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Dr. Andrew Rynne

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Can Citalopram cause fatigue and nausea?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 5732 Questions

Posted on Mon, 23 Apr 2018 in Hypertension and Heart Disease
Question: I had a pacemaker put in November 27 2015 my Dr. put me on Citalopram 20mg and diazepam on 10mg 2 times a day. Changed the diazepam to 1/2 tablet twice daily for anxiety and I take dicyclomine pills for IBS 20mg tablets 3 times a day. For high blood pressure I take omeprazole 40mg and valsartan 160 mg 1tablet a day and amlodipine besylate 5mg at night, cut my pill in half it is 10mgs. Had to go too the ER yesterday because I was dehydrated and very weak. My personal doctor wants me to cut the diazepam to 1/2 tablet a day and I have been taking 1/2 tablet twice a day for over a year. They upped the Citalopram to 40 mg on 11/10 and when I started becoming very nervous and sick at my stomach. Doctor stated to go back to the 20 mg Citalopram on 11/16. I am still very weak and sick feeling. Feeling anxious and nauseous at stomach. Restless.

do you have a answer

Hello I am waiting
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

I passed carefully through your question and would agree with your doctor decision on reducing the dose of Citalopram.

You should also know that high doses of Citalopram, may trigger cardiac arrhythmia.

From the other hand, you should know that diazepam should not be taken regularly for such a long time, because it can cause addiction and tolerance. That is why, it is necessary to gradually stop taking it.

Coming to this point, I would recommend discussing with your doctor on the possibility of switching gradually to another antidepressant, like sertraline, which has a lower risk for cardiac arrhythmia.

Considering your anxiety during these days, I would recommend switching from diazepam to alprazolam 0.5mg three times daily for some days, and gradually reduce the dose, until stopping. Alprazolam is better tolerated compared to diazepam and does not cause such adverse effects like weakness and sedation.

Starting at low doses is necessary in order to avoid possible adverse effects like stomach pain.

Regarding the weakness and dehydration, I would recommend taking plenty of fluids and stay at bed rest. It is also necessary to closely monitor your blood pressure values. In case of low blood pressure, it is necessary reduce the doses of your anti-hypertensive drugs or even not to take them, as long as your blood pressure values are too low. This will help improve your weakness.

Taking a balanced diet, full in vitamins will help improve your situation too.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 51 minutes later
I had shingles 11/9/17 took valacyclovir 1mg tablets for 21days.and took prednisone 20mg 5pills just got over that and a cold. Had a colonoscopy Oct 26 2016.
Answered by Dr. Ilir Sharka 4 minutes later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Your actual situation does not seem to be related to your past medical history of shingles and colonoscopy.

So, there is nothing to worry about!

Having some rests and take plenty of fluids is necessary to improve your situation.

Anyway, if the weakness persists, I would recommend consulting with your doctor and performing some tests:

- a chest X ray study
- complete blood count for anemia
- PCR, ESR for inflammation
- blood electrolytes for electrolyte imbalance
- thyroid hormone levels to exclude possible thyroid dysfunction.

If all the above tests result normal, there is nothing to worry about!

Hope you will find this answer helpful!

Wishing good health,

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

The User accepted the expert's answer

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