Celexa withdrawal. Celexa withdrawal side effects, Celexa withdrawal warnings, Celexa withdrawal precautions, Celexa withdrawal adverse effects, overdose, withdrawal symptoms and Celexa natural alternatives. Before you begin the spiral down with Celexa, try giving your body what it really wants.

Celexa

Celexa withdrawal Body

Celexa withdrawal Dry Mouth - The usual amount to moisture in the mouth is noticeably less.

Celexa withdrawal Sweating Increased - A large quantity of perspiration that is medically caused.

Celexa withdrawal Cardiovascular (Involving the heart and the blood vessels)

Celexa withdrawal Palpitation - Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering.  It can be brought on by shock, excitement, exertion, or medical stimulants.  A person is normally unaware of his/her heartbeat.

Celexa withdrawal Hypertension - is high blood pressure, which is a symptom of disease in the blood vessels leading away from the heart.  Hypertension is known as the “silent killer”.  The symptoms are usually not obvious, however it can lead to damage to the heart, brain, kidneys and eye, and even to stroke and kidney failure. Treatment includes dietary and lifestyle changes.

Celexa withdrawal Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.

Celexa withdrawal Tachycardia - The heart rate is speeded up to above 100 beats per minute in an adult.  Normal adult heart rate is 72 beats per minute.

Celexa withdrawal ECG Abnormal - A test called an electrocardiogram (ECG) that records the activity of the heart.  It measures heartbeats as will as the position and size of the heart’s four chambers.  It also measures if there is damage to the heart and the effects of drugs or mechanical devices like a pacemaker on the heart.  When the test is abnormal this means that one or more of the following are present: heart disease, defects, beating too fast or too slow, disease of the blood vessels leading from the heart or of the heart valves, and/or a past or about to occur heart attack. 

Celexa withdrawal Flushing - The skin all over the body turns red.

Celexa withdrawal Varicose Vein - Unusually swollen veins near the surface of the skin that sometimes appear twisted and knotted, but always enlarged.  They are called hemorrhoids when they appear around the rectum.  The cause is attributed to hereditary weakness in the veins aggravated by obesity, pregnancy, pressure from standing, aging, etc.  Severe cases may develop swelling in the legs, ankles and feet, eczema and/or ulcers in the affected areas.

Celexa withdrawal Gastrointestinal (Involving the stomach and the intestines)

Celexa withdrawal Abdominal Cramp/Pain - Sudden, severe, uncontrollable and painful shortening and thickening of the muscles in the belly.  The belly includes the stomach as well as the intestines, liver, kidneys, pancreas, spleen, gall bladder, and urinary bladder.

Celexa withdrawal Belching - Noisy release of gas from the stomach through the mouth; a burp.

Celexa withdrawal Bloating - Swelling of the belly caused by excessive intestinal gas.

Celexa withdrawal Constipation - Difficulty in having a bowel movement where the material in the bowels is hard due to a lack of exercise, fluid intake, and roughage in the diet, or due to certain drugs.

Celexa withdrawal Diarrhea - Unusually frequent and excessive, runny bowel movements that may result in severe dehydration and shock. 

Celexa withdrawal Dyspepsia - Indigestion.  This is the discomfort you experience after eating.  It can be heartburn, gas, nausea, a bellyache or bloating.

Celexa withdrawal Flatulence - More gas than normal in the digestive organs.

Celexa withdrawal Gagging - Involuntary choking and/or involuntary throwing up.

Celexa withdrawal Gastritis - A severe irritation of the mucus lining of the stomach either short in duration or lasting for a long period of time.

Celexa withdrawal Gastroenteritis - A condition where the membranes of the stomach and intestines are irritated.

Celexa withdrawal Gastroesophageal Reflux - A continuous state where stomach juices flow back into the throat causing acid indigestion and heartburn and possibly injury to the throat.

Celexa withdrawal Heartburn - A burning pain in the area of the breastbone caused by stomach juices flowing back up into the throat.

Celexa withdrawal Hemorrhoids - Small rounded purplish swollen veins that either bleed, itch or are painful and appear around the anus.

Celexa withdrawal Increased Stool frequency - Diarrhea.  

Celexa withdrawal Indigestion - Unable to properly consume and absorb food in the digestive tract causing constipation, nausea, stomach ache, gas, swollen belly, pain and general discomfort or sickness.

Celexa withdrawal Nausea - Stomach irritation with a queasy sensation similar to motion sickness and a feeling that one is going to vomit.

Celexa withdrawal Polyposis Gastric - Tumors that grow on stems in the lining of the stomach, which usually become cancerous.

Celexa withdrawal Swallowing Difficulty - A feeling that food is stuck in the throat or upper chest area and won’t go down, making it difficult to swallow.

Celexa withdrawal Toothache - Pain in a tooth above and below the gum line.

Celexa withdrawal Vomiting - Involuntarily throwing up the contents of the stomach and usually getting a nauseated, sick feeling just prior to doing so.

Celexa withdrawal General

Celexa withdrawal Allergy - The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Celexa withdrawal Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Celexa withdrawal Asthenia - A physically weak condition.

Celexa withdrawal Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Celexa withdrawal Chills - Appearing pale while cold and shivering; sometimes with a fever.

