Are you or a loved one suffering from depression or anxiety?
Has your doctor recommended you take Celexa or the generic version Citatopram?
Are you concerned about possible side effects? If so then this is the video for you. Keep watching
to learn a little more about what to watch out for and how this medication can be a help to you.
Hi, I m Dr. Erik Richardson a board certified Family Practice physician.
I d like to welcome you to FamilyMed, a channel that focuses giving you practical and accurate
medical information to help you and your family. If you think this would be something that is
helpful to you make sure you subscribe, hit that notification button and follow along with us.
On today s episode we are going to be going over a common antidepressant named Citalopram or more
commonly referred to as Celexa. Citalopram is the generic version of Celexa which was released
in 1998. Celexa is a medication that is used most commonly to treat clinical depression and anxiety.
It's in the class of medications that we call SSRI s or Selective Serotonin Reuptake Inhibitors.
These are a group of medications that target the hormone Serotonin and help decrease how rapidly it
is broken down in the nerves thus keeping your serotonin levels higher. It's one of the vital
chemicals or neurotransmitters that help regulate a lot of the functions of the body like mood,
social behavior, appetite and digestion, sleep, memory among other things. It is
one of the chemicals that plays a big role in depression and anxiety.
When you are suffering from depression or anxiety, in addition to things like eating
healthy and exercise, counseling and therapy and getting plenty of sleep, targeting these chemicals
in the brain has been found to be very helpful in allowing people to resume a normal life when they
are battling with these conditions. Not every person who is suffering from depression needs
or even should take medication for it. It can be a helpful tool though when everything else fails.
If you are wondering if taking a medication is the right thing for you, make sure you talk to your
doctor. To give you a few ideas on what to talk to them about watch this video where we go over
who tends to benefit from taking a medication. Let s talk specifically about what kinds of
conditions tend to benefit from taking citalopram. The first condition that we use it for is clinical
depression. With depression you tend to have symptoms like difficulty concentrating,
remembering things or making decisions. You may also suffer from fatigue, feelings of guilt,
worthlessness and helplessness. You may also feel hopeless, experience sleeping problems,
mood swings, have a loss of interest in things that you once enjoyed, appetite changes,
generalized pain, persistent sad or empty feelings or even suicidal thoughts or attempts.
The other common condition it is used for is panic and anxiety disorders. In these conditions you
can have symptoms such as sudden and unexplained onset of a rapid heart rate, sweating, trembling,
shortness of breath, pain in your chest, fear of dying, numbness and tingling throughout your body
or just generalized feeling of anxiousness all the time that you just can't explain.
If you are going through these symptoms you need to seek help. You don t have to live
your whole life feeling this way. Go see your doctor so you can get an accurate diagnosis
and figure out a good treatment plan for you. Remember depression and anxiety are as
real of a medical condition as diabetes or high blood pressure and you shouldn't feel
any different about treating these conditions than you would any other medical condition.
Ok, so you've talked to your doctor and you both have decided that for your symptoms
Lexapro is going to part of your treatment plan. What should you expect?
Well, first of all it comes in a pill at doses of 10, 20 and 40mg. Most people end up being
on 10-20mg. It's the kind of medication that you need to take daily if you are going to be on it.
Most people will start to notice some difference within 1-2 weeks but it typically doesn't reach
its full effect for 4-6 weeks. So, you should be following up with your doctor within 2-4 weeks
after starting on it to report on how things are working. If you are going to be taking it,
you want to make sure that you are not missing a lot of doses. Doing so
can really affect how well it's going to work and increase your risk of having side effects.
Also, unless you're having some significant problems with the medication, especially
after being on it a few weeks, you don't want to stop this medication abruptly. After being on it
for a while your brain gets used to a certain level of the Serotonin and stopping it quickly
will really throw you off and make you feel bad. Most doctors recommend that, if the medication is
working well, you take it for at least 6 months before you think about stopping it. Stopping
it sooner than that, because you feel like your depression or anxiety is gone, increases your risk
for having your symptoms return. If you feel like it is something that is making a big difference in
your life and you want to continue on it longer than the 6 months then it is safe to do so.
I have patients that have decided that they need to stay on it for years and that works for them.
So what kind of side effects should you look out for? Well, as with any medication you can
find a big list of side effects that will be listed in the paperwork from your pharmacist.
