • Bruxism
  • Hiccups
  • Gingivitis
  • Glossitis
  • Dysphagia
  • Stomatitis
  • Esophagitis
  • Gastroesophageal reflux
  • Gastritis
  • Gastroenteritis
  • Jaundice
  • Colitis
  • Diverticulosis
  • Tinnitus
  • Aggressiveness
  • Impulsiveness
  • Paroniria (nightmares)
  • Exaggerated feeling of well-being
  • Memory loss (up to amnesia)
  • Muscle weakness and pain
  • Joint pain
  • Arthritis
  • Dysuria (micturition frequency, urinary incontinence, urinary retention)
  • Flu-like symptoms (fever, sore throat, laryngitis, pharyngitis, sinus infections, stuffy nose, cough)
  • Easy bruising or bleeding
  • Lymphadenopathy
  • Flushing
  • Skin rash
  • Dermatitis
  • Alopecia
  • Acne
  • Dry skin
  • Photosensitivity
  • Skin discoloration
  • Eczema
  • Psoriasis
  • Goiter
  • Hypothyroidism

Like any other drug, Citalopram can cause allergic reactions such as rash, urticaria, itching, severe dizziness, difficulty in swallowing something or in breathing, chest tightness, swelling of the mouth, hands, eyes, conjunctivae, face, lips, tongue and throat, unusual hoarseness, hayfever, angioedema, anaphylaxis, anaphylactic shock and anaphylactoid reactions. These reactions are serious and require urgent medical attention.

Citalopram may cause development of the serotonin syndrome that manifests in confusion or other mental changes, poor coordination, sudden body or facial movements, excitement, agitation, hallucinations, shakiness, overactive reflexes, fever, sweating, shivering, rapid or irregular heart rhythm, changes in blood pressure, trouble holding or releasing urine, nausea, vomiting, or diarrhea, seizures, and coma.

Rare side effects

In some rare cases, Citalopram can cause hair loss, change in sense of taste, gingival bleeding, rigors, hot flushes, mydriasis, ptosis, diplopia, abnormal lacrimation, red and irritated eyes, cataract, asthma, phlebitis, leg cramps, bursitis, osteoporosis, melanosis, keratitis, cellulites, hypertrichosis, decreased sweating, tingling or burning in skin, pruritus ani, genital anesthesia, ejaculatory anhedonia, kidney stones formation, diabetes mellitus, obesity, galactorrhea, gynecomastia, breast pain and enlargement, and alcohol intolerance.

Changes in laboratory test

Laboratory test results can reveal some changes caused by Citalopram intake. Among them are anemia (hemolytic, hypochromic), leukocytosis, leucopenia, lymphocytosis, lymphopenia, granulocytopenia, thrombocytopenia, coagulation disorder (low prothrombin level), increased hepatic enzymes (alanine aminotransferase, aspartate aminotransferase, lactat dehydrogenase, gammaglutamyl transferase, bilirubin, alkaline phosphatase), hyponatremia, hypokalemia, hypoglycemia, abnormal glucose tolerance, hypothyroidism, and prolactinemia. The following abnormalities can be found in urine tests: polyuria, oliguria, hematuria, leukocyturia, bacteriuria. The patient may have bloody or tarry stools.

EKG changes may include bundle branch block, prolongation of the QT interval, arrhythmias, and torsade de pointes.

Serious side effects

Citalopram intake can cause some serious side effects that may require immediate medical attention. Among such effects are:

  • Suicidal thought, behavior or attempts (especially among patients under 24 years old)
  • Drug dependence
  • Withdrawal syndrome
  • Fainting
  • Seizures
  • Abnormal gait
  • Worsening of depression
  • Depersonalization
  • Manic episodes
  • Unmasking of the bipolar disorder
  • Paranoid reaction
  • Euphoria
  • Catatonic reaction
  • Psychosis
  • Hyperkinesia
  • Akathisia
  • Hypokinesia
  • Dystonia
  • Hallucinations
  • Engaging in unusual or dangerous activities
  • Panic attacks
  • Neuralgia
  • Nystagmus
  • Glaucoma
  • Cerebrovascular accident (transient ischemic attack)
  • Uneven breathing and breathing that stops
  • Bronchitis
  • Pneumonia
  • Short breath
  • Bronchospasm
  • Chest pain
  • Myocardial infarction
  • Cardiac arrest
  • Heart arrhythmias (fast, slow, or irregular heartbeat)
  • Atrial fibrillation
  • Hyper- or hypotension
  • Peripheral edema
  • Cardiac failure
  • Gastric ulcer
  • Duodenal ulcer
  • Gastrointestinal hemorrhage
  • Cholecystitis
  • Cholelithiasis
  • Hepatitis
  • Hepatic necrosis
  • Pancreatitis
  • Rectal hemorrhage
  • Increased risk of bleeding
  • Epistaxis (nose bleeding)
  • Vaginal hemorrhage
  • Purpura
  • Epidermal necrolysis
  • Erythema multiforme
  • Rhabdomyolysis
  • Muscle stiffness
  • Priapism
  • Pyelonephritis
  • Nephrolithiasis
  • Acute renal failure
  • SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)

Side effects in pregnant women

Citalopram intake during pregnancy may cause serious problems in the newborn, so it should be taken during pregnancy only when the benefit outweighs the risk. Spontaneous abortion, heart defects or serious life-threatening lung problems could develop in the fetus. The newborn child may also suffer respiratory distress and withdrawal syndromes. Therefore, a pregnant woman should consult her doctor before using Citalopram.

Side effects in children

The most common side effects of Citalopram in children are depression worsening, suicidal thoughts, serotonin syndrome (loose stools, upset stomach, fast heartbeat, hypertension, agitation, hallucinations), headache, migraine, insomnia, dry mouth, and allergic reaction.

Conclusions

You may never experience any of the side effects listed above. Your doctor cannot predict your body’s reaction to Citalopram until you have tried it. That is why you should immediately inform your doctor of any changes in your health condition after taking Citalopram. Therefore, when you feel something is wrong, ask your doctor for advice and he or she will diagnose if your problem is connected with the medicine intake. You should also be careful because some of the side effects of Citalopram require urgent medical attention. In addition, it is strongly recommended not to stop Citalopram intake suddenly because this can lead to withdrawal syndrome.