Celexa withdrawal Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid.

Celexa withdrawal Fall - To suddenly lose your normal standing upright position as if you were shot.

Celexa withdrawal Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities. 

Celexa withdrawal Fever - Abnormally high body temperature, the normal being 98 degrees Fahrenheit or 37 degrees Centigrade in humans, which is a symptom of disease or disorder in the body.  The body is affected by feeling hot, chilled, sweaty, weak and exhausted.  If the fever goes too high, death can result.

Celexa withdrawal Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body.  Women in menopause will sometimes experience this.

Celexa withdrawal Influenza-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu.

Celexa withdrawal Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Celexa withdrawal Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick.

Celexa withdrawal Pain in Limb - Sudden, sharp and uncontrolled leg discomfort.

Celexa withdrawal Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain.

Celexa withdrawal Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly).  The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles.

Celexa withdrawal Hemic and Lymphatic Disorders (Involving the blood and the clear fluids in the tissues that contain white blood cells)

Celexa withdrawal Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin.

Celexa withdrawal Anemia - A condition where the blood is no longer carrying enough oxygen, so the person looks pale and easily gets dizzy, weak and tired.  More severely, a person can end up with an abnormal heart, as well as breathing and digestive difficulties.  The causes of anemia are not enough protein in the red blood cells, or missing and chemically destroyed red blood cells, as well as diseased or destroyed bone marrow.

Celexa withdrawal Nosebleed - Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen.

Celexa withdrawal Hematoma - Broken blood vessels that cause a swelling in an area on the body.

Celexa withdrawal Lymphadenopathy Cervical - The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug.  The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

Celexa withdrawal Metabolic and Nutritional Disorders (Energy and health)

Celexa withdrawal Arthralgia - Sudden sharp nerve pain in one or more joints.

Celexa withdrawal Arthropathy - Having joint disease or abnormal joints.

Celexa withdrawal Arthritis - Painfully inflamed and swollen joints.  The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Celexa withdrawal Back Discomfort - Severe physical distress in the area from the neck to the pelvis along the backbone.

Celexa withdrawal Bilirubin Increased - Bilirubin is a waste product of the breakdown of old blood cells.  Bilirubin is sent to the liver to be made water-soluble so it can be eliminated from the body through emptying the bladder.  A drug can interfere with or damage this normal liver function creating liver disease.

Celexa withdrawal Decreased Weight - Uncontrolled and measured loss of heaviness or weight.

Celexa withdrawal Gout - A severe arthritis condition that is caused by the dumping of a waste product called uric acid in the tissues and joints.  It can become worse and cause the body to develop a deformity after going through stages of pain, inflammation, severe tenderness, and stiffness.

Celexa withdrawal Hepatic Enzymes Increased - An increase in the amount of paired liver proteins that regulate liver processes causing a condition where the liver functions abnormally.

Celexa withdrawal Hypercholesterolemia - Too much cholesterol in the blood cells.

Celexa withdrawal Hyperglycemia - An unhealthy amount of sugar in the blood.

Celexa withdrawal Increased Weight - A concentration and storage of fat in the body accumulating over a period of time caused by unhealthy eating patterns, that can predispose the body to many disorders and diseases.

Celexa withdrawal Jaw Pain - The pain due to irritation and swelling of the nerves associated with the mouth area where it opens and closes just in front of the ear.  Some of the symptoms are pain when chewing, head aches, losing your balance, stuffy ears or ringing in the ears, and teeth grinding.

Celexa withdrawal Jaw Stiffness - The result of squeezing and grinding the teeth while asleep that can cause your teeth to deteriorate as well as the muscles and joints of the jaw.

Celexa withdrawal Joint Stiffness - A loss of free motion and easy flexibility where any two bones come together.

Celexa withdrawal Muscle Cramp - When muscles contract uncontrollably without warning and do not relax.  The muscles of any of the body’s organs can cramp.

Celexa withdrawal Muscle Stiffness - Tightening of muscles making it difficult to bend.

Celexa withdrawal Muscle Weakness - Loss of physical strength.

Celexa withdrawal Myalgia - A general widespread pain and tenderness of the muscles.

Celexa withdrawal Thirst - A strong, unnatural craving for moisture/water in the mouth and throat. 

Celexa withdrawal Nervous System (Sensory channels)

Celexa withdrawal Carpal Tunnel Syndrome - A pinched nerve in the wrist that causes pain, tingling, and numbing.

Celexa withdrawal Coordination Abnormal - A lack of normal, harmonious interaction of the parts of the body when it is in motion.

Celexa withdrawal Dizziness - Losing one’s balance while feeling unsteady and lightheaded which may lead to fainting.

Celexa withdrawal Disequilibrium - Lack of mental and emotional balance.

Celexa withdrawal Faintness - A temporary condition where one is likely to go unconscious and fall.

Celexa withdrawal Headache - A sharp or dull persistent pain in the head

Celexa withdrawal Hyperreflexia - A not normal and involuntary increased response in the tissues connecting the bones to the muscles.

Celexa withdrawal Light-headed Feeling – Uncontrolled and usually brief loss of consciousness caused by lack of oxygen to the brain.