Sometimes these lists can be intimidating but in the case of citalopram, it is usually well
tolerated. It s not common that many want to stop it because of significant side effects. However,
any medication has the potential to having some side effects. Some common ones that are possible
would be some headaches, nausea, tiredness or difficulty sleeping, some dry mouth,
tremor, constipation or abdominal pain. These types of symptoms tend to be short lived in
most people and often times, by modifying when you take it or by taking it with food you can
improve or even avoid a lot of them. Usually with time, they start to get better on their own.
One area that concerns a lot of people is the effect that antidepressants can have
on your intimate relations. This can be a known problem with most antidepressants
and we tend to see it a little more with celexa. If it happens to you, make sure
you talk to your doctor about your options. Probably the most common reason I have somebody
stop this or any antidepressant medication is that they didn t like the way it made
them feel . It may help with their depression or anxiety, so they don't feel sad anymore, but they
don't feel happy either. That certainly isn't the goal of this kind of treatment. Our goal is
to help lift you up out of the hole you are in and help you see that life is doable again. If we turn
you into a zombie and you are neither happy or sad we aren't doing you any favors. We still want you
to be happy when you are supposed to be happy and sad when your supposed to be sad. So if you
are noticing things like that then talk to your doctor about other options that are out there.
There are some rare side effects that you need to pay more close attention to though.
This is not an exhaustive list, however it s important to know that first, all antidepressant
medication including citalopram have the risk of making your symptoms worse at first. You may
be feeling really down right now, but if all of a sudden your depression and anxiety get worse
or you start having suicidal thoughts you need to be in contact with your doctor and get help.
All these types of medications carry what we call a Black Box warning, or a special alert from the
FDA that we should be careful of. Increased risk of suicide is what you need to watch out for.
It s rare but possible so you need to be careful. I always recommend when starting these kinds of
medications that you confide in somebody you trust and tell them that you are taking it.
Let them know about these risks so they can help you recognize what is happening
and assist you in getting the help you need. There can be some more rare side effects such
as electrolyte disturbances, allergic reactions and something called Serotonin syndrome where
your body gets too much serotonin. This is very rare but can present with symptoms like agitation,
confusion, rapid heart rate and high blood pressure,
dilated pupils, loss of muscle coordination, muscle rigidity,
diarrhea and heavy sweating. If you think this is happening to you, get into your
doctor or the emergency room right away. There are some specific things to citalopram
as well though that you need to be aware of depending on other health conditions or your age.
The main concern that your doctor needs to be watching with you is it can cause something we
call Q-T prolongation. This means that it can extend the time that it takes for the bottom
part of your heart to recharge and get ready for a new beat. The problem with this is that the
longer that takes to recharge it puts you at risk for your heart going into a dangerous rhythm.
To avoid this risk it s usually good for your doctor to do an EKG or a heart tracing before
starting on the medication. The FDA has warned that you should not take over 40mg and if you
are over the age of 60 then you should keep your dose to no more than 20mg. There are also
medications that you should be careful taking if you are on this so make sure that you talk
to your pharmacist and make sure that there isn t any problems for you. One over the counter
medication that you should avoid taking is an acid pill called cimetidine or Tagamet.
Also, your doctor may want to check your potassium and magnesium levels because if these are off then
it can put you at greater risk of having this happen. Taking an occasional EKG while on it
also may be something you want to talk to them about. Through all of this though, if
you experience an irregular heartbeat, shortness of breath and dizziness or fainting while taking
citalopram, you need to seek care immediately. The worst part about discussing the side effects
of medications is scaring you away from taking them. It's important to keep the perspective that
the vast majority of people taking citalopram do really well with minimal to no side effects.
You just need to make sure that you are taking proper precautions
and are a good candidate to be on it. Depression and anxiety can be a very debilitating
condition. Its as real as any other medical condition out there. When you have a true clinical
depression taking something like citalopram can be just what you need. It's certainly not for
everybody and yes there are other nonmedication options out there that may work for you.
If, however, you and your doctor feel that this is the best option for your treatment plan you
now have a good foundation of knowledge of what to expect and what kind of side effects to watch for.
Having that information can be really powerful in your life.
Well, I hope you found this to be helpful, if you did, please take the time to give this video a
like and share it with your friends. It helps our channel to grow and reach other people that may
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So until next time, this is FamilyMed with Dr. Richardson and remember to take
care of your body because it s the only one you have.