High doses of the antidepressant Celexa can cause abnormal heart rhythms, leading federal regulators to issue a new warning that Celexa should no longer be prescribed at doses that exceed 40 mg per day.
According to a drug safety communication issued by the FDA on Wednesday, Celexa side effects can cause prolongation of QT intervals, interrupting the regular electrical activity of the heart. This may lead to a serious and potentially fatal abnormal heart rhythm, including Torsade de Pointes.
Celexa (citalopram hydrobromide) belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It was originally created in 1989 by Lundbeck, and is approved for the treatment of major depression. However, it is often used off-label to treat other psychological disorders. Celexa is available in brand name form or as a generic in 10 mg, 20 mg and 40 mg tablets, as well as a 10 mg/5 mL oral solution.
Patients with low potassium and magnesium are at increased risk of the serious heart problems from Celexa, the FDA warned. The agency also noted that data suggests doses above 40 mg per day do not provided any increased benefit for patients.
Celexa warnings will now include information about the potential heart rhythm risks, as well as the new dosage recommendations. The FDA did not provide any information about reports of serious illnesses or deaths associated with the Celexa heart problems.
Patients have been advised to talk to their health care provider if they have been prescribed a daily dose of Celexa exceeding 40 mg. They were also warned to seek immediate medical attention if they experience irregular heartbeats, shortness of breath, dizziness or fainting while taking Celexa.
Doctors were warned not to prescribe Celexa above 40 mg per day and not to use it at all in patients with congenital long QT syndrome. The agency also called on doctors to give patients taking Celexa more frequent electrocardiogram monitoring.