Celexa withdrawal Migraine - Reoccurring severe head pain usually with nausea, vomiting, dizziness, flashes or spots before the eyes, and ringing in the ears

Celexa withdrawal Muscle Contractions Involuntary - Spontaneous and uncontrollable tightening reaction of the muscles caused by electrical impulses from the nervous system.

Celexa withdrawal Muscular Tone Increased - Uncontrolled and exaggeration muscle tension.  Muscles are normally partially tensed and this is what gives us muscle tone. 

Celexa withdrawal Paresthesia - Burning, prickly, itchy, or tingling skin with no obvious or understood physical cause.

Celexa withdrawal Restless Legs - A need to move the legs without any apparent reason.  Sometimes there is pain, twitching, jerking, cramping, burning, or a creepy-crawly sensation associated with the movements.  It worsens when a person is inactive and can interrupt one’s sleep so one feels the need to move to gain some relief.

Celexa withdrawal Shaking - Uncontrolled quivering and trembling as if one is cold and chilled.

Celexa withdrawal Sluggishness - Lack of alertness and energy, as well as being slow to respond or perform in life.

Celexa withdrawal Tics - A contraction of a muscle causing a repeated movement not under the control of the person usually on the face or limbs.

Celexa withdrawal Tremor - A nervous and involuntary vibrating or quivering of the body.

Celexa withdrawal Twitching - Sharp, jerky and spastic motion sometimes with a sharp sudden pain.

Celexa withdrawal Vertigo - A sensation of dizziness with disorientation and confusion.

Celexa withdrawal Psychiatric Disorders (Mental and emotional)

Celexa withdrawal Aggravated Nervousness - A progressively worsening, irritated and troubled state of mind.

Celexa withdrawal Agitation - Suddenly violent and forceful, emotionally disturbed state of mind.

Celexa withdrawal Amnesia - Long term or short term, partial or full memory loss created by emotional or physical shock, severe illness, or a blow to the head where the person was caused pain and became unconsciousness.

Celexa withdrawal Anxiety Attack - Sudden and intense feelings of fear, terror, and dread physically creating shortness of breath, sweating, trembling and heart palpitations.

Celexa withdrawal Apathy - Complete lack of concern or interest for things that ordinarily would be regarded as important or would normally cause concern.

Celexa withdrawal Appetite Decreased - Having a lack of appetite despite the ordinary caloric demands of living with a resulting unintentional loss of weight.

Celexa withdrawal Appetite Increased - An unusual hunger causing one to overeat.

Celexa withdrawal Auditory Hallucination - Hearing things without the voices or noises being present.

Celexa withdrawal Bruxism - Grinding and clenching of teeth while sleeping.

Celexa withdrawal Carbohydrate Craving - A drive and craving to eat foods rich in sugar and starches (sweets, snacks and junk foods) that intensifies as the diet becomes more and more unbalanced due to the unbalancing of the proper nutritional requirements of the body.

Celexa withdrawal Concentration Impaired - Unable to easily focus your attention for long periods of time.

Celexa withdrawal Confusion - Not able to think clearly and understand in order to make a logical decision.

Celexa withdrawal Crying Abnormal - Unusual and not normal fits of weeping for short or long periods of time for no apparent reason.

Celexa withdrawal Depersonalization - A condition where one has lost a normal sense of personal identity.

Celexa withdrawal Depression - A hopeless feeling of failure, loss and sadness that can deteriorate into thoughts of death.

Celexa withdrawal Disorientation - A loss of sense of direction, place, time or surroundings as well as mental confusion on personal identity.

Celexa withdrawal Dreaming Abnormal - Dreaming that leaves a very clear, detailed picture and impression when awake that can last for a long period of time and sometimes be unpleasant.

Celexa withdrawal Emotional Lability - Suddenly breaking out in laughter or crying or doing both without being able to control the outburst of emotion.  These episodes are unstable as they are caused by things that normally would not have this effect on an individual.

Celexa withdrawal Excitability - Uncontrollably responding to stimuli.

Celexa withdrawal Feeling Unreal - The awareness that one has an undesirable emotion like fear but can’t seem to shake off the irrational feeling.  For example, feeling like one is going crazy but rationally knowing that it is not true.  The quality of this side effect resembles being in a bad dream and not being able to wake up.

Celexa withdrawal Forgetfulness - Unable to remember what one ordinarily would remember.

Celexa withdrawal Insomnia - Sleeplessness caused by physical stress, mental stress or stimulants such as coffee or medications; it is a condition of being abnormally awake when one would ordinarily be able to fall and remain asleep.

Celexa withdrawal Irritability - Abnormally annoyed in response to a stimulus.

Celexa withdrawal Jitteriness - Nervous fidgeting without an apparent cause.

Celexa withdrawal Lethargy - Mental and physical sluggishness and apathy that can deteriorate into an unconscious state resembling deep sleep.  A numbed state of mind.

Celexa withdrawal Libido Decreased - An abnormal loss of sexual energy or desire.

Celexa withdrawal Panic Reaction - A sudden, overpowering, chaotic and confused mental state of terror resulting in being doubt ridden often accompanied with hyperventilation, and extreme anxiety.

Celexa withdrawal Restlessness Aggravated - A constantly worsening troubled state of mind characterized by the person being increasingly nervous, unable to relax, and easily angered.

