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Celexa: Headache and Migraine Drug Profiles.

CelexaŽ (citalopram hydrobromide)

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Updated: June 17, 2006

Celexa
Type of medication: Rx, SSRI antidepressant, Migraine Preventive.
Celexa® is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) family. SSRI's are used to treat depression and, in some cases, anxiety. They are also being prescribed by some doctors as Migraine preventives. In addition to their use as a Migraine preventive, Migraineurs may find these medications useful for clinical (chemical) depression. Migraine and depression have a definite link - 47% of Migraineurs experience clinical depression as opposed to just 17% of the general population.

Precautions:

  • It is important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects.
  • Do not take citalopram with or within 14 days of taking an MAO inhibitor (furazolidone, isocarboxazid, phenelzine, procarbazine, selegiline, tranylcypromine). Do not take an MAO inhibitor within 14 days of taking citalopram
  • Avoid drinking alcoholic beverages while you are taking citalopram.
  • This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to citalopram before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Pregnancy and Breastfeeding:

  • FDA Pregnancy Category C. Studies have not been done in pregnant women. However, studies in animals have shown that citalopram may cause decreased survival rates and slowed growth in offspring when given to the mother in doses many times higher than the usual human dose. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.
  • Citalopram passes into breast milk and may cause unwanted effects, such as drowsiness, decreased feeding, and weight loss in the breast-fed baby. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Other medical conditions:
The presence of other medical problems may affect the use of citalopram. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bipolar disorder (history of)-May be activated
  • Diabetes mellitus (sugar diabetes)-Hypoglycemia has occurred rarely in diabetic patients receiving citalopram
  • Kidney disease, severe- Until enough patients have been evaluated, caution is recommended for patients with severe kidney disease
  • Liver disease-Higher blood levels of citalopram may occur, increasing the chance of having unwanted effects. You may need to take a lower dose than a person without kidney or liver disease
  • Mania (history of)-May be activated
  • Seizure disorders (history of)-The risk of having seizures may be increased.

Other medications:
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking citalopram, it is especially important that your health care professional know if you are taking any of the following:

  • Bromocriptine (e.g., Parlodel)
  • Buspirone (e.g., BuSpar)
  • Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], or imipramine [e.g., Tofranil])
  • Dextromethorphan (cough medicine)
  • Levodopa (e.g., Sinemet)
  • Lithium (e.g., Eskalith)
  • Meperidine (e.g., Demerol)
  • Moclobemide (e.g., Manerix)
  • Nefazodone (e.g., Serzone)
  • Pentazocine (e.g., Talwin)
  • Selective serotonin reuptake inhibitors, other (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft])
  • Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
  • Tramadol (e.g., Ultram)
  • Trazodone (e.g., Desyrel)
  • Triptans (e.g., Imitrex, Maxalt, Zomig, Amerge, Axert, Frova)
  • Tryptophan
  • Venlafaxine (e.g., Effexor)-Using these medicines with citalopram may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome. This syndrome may cause confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching. If you develop these symptoms, contact your doctor as soon as possible
  • Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])-
  • Do not take citalopram while you are taking or within 2 weeks of taking an MAO inhibitor. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, severe convulsions, or the serotonin syndrome. At least 14 days should pass between stopping treatment with one medicine (citalopram or the MAO inhibitor) and starting treatment with the other.
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