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Citalopram causes dose-dependent QTc prolongationan ECG abnormality that has been associated with Torsade de PointesTdPventricular tachycardiaand sudden deathall of which have been observed in postmarketing reports for citalopram.

A major depressive episode may be the initial presentation of bipolar disorderIt is generally believedthough not established in controlled trialsthat treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorderWhether any of the symptoms described above represent such a conversion is unknownHoweverprior to initiating treatment with an antidepressantpatients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disordersuch screening should include a detailed psychiatric historyincluding a family history of suicidebipolar disorderand depressionIt should be noted that Celexa is not approved for use in treating bipolar depression.

The only commonly observed adverse event that occurred in Celexa patients with an incidence of 5or greater and at least twice the incidence in placebo patients was ejaculation disorderprimarily ejaculatory delayin male patientssee TABLE 3

Tell your doctor if you’re taking these medicines before you start citalopram

You can take citalopram at any time of dayas long as you stick to the same time every dayIf you have trouble sleepingit’s best to take it in the morning.

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call your doctor and make an appointment to discuss your decision to come off citalopram.

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