Celexa withdrawal Somnolence - Feeling sleepy all the time or having a condition of semi-consciousness.

Celexa withdrawal Suicide Attempt - An unsuccessful deliberate attack on one’s own life with the intention of ending it.

Celexa withdrawal Suicidal Tendency - Most likely will attempt to kill oneself.

Celexa withdrawal Tremulousness Nervous - Very jumpy, shaky, and uneasy while feeling fearful and timid.  The condition is characterized by thoughts of dreading the future, involuntary quivering, trembling, and feeling distressed and suddenly upset.

Celexa withdrawal Yawning - involuntary opening of the mouth with deep inhalation of air.

Celexa withdrawal Reproductive Disorder Female

Celexa withdrawal Breast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman. 

Celexa withdrawal Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Celexa withdrawal Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Celexa withdrawal Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period.

Celexa withdrawal Pelvic Inflammation - The reaction of the body to infectious, allergic, or chemical irritation, which in turn causes tissue irritation, injury, or bacterial infection characterized by pain, redness, swelling, and sometimes loss of function. The reaction usually begins in the uterus and spreads to the fallopian tubes, ovaries, and other areas in the hipbone region of the body.

Celexa withdrawal Premenstrual Syndrome - Various physical and mental symptoms commonly experienced by women of childbearing age usually 2 to 7 days before the start of their monthly period.  There are over 150 symptoms including eating binges, behavioral changes, moodiness, irritability, fatigue, fluid retention, breast tenderness, headaches, bloating, anxiety, and depression.  The symptoms cease shortly after the period begins, and disappear with menopause.

Celexa withdrawal Spotting Between Menses - Abnormal bleeding between periods.  Unusual spotting between menstrual cycles.

Celexa withdrawal RESPIRATORY SYSTEM (Organs involved in breathing)

Celexa withdrawal Asthma - A disease of the breathing system initiated by and allergic reaction or a chemical with repeated attacks of coughing, sticky mucus, wheezing, shortness of breath, and a tight feeling in the chest.  The disease can reach a state where it stops a person from exhaling, leading to unconsciousness and death.

Celexa withdrawal Breath Shortness - Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.

Celexa withdrawal Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs.  The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction.

Celexa withdrawal Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.

Celexa withdrawal Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing.  It can be cause by straining the voice or exposure to infectious, allergic or chemical irritation.

Celexa withdrawal Nasal Congestion - The presence of an abnormal amount of fluid in the nose.

Celexa withdrawal Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe.  Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge.

Celexa withdrawal Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Celexa withdrawal Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose.  These areas become clogged with excess fluid or infected.

Celexa withdrawal Sinus Headache - The abnormal amount of fluid in the hollows of the face bone area especially around the nose.  This excess fluid creates pressure, causing pain in the head.

Celexa withdrawal Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

Celexa withdrawal SKELETAL

Celexa withdrawal Neck/Shoulder Pain - Hurtful sensations of the nerve endings caused by damage to the tissues in the neck and shoulder signaling danger of disease.

Celexa withdrawal SKIN and APPENDAGES DISORDERS (Skin, legs and arms)

Celexa withdrawal Acne - Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Celexa withdrawal Alopecia - The loss of hair or baldness.

Celexa withdrawal Eczema - A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching.  It is often difficult to treat and will sometimes go away only to reappear again.

Celexa withdrawal Dermatitis - Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction.  It is a general inflammation of the skin.

Celexa withdrawal Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.

Celexa withdrawal Dry Skin - The lack of normal moisture/oils in the surface layer of the body.  The skin is the body’s largest organ.

Celexa withdrawal Folliculitis - Inflammation of a follicle (small body sac) especially a hair follicle.  A hair follicle contains the root of a hair.

Celexa withdrawal Furunculosis - Skin boils that show up repeatedly.

Celexa withdrawal Lipoma - A tumor of mostly fat cells that is not health endangering.

Celexa withdrawal Pruritus - Extreme itching of often-undamaged skin.

Celexa withdrawal Rash - A skin eruption or discoloration that may or may not be itching, tingling, burning, or painful.  It may be caused by an allergy, an skin irritation, a skin disease.

Celexa withdrawal Skin Nodule - A bulge, knob, swelling or outgrowth in the skin that is a mass of tissue or cells.

Celexa withdrawal SPECIAL SENSES

Celexa withdrawal Conjunctivitis - Infection of the membrane that covers the eyeball and lines the eyelid, caused by a virus, allergic reaction, or an irritating chemical.  It is characterized by redness, a discharge of fluid and itching.

Celexa withdrawal Dry Eyes - Not enough moisture in the eyes.

Celexa withdrawal Earache - Pain in the ear.

Celexa withdrawal Eye Infection - The invasion of the eye tissue by a bacteria, virus, fungus, etc, causing damage to the tissue, with toxicity.  Infection spreading in the body progresses into disease.

Celexa withdrawal Eye Irritation - An inflammation of the eye.

Celexa withdrawal Metallic Taste - A range of taste impairment from distorted taste to a complete loss of taste.

Celexa withdrawal Pupils Dilated - Abnormal expansion of the blace circular opening in the center of the eye.

Celexa withdrawal Taste alteration - Abnormal flavor detection in food.

