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What Are The Side Effects Of Celexa?

Posted on Mon, 10 Jul 2017

Question: I have panic disorder and switched from Prozac to Celexa nearly 4 weeks ago. I had been on prozac for many years when out of the blue the panic disorder suddenly returned. I cross tapered the first week reducing from 20 mg prozac to none while starting at 10 mg. Celexa. At the end of the week I went to the full 20 mg. of Celexa. I have had a much higher level of anxiety the last two weeks. Could this be a side effect of starting the Celexa or perhaps stopping the prozac too quickly?

Answered by Dr. Seikhoo Bishnoi (27 minutes later)

Brief Answer:
Wait for the response of the drug.

Detailed Answer:
Hello thanks for asking from HCM

I can understand your concern. Celexa and Prozac both are SSRI drugs. Both have almost same efficacy but response in individuals varies. You have cross tapered the drug and dose of Fluoxetine was not high so I don't think it's due to reduction of dose of Fluoxetine.

In my opinion the symptoms are due to persisting anxiety. Wait for some more days and then Celexa will start showing its response. If you have prescription then you can take Clonazepam or Alprazolam on SOS basis for relief of anxiety.

Thanks and Take care

You are welcome to ask follow up doubts.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (50 minutes later)

Thank you very much for you input. I have a follow up with the prescribing psychiatrist in a few days. I see that the FDA has only approved Celexa for depression, is there a medication you feel might be more effective for panic disorder? The prozac worked so well for many years and just seemed to stop being effective. Primary doctor sent me to the psychiatrist to ask for an antidepressant lest agitating than prozac and the psychiatrist picked Celexa. Any other ideas? I am a little concerned about the Celexa heart warning.

Answered by Dr. Seikhoo Bishnoi (9 hours later)

Brief Answer:
Zoloft can be kept as option.

Detailed Answer:
Hello thanks for asking again

Though its not approved by FDA but since its a SSRI drug so the drug will definitely help to improve the anxiety and panic symptoms. No need to worry about that. The drug is having great efficacy. Lexapro is another option. The drug is molecularly similar to Celexa and has great efficacy in anxiety and panic disorder too. Both Celexa and Lexapro are safe and least agitating. But yes both are known to result in QT prolongation cardiac arrhythmia. In that case we can keep Zoloft (Sertraline) as option. The drug is also a SSRI drug and has great efficacy in panic and depression both. The drug is safest of all SSRI drugs and has safe cardiac profile. The drug can be used safely without worries.

So you can talk with your psychiatrist for these drugs and discuss about the management.

Thanks and Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (24 hours later)

One final question. I also take medication for hypertension. Do you think it would be helpful to switch to propranolol to help with the anxiety.

Answered by Dr. Seikhoo Bishnoi (8 minutes later)

Brief Answer:
Yes that will help to keep anxiety under control

Detailed Answer:
Hello thanks for asking

Yes low dose Propranolol would do no harm. This will keep anxiety under control without interacting much with your antihypertensive medicine. The dose of 10-20 mg on SOS basis or regular basis can be used without worries.

Which antihypertensive medicine are you taking?

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (20 minutes later)

I currently take Verapamil and Triamterene. They mentioned changing the Verapamil to proranolol, but there is an interaction with Celexa according to an online drug checker that increases the level of propranolol. No interaction with Lexapro.

Answered by Dr. Seikhoo Bishnoi (5 minutes later)

Brief Answer:
You can take Propranolol

Detailed Answer:
Hello again

Yes you can go with Propranolol without any worries. Slight increase in levels could be seen due to metabolic interactions but that will not cause any issues. Dose can be adjusted accordingly, no need to worry.

Propranolol is a non selective beta blocker and slightly increased levels would not affect the blood pressure. You can keep taking Celexa or if have doubts then shift to Lexapro which will not cause drowsiness also.

Thanks and Take care

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (13 minutes later)

Thank you

Answered by Dr. Seikhoo Bishnoi (1 minute later)

Brief Answer:
Thanks and Take care

Detailed Answer:
Take care and good day!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (34 hours later)

New Question. After seeing the psychiatrist today for my follow up and expressing my lack of improvement. He wants to add Effexor 75mg. XR and Risperdal .25 to my meds because of the lack of improvement in my comorbid depression. I can see how the Risperdal augmentation might be helpful, but don't understand the SSRI, SNRI combination. Do you think this is a good idea or should I talk with a different prescribing psychaitrist?

Answered by Dr. Seikhoo Bishnoi (6 hours later)

Brief Answer:
Adding Effexor would not cause much benefits.

Detailed Answer:
Hello again

Adding Risperidone to your prescription is right choice in my opinion. The dose is low (0.25mg) but this should help. In coming weeks it can be increased to 1 mg one tablet after dinner.

You are already on Celexa and adding a SNRI drug like Venlafaxine will not provide much therapeutic benefit and instead will add to side effects. Any try to increase the dose of either of these drugs will increase the risk of serotonin syndrome.

So yes you can take opinion of a different psychiatrist also. You can discuss about Lexapro too. Addition of any augmentation drug like Burpropion can also be discussed. Addition of Bupropion will help in reducing the anxiety.

Thanks and Take care

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Seikhoo Bishnoi (11 hours later)

Thanks for your input I was given a message by the prescribing doctor that he uses this combination often, but I still have my doubts. I have made an appointment with a different psychiatrist next week. I will continue the risperidone and the celexa for now, but am wondering if I should try the Effexor until I see the other psychiatrist next week. I can't find any real info on celexa effexor combinations. I also am prescribed .5 klonopin twice a day, and ambien for sleep. So I feel a little overwhelmed that I now take 4 drugs after 1 medication seemed to fail.

Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
You can wait for one week.

Detailed Answer:
Hello again

You can wait till next appointment, in my opinion starting Effexor before consulting a different psychiatrist is not a good idea. Yes, in normal doses Effexor with Celexa will not cause much serious issues but in my opinion higher dose of either of these drugs should be used for control of symptoms rather than using low doses of two drugs.

Klonopin twice a day and Ambien for sleep are ok, but try not to use these drugs for long periods of time. Over all these are safe to use and free of any serious side effects.

Thanks and Take care

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar