Celexa interactions: Alcohol, medications, and other factors

Celexa (citalopram) is a brand-name prescription drug used to treat major depressive disorder in adults. As with other medications, Celexa can interact with certain other drugs. It can also interact with some supplements. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Celexa’s interactions and what you should not take with Celexa, keep reading. For additional information about Celexa, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Celexa due to a risk of harm. These are known as contraindications. The contraindications of Celexa include:

Taking pimozide

Before starting treatment with Celexa, tell your doctor if you take pimozide. This drug is used to treat symptoms of Tourette’s syndrome.

Celexa can raise the level of pimozide in your body. This can increase your risk of serious side effects, including heart problems. Due to this risk, doctors typically will not prescribe Celexa if you’re taking pimozide. Instead, they may recommend a different treatment option for you.

Taking monoamine oxidase inhibitors

If you’re taking any monoamine oxidase inhibitors (MAOIs) or have taken them within the past 14 days, tell your doctor before starting Celexa treatment. Similar to Celexa, MAOIs are used to treat depression.

Taking an MAOI along with Celexa can increase your risk of a serious side effect called serotonin syndrome. (With serotonin syndrome, a chemical called serotonin builds up in your body. High levels of serotonin may lead to life threatening side effects, such as seizures.)

Due to this risk, doctors typically won’t prescribe Celexa along with MAOIs. In fact, they’ll recommend waiting at least 14 days after stopping an MAOI before starting Celexa treatment. Examples of MAOIs include:

• linezolid (Zyvox)
• methylene blue (ProvayBlue)
• tranylcypromine (Parnate)
• phenelzine (Nardil)
• selegiline (Emsam)
• isocarboxazid (Marplan)

Having had an allergic reaction to Celexa or any of its ingredients

If you have had an allergic reaction to Celexa or any of its ingredients, your doctor will likely not prescribe Celexa. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Celexa, it’s important to tell your doctor if any of these contraindications apply to you. They can use this information to determine whether to prescribe Celexa.

Before you start treatment with Celexa, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Celexa. Keep in mind that this table doesn’t include all drugs that may interact with Celexa. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn about the side effects of Celexa, see this article.

Here’s a closer look at certain drug interactions of Celexa.

Certain stimulant drugs

Stimulant drugs are typically used for attention-deficit hyperactivity disorder (ADHD) or narcolepsy (a condition that causes excessive daytime sleepiness).

Interaction result. Taking Celexa and stimulant drugs can increase the risk of serotonin syndrome, a serious side effect.

Interaction explained. Both Celexa and certain stimulant drugs can increase the level of serotonin in your body. Taking a combination of Celexa and stimulant drugs can increase serotonin to an unsafe level. In rare cases, this can lead to serotonin syndrome, which may lead to life threatening side effects, such as seizures.

Examples of stimulant drugs. Here are some stimulant drugs that may interact with Celexa:

• lisdexamfetamine (Vyvanse)
• methylphenidate (Ritalin)
• amphetamine salts (Adderall)

Steps you or your doctor may take. Tell your doctor if you’re taking any stimulant drugs before starting treatment with Celexa. Due to the risk of serotonin syndrome, your doctor may monitor you more often if you take Celexa with certain stimulant drugs.

It’s important to be aware of the symptoms of serotonin syndrome so that you can seek emergency help right away if you develop any. Symptoms may include anxiety, confusion, hallucinations, and muscle spasms. Other possible symptoms may be changes in heart rate or blood pressure.

Your doctor can help determine whether it’s safe to take Celexa along with certain stimulant drugs.

Ondansetron (Zofran)

Ondansetron is a medication that’s often used to treat nausea or vomiting.

Interaction result. Taking Celexa with ondansetron can increase the risk of heart problems or serotonin syndrome.

Interaction explained. It’s possible for both ondansetron and Celexa to cause changes in your heart rhythm. So taking the combination of these drugs can increase your risk of an irregular heart rhythm. In addition, both drugs can increase the serotonin level in your body. Taking a combination of Celexa and ondansetron can increase serotonin to an unsafe level. In rare cases, this can cause serotonin syndrome, a serious side effect.