Celexa withdrawal Tinnitus - A buzzing, ringing, or whistling sound in one or both ears occurring from the internal use of certain drugs.

Celexa withdrawal Vision Abnormal - Normal images are seen differently by the viewer.

Celexa withdrawal Vision Blurred - Eyesight is dim or indistinct and hazy in outline or appearance.

Celexa withdrawal Visual Disturbance - Eyesight is interfered with or interrupted.  Some disturbances are light sensitivity and the inability to easily distinguish colors.

Celexa withdrawal URINARY SYSTEM DISORDER

Celexa withdrawal Blood in Urine - Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red.  Or you could see pots of blood in the water after urinating. 

Celexa withdrawal Dysuria - Difficult or painful urination.

Celexa withdrawal Kidney Stone - Small hard masses of salt deposits that the kidney forms.

Celexa withdrawal Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.

Celexa withdrawal Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body.  If the invasion goes unchecked it can injure tissue and progress into disease.

Celexa withdrawal Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

Celexa withdrawal UROGENITAL (Urinary tract and genital structures or functions)

Celexa withdrawal Anorgasmia - Failure to experience an orgasm.

Celexa withdrawal Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.

Celexa withdrawal Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.

Celexa withdrawal Acute Renal Failure - The kidneys stop functioning properly to excrete wastes.

Celexa withdrawal Angioedema - Intensely itching and swelling welts on the skin called hives caused by an allergic reaction to internal or external agents.  The reaction is common to a food or a drug. Chronic cases can last for a long period of time. 

Celexa withdrawal Toxic Epidermal Necrolysis - An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn.  Often the symptoms include blistering.

Celexa withdrawal Gastrointestinal Hemorrhage - Stomach and intestinal excessive internal bleeding.

Celexa withdrawal Grand Mal Seizures (or Convulsions) - A recurring sudden violent and involuntary attack of muscle spasms with a loss of consciousness.

Celexa withdrawal Neuroleptic Malignant Syndrome - A life threatening, rare reaction to an anti-psychotic drug marked by fever, muscular rigidity, changed mental status, and dysfunction of the autonomic nervous system.

Celexa withdrawal Pancreatitis - Chemical irritation with redness, swelling, and pain in the pancreas where digestive enzymes and hormones are secreted.

Celexa withdrawal QT Prolongation - A very fast heart rhythm disturbance that is too fast for the heart to beat effectively so the blood to the brain falls causing a sudden loss of consciousness and may cause sudden cardiac death.

Celexa withdrawal Rhabdomyolysis - The breakdown of muscle fibers that releases the fibers into the circulatory system.  Some of the fibers are poisonous to the kidney and frequently result in kidney damage.

Celexa withdrawal Serotonin Syndrome - A disorder brought on by excessive levels of serotonin caused by drugs and can be fatal as death from this side effect can come very rapidly.

Celexa withdrawal Thrombocytopenia - An abnormal decrease in the number of blood platelets in the circulatory system. A decrease in platelets would cause a decrease in the ability of the blood to clot when necessary.

Celexa withdrawal Torsades de Pointes - Unusual rapid heart rhythm starting in the lower heart chambers.  If the short bursts of rapid heart rhythm continue for a prolonged period it can degenerate into a more rapid rhythm and can be fatal.

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Action and Clinical Pharmacology  

Antidepressant

Citalopram hydrobromide is a highly selective and potent serotonin 
(5-hydroxytryptamine 5-HT) reuptake inhibitor with minimal effects on the 
neuronal reuptake of norepinephrine (NE) and dopamine (DA). The ability 
of citalopram to potentiate serotonergic activity in the central nervous 
system via inhibition of the neuronal reuptake of serotonin is thought to be 
responsible for its antidepressant action. Tolerance to the inhibition of serotonin reuptake is not induced by long term (14 days) treatment of rats with citalopram.

Citalopram has no or very low affinity for a series of receptors including serotonin 5-HT_1A, 5-HT₂, dopamine D₁, and D₂, a₁-, a₂-, b-adrenergic, histamine H₁, muscarinic cholinergic, benzodiazepine, gamma aminobutyric acid (GABA) and opioid receptors.

Pharmacokinetics

Absorption
Following the administration of a single oral dose of citalopram (40 mg) to healthy male volunteers, peak blood levels occurred at about 4 hours (range 1 to 6 hours). The absolute bioavailability of citalopram was about 80% (range 52 to 93%) relative to an intravenous dose. Absorption was not affected by food.

Distribution
After intravenous infusion in healthy male volunteers the apparent volume of distribution (V_d)b was about 12 L/kg (range 9-17 L/kg), indicating a pronounced tissue distribution: (V_d)b oral was about 17 L/kg (range 14-17 L/kg). The binding of citalopram and its demethylated metabolites to human plasma proteins is about 80%.

Steady-state
The single- and multiple dose pharmacokinetics of citalopram are linear and dose proportional in a dose range of 10 to 60 mg/day. Steady-state plasma levels are achieved in patients in 1-2 weeks. At a daily dose of 40 mg, the average plasma concentration is about 83 ng/mL (n=114) with a range from 30 to 200 ng/mL. Citalopram does not accumulate during long term treatment. A clear relationship between citalopram plasma levels and therapeutic response or side effects has not been established.

