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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Can Citalopram cause agitation?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Sat, 13 May 2017 in Mental Health
Question: I am taking 40mg per day of Citalopram for depression. Although it seems to have thwarted some of my depressive symptoms, I am concerned that my perceived increase feelings of being tense and irritable have been increased by my use of Citalopram. Could it be that I am hypomanic and the Citalopram is aggravating symptoms of hypomania that I have never acknowledged in myself before but, instead, have just considered myself a rather anxious person?
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Answered by Dr. Bonnie Berger-Durnbaugh 56 minutes later
Brief Answer:
Information

Detailed Answer:
Hello XXXX

In some people citalopram can cause a sort of restlessness or agitation. It is more common when people first start taking it, but it is possible in some people for it to continue. The "daughter" compound of citalopram which is called escitalopram (brand name Lexapro) has less of this side effect (and tends to have fewer side effects in general). This SSRI medication is used to treat depression just as citalopram is.

Another possibility is that in some people, and it is more common in men, that depression can manifest in anger and irritability. So while the citalopram may have taken away some of the sad feelings, it hasn't fully treated your depression.

I know you said you take Xanax occasionally, but you might benefit from an ongoing anti anxiety medication such as buspirone (Buspar). This can help augment the SSRI and is also an anti anxiety medication. Alternatively, if your symptoms are daily, instead of taking as needed Xanax, a low dose of a medication in the same family (benzodiazepines) that is long lasting, such as clonazepam, might help. If the Xanax helps your irritability, then other anti anxiety medications are likely to help too.

In terms of hypomania, or some form of bipolar disorder being unmasked or aggravated by the SSRI: you are right that SSRIs can cause people with bipolar disorder to be manic or hypomanic. With hypomania and mania, people tend to have more energy, sleep less, talk more (often excessively) and are more impulsive. That doesn't sound like what is going on with you, but if you are concerned, I recommend talking with a psychiatrist who has many years of experience treating bipolar disorder.

I hope this information helps. If you are interested, I can also tell you about mindfulness meditation, yoga, and other alternative practices that may help too.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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