Metabolism
Citalopram is metabolized in the liver to demethylcitalopram (DCT), didemethylcitalopram (DDCT), citalopram N-oxide and a deaninated propionic acid derivative. In vitro studies show that DCT, DDCT and citalopram-N-oxide also inhibit the neuronal reuptake of serotonin but are less selective and less potent than the parent compound and are of minor clinical importance. Unchanged citalopram is the predominant compound in plasma. In vitro studies indicated that the biotransformation of citalopram to its demethyl metabolites depends on both CYP2C19 and CYP3A4, with a small contribution from CYP2D6.

Elimination
The elimination half life of citalopram (t_1/2b) is approximately 37 hours (range 30-42 hours) which allows recommendation of once-daily dosing. The systemic citalopram plasma clearance (Cl₅) is 0.33 L/min. Citalopram is eliminated primarily via the liver (85%) and the remainder via the kidneys; approximately 12% (range 6-21%) of the daily dose is excreted in urine as unchanged citalopram.

Special Populations:   Back to top of page

Elderly Patients
Elderly patients (4 males and 7 females aged 73-90 years), received a 20 mg/day dose of citalopram for 3-4 weeks. In the elderly, steady state plasma levels were elevated (106 ng/mL), half-life prolonged (1.5-3.75 days) and clearance decreased (0.08-0.3 L/min). Elevation of citalopram plasma levels occurred at an earlier age in females than in males, In this population, lower doses and a lower maximum dose of citalopram are recommended.

Reduced Hepatic Function
The pharmacokinetics of citalopram were compared in patients with reduced hepatic function (3 female and 6 male patients aged 41-60 years) to those seen in 12 healthy male volunteers (aged 21-43 years), In patients with reduced hepatic function the half-life of citalopram was approximately doubled (83 hours versus 37 hours), steady state citalopram concentrations increased by 61% and oral clearance decreased by 37%. Consequently the use of citalopram in patients with reduced hepatic function should be approached with caution and lower maximal doses should be prescribed (see PRECAUTIONS and DOSAGE AND ADMINISTRATION).

Reduced Renal Function
In patients with mild to moderate reduction of the renal function (4 females and 3 males, aged 30-55 years), citalopram was being eliminated more slowly than in 12 healthy male volunteers (aged 21-43 years), half-lives being 49 hours versus 37 hours. However, mild to moderate renal impairment had no major influence on the kinetics of citalopram. At present, no information is available for chronic treatment of patients with severely reduced renal function (creatinine clearance <20 mL/min). 

Indications and Clinical Use   Back to top of page

Citalopram hydrobromide is indicated for the symptomatic relief of depressive illness.

The relapse rate was significantly lower in citalopram-treated patients than in placebo-treated patients in two placebo-controlled studies, that were conducted over a 24-week period in patients who responded to 6 or 8 weeks of acute treatment with citalopram (see CLINICAL TRIALS under ACTION AND CLINICAL PHARMACOLOGY.) Nevertheless, the physician who elects to use citalopram for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.

Contraindications   Back to top of page

Monoamine Oxidase Inhibitors
In patients, receiving selective serotonin reuptake inhibitors (SSRIs) in combination with a monoamine oxidase inhibitor (MAOI), there have been reports of serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes, including extreme agitation progressing to delirium and coma. These reactions have also been reported in patients who have recently discontinued SSRI treatment and have been started on a MAOI. Some cases presented with features resembling serotonin syndrome. Therefore, it is recommended that citalopram should not be used in combination with a MAOI or within 14 days of discontinuing treatment with a MAOI. Similarly, at least 14 days should elapse after discontinuing citalopram treatment before starting a MAOI.

Precautions   Back to top of page

Suicide
The possibility of a suicide attempt is inherent in depression and may persist until remission occurs. Therefore, high risk patients should be closely supervised throughout therapy with Citalopram hydrobromide and consideration should be given to the possible need for hospitalization. In order to minimize the opportunity for overdosage, prescription for citalopram should be written for the smallest quantity of drug consistent with good patient management.

Activation of Mania/Hypomania
In placebo-controlled trials with citalopram, some of which included patients with bipolar disorder, mania/hypomania was reported in 0.1% of 1027 patents treated with citalopram versus none of the 426 patients treated with placebo. Activation of mania/hypomania has also been reported in a small proportion of patients with major affective disorders treated with other marketed antidepressants. If a patient enters a manic phase, citalopram should be discontinued.

Seizures
Citalopram has not been systematically evaluated in patients with a seizure disorder. These patients were excluded from clinical studies during the premarketing testing of citalopram. In clinical trials, seizures occurred in 0.25% of patients treated with citalopram and in 0.23% patients treated with placebo. Like other antidepressants, citalopram should be used with caution in patients with a history of seizure disorder.

Serotonin Syndrome
Rarely, the occurrence of serotonin syndrome has been reported in patients receiving SSRIs. A combination of symptoms, possibly including agitation, confusion, tremor, myoclonus and hyperthermia, may indicate the development of this condition.

5-HT₁ Agonists
There have been rare postmarketing reports describing patients with weakness, hyperreflexia and incoordination, following the concomitant use of a SSRI and the antimigraine drug sumatriptan, a 5-HT₁ agonist. Such interaction should be considered if citalopram is to be used in combination with a 5-HT₁ agonist.

Hyponatremia
Hyponatremia and SIADH (syndrome of inappropriate antidiuretic hormone secretion) have been reported with citalopram use as a rare adverse event.

Pregnancy and Nursing Mothers
The safety of citalopram during pregnancy and lactation has not been established. Therefore, citalopram should not be used during pregnancy, unless, in the opinion of the physician, the expected benefits to the patient markedly outweigh the possible hazards to the fetus. Citalopram is excreted in human milk. Citalopram should not be administered to nursing mothers unless, in the opinion of the treating physician, the expected benefits to the patient markedly outweigh the possible hazards to the child.

Pediatric Use
Safety and effectiveness in patients below the age of 18 have not been established.

Geriatric Use
In premarketing clinical trials, 800 elderly patients (>=65 years of age) have been treated with citalopram. Of these patients 298 were >=75 years old. In a pharmacokinetic study (n=11, age 73 to 90 years), clearance was substantially decreased and half-life prolonged (see PHARMACOKINETICS). In a 6-week placebo-controlled study, approximately equal numbers of patients received citalopram at 20 or 30 mg per day, as the final dose. In about 5% of patients, the final dose was 10 mg per day (see CLINICAL TRIALS). Consequently, elderly patients should be administered lower doses and a lower maximum dose.

Hepatic Impairment
Citalopram clearance was significantly decreased and plasma concentrations, as well as elimination half-life significantly increased (see PHARMACOKINETICS). Consequently, the use of citalopram in hepatically impaired patients should be approached with caution and a lower maximum dosage is recommended.

Renal Impairment
No dosage adjustment is needed in patients with mild to moderate renal impairment. To date, no information is available on the pharmacokinetic or pharmacodynamic effects of citalopram in patients with severely reduced renal function (creatinine clearance <20 mL/min).

Use in Patients with Cardiac Disease
Citalopram has not been systematically evaluated in patients with a recent history of myocardial infarction or unstable heart disease. Patients with these diagnoses were generally excluded from clinical trials during the drugs premarketing assessment. However, the electrocardiograms of patients, who received citalopram in clinical trials, indicate that citalopram was not associated with the development of clinically significant ECG abnormalities.

In clinical trials, citalopram caused small but statistically significant decreases in heart rate (see ECG under ADVERSE REACTIONS) Consequently, caution should be observed when citalopram is initiated in patients with pre-existing slow heart rate.

Use in Diabetic Patients
Citalopram has not been systematically evaluated in diabetic patients since diabetes constituted an exclusion criterion. Although 13 patients did receive insulin during the studies, this number is too small to determine whether citalopram affects the response to insulin. Rare events of hypoglycemia were reported. Citalopram should be used with caution in diabetic patients on insulin or other antidiabetic drugs.

Interference with Cognitive and Motor Performance
In studies in normal volunteers, citalopram in doses of 40 mg/day did not impair cognitive function or psychomotor performance. However, psychotropic medications may impair judgement, thinking or motor skills. Consequently, patients should be cautioned against driving a car or operating hazardous machinery until they are reasonably certain that citalopram does not affect them adversely.

Electroconvulsive Therapy (ECT)
The safety and efficacy of the concurrent use of citalopram and ECT have not been studied.

Abrupt Discontinuation   Back to top of page

After 8 weeks of treatment with citalopram, abrupt discontinuation of treatment caused a higher incidence of anxiety, emotional indifference, impaired concentration, headache, migraine, paresthesia, and tremor than was seen in patients who continued on citalopram. These symptoms are not indicative of addiction.

Although it is not known whether gradual discontinuation will prevent the discontinuation symptoms, it is recommended that the dosage of citalopram should be tapered off over 1 to 2 weeks.

Additional Adverse Events Observed During the Premarketing Evaluation of Citalopram   Back to top of page

The events listed below include all adverse events that were reported in the overall development program of citalopram (n=3652). All reported events are included except those already listed in Table 1 and those events which occurred in only one patient. It is important to emphasize that, although the events reported occurred during treatment with citalopram, they were not necessarily caused by it. The events are enumerated using the following criteria: frequent: adverse events that occurred on one or more occasions in at least 1/100 patients; infrequent: adverse events that occurred in less than 1/100 patients but at least in 1/1000 patients; rare: adverse events that occurred in fewer than 1/1000 patients.

Body as a Whole - General Disorders
Frequent: Influenza-like symptoms, nonpathological trauma, pain. Infrequent: Alcohol intolerance, allergic reaction, allergy, chest pain, edema, hot flushes, leg pain, malaise. rigors, syncope. Rare: Peripheral edema, sudden death, traumatic injury.

Cardiovascular Disorders
Frequent: Postural hypotension, tachycardia. Infrequent: Angina pectoris, arrhythmia. bradycardia, cardiac failure, cerebrovascular disorders, edema dependent, extrasystoles, flushing, hypertension, hypotension, myocardial infarction, myocardial ischemia, peripheral ischemia. Rare: Aggravated hypertension, bundle branch block, cardiac arrest, coronary artery disorder, ECG abnormal, heart disorder, phlebitis, supraventricular extrasystoles.

Central and Peripheral Nervous System Disorders
Frequent: Migraine, paraesthesia. Infrequent: Abnormal gait, ataxia, convulsions, dysphonia, dystonia, extrapyramidal disorder, hyperkinesia, hypertonia, hypoesthesia, hypokinesia, involuntary muscle contractions, leg cramps, neuralgia, speech disorder, vertigo Rare: Abnormal coordination, convulsions grand mal, hyperesthesia, ptosis, sensory disturbance, stupor.

Collagen Disorders
Rare: Rheumatoid arthritis.

Endocrine Disorders
Rare: Goiter, gynecomastia, hypothyroidism.

Gastrointestinal System Disorders
Frequent: Flatulence. Infrequent: Colitis, dental abscess, dysphagia, eructation, gastritis, gastroenteritis, gastrointestinal disorder (not specified), hemorrhoids, increased saliva, teeth-grinding, toothache. Rare: Appendicitis, esophagitis, gastric ulcer, gastroesophageal reflux, gingivitis, stomatitis, tooth disorder, ulcerative stomatitis.

Hematopoietic and Lymphatic Disorders
Infrequent: Anemia, epistaxis, leukocytosis, purpura. Rare: Coagulation disorder, gingival bleeding, granuloytopenia, hematoma, leukopenia, lymphadenopathy, lymphocytosis, pulmonary embolism.

Liver and Biliary System Disorders.
Infrequent: Cholecystitis, cholelithiasis, increased gamma-GT, increased SGPT. Rare: Bilirubinemia, increased SGOT, jaundice.

Metabolic and Nutritional Disorders
Frequent: Weight decrease, weight increase. Infrequent: Leg edema, xerophthalmia. Rare: Dehydration, edema, hypoglycemia, hypokalemia, increased alkaline phosphatase, obesity, thirst.

Musculo-Skeletal System Disorders
Infrequent: Arthralgia, arthritis, arthrosis, dystonia, muscle weakness, myalgia. Rare: Bone disorder, bursitis, osteoporosis, tendon disorder.

Neoplasm
Rare: Breast neoplasm malignant female.

Psychiatric Disorders
Frequent: Abnormal dreaming, aggravated depression, amnesia, apathy, confusion, depression, impaired concentration, increased appetite, sleep disorder, suicide attempt. Infrequent: Abnormal thinking, aggressive reaction, delusion, depersonalization, drug abuse, drug dependence, emotional lability, euphoria, hallucination, increased libido, manic reaction, neurosis, paranoid reaction, paroniria, psychosis, psychotic depression. Rare: Catatonic reaction, hysteria, personality disorder.

Reproductive Disorders, Female
Infrequent: Amenorrhea, breast pain, lactation nonpuerperal, menorrhagia, menstrual disorder, premenstrual syndrome, salpingitis, unintended pregnancy, vaginal dryness, vaginitis. Rare: Breast enlargement, vaginal hemorrhage.

Reproductive Disorders, Male
Infrequent: Penis disorder, prostatic disorder, testis disorder.

Resistance Mechanism Disorders
Infrequent: Abscess, fungal infection, herpes simplex infection, otitis media, viral infection. Rare: Bacterial infection, moniliasis, sepsis.

Respiratory System Disorders
Infrequent: Bronchitis, coughing, dyspnea, pneumonia. Rare: Asthma, bronchospasm, increased sputum, laryngitis, pneumonitis, respiratory disorder.

Skin and Appendage Disorders
Frequent: Pruritus, rash. Infrequent: Acne, alopecia, dermatitis, dry skin, eczema, photosensitivity reaction, psoriasis, rash erythematous, rash maculo-papular, skin discoloration, urticaria. Rare: Cellulitis, decreased sweating, hypertrichosis, melanosis, pruritus ani.

Special Senses, Vision, Hearing and Vestibular Disorders
Frequent: Abnormal accommodation. Infrequent: Conjunctivitis, earache, eye pain, mydriasis, taste perversion, tinnitus. Rare: Eye abnormality, keratitis, photophobia.

Urinary System Disorders
Frequent: Polyuria. Infrequent: Abnormal urine, cystitis, hematuria, micturition frequency, urinary incontinence, urinary retention, urinary tract infection. Rare: Dysuria, facial edema, oliguria, renal calculus, renal pain.

Events Observed During the Post-Marketing Evaluation of Citalopram   Back to top of page

It is estimated that approximately 8 million patients have been treated with citalopram since market introduction. The following adverse events have been reported to be temporarily associated with citalopram treatment in at least 3 patients and are not described elsewhere in labeling.

Abnormal hepatic function, aggravated condition, aggravated migraine, angioedema, asthma, choreoathetosis, decreased drug level, decreased prothrombin time, dyskinesia, eosinophilia, erythema multiforms, gynecological problems, hepatitis, hyperprolactinemia, hyponatremia, increased drug level, increased prothrombin time, mydriasis, neuroleptic malignant syndrome, neuropathy, pancreatitis, pancytopenia, postural hypotension, serotonin syndrome, SIADH, spontaneous abortion/fetal death, thrombocytopenia, ventricular arrhythmia, Torsade de pointes, withdrawal syndrome.

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