Steps you or your doctor may take. If you take ondansetron (Zofran), tell your doctor before starting Celexa treatment. Your doctor may recommend that you avoid taking Celexa with ondansetron. However, if they prescribe ondansetron along with Celexa, your doctor may monitor you more often throughout your treatment. This may include ordering blood tests and checking your heart function.

Also, it’s important to be aware of the symptoms of serotonin syndrome. This is so you can go to the hospital right away if you develop any. Symptoms may include anxiety, confusion, hallucinations, and muscle spasms. Other symptoms may include changes in heart rate or blood pressure.

Talk with your doctor to determine whether taking Celexa and ondansetron together is safe for you.

Phentermine

Phentermine is used to help with weight loss.

Interaction result. Taking Celexa with phentermine can increase your risk of serotonin syndrome.

Interaction explained. It’s possible for both Celexa and phentermine to increase the level of serotonin in your body. Taking a combination of Celexa and phentermine can increase serotonin to an unsafe level. This may cause serotonin syndrome, which is a rare, serious side effect.

Steps you or your doctor may take. Tell your doctor if you take phentermine (Adipex-P) before starting Celexa. Due to the risk of serotonin syndrome, your doctor may monitor you more often if you take both phentermine and Celexa. You should be aware of the symptoms of serotonin syndrome. This is so you can go to the hospital right away if you develop any. Symptoms may include anxiety, confusion, hallucinations, and muscle spasms. Other symptoms may include changes in heart rate or blood pressure.

Your doctor can help determine whether it’s safe for you to take Celexa along with phentermine.

Celexa is not known to interact with alcohol.

However, your doctor may recommend avoiding alcohol while you’re taking Celexa. The combination of alcohol and Celexa may increase your risk of serious side effects such as:

• trouble breathing or slower breathing rate
• bleeding in your stomach or intestines
• sleepiness
• confusion
• nausea or vomiting
• low blood pressure

Talk with your doctor if you’d like to drink alcohol while you’re taking Celexa. They can help determine whether it’s safe for you.

Celexa may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Celexa.

Celexa interactions and supplements

Before you start treatment with Celexa, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Certain supplements, such as tryptophan, may increase your risk of a rare condition called serotonin syndrome. (With serotonin syndrome, a chemical called serotonin builds up in your body. High levels of serotonin may lead to life threatening side effects, such as seizures.) You may have an increased risk of this condition if you’re taking multiple substances that can increase your serotonin level.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Celexa interactions with herbs

It’s possible that taking certain herbs, such as St. John’s wort, may increase your risk of serotonin syndrome. This risk may be higher if you’re taking different substances that can increase your serotonin level.

If you’re taking any herbs while taking Celexa, talk with your doctor. In some cases, they may recommend you stop taking them during Celexa treatment. This is to help prevent possible interactions from occurring.

Celexa and vitamins

There are no specific reports of vitamins interacting with Celexa. However, it’s possible that interactions with vitamins could be recognized in the future. Due to this risk, you should talk with your doctor or pharmacist before taking any vitamin product with Celexa. Also, talk with them if you have any concerns about Celexa’s interactions with vitamins.

Celexa and food

There were no reports of food interactions with Celexa. If you’d like to learn more about eating certain foods during treatment with Celexa, talk with your doctor.

Celexa and vaccines

Celexa isn’t known to interact with any vaccines. To find out what vaccines are recommended for you, talk with your doctor or pharmacist.

Celexa and lab tests

There aren’t any known interactions between Celexa and lab tests. If you have questions about lab tests and Celexa, talk with your doctor.

CELEXA AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Celexa. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Celexa. The impact of cannabis may affect how well you stick to your Celexa treatment plan.

Note: Cannabis is illegal at a federal level. However, it is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Celexa. Before you take this drug, be sure to talk with your doctor about your health history. Celexa may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might increase the risk of interactions with Celexa include:

Risk of suicidal thoughts and actions in young adults and children. This medication has a boxed warning about an increased risk of suicidal thoughts and actions* in young adults and children. This risk was seen in clinical trials of children and adults ages 24 years and younger taking antidepressant drugs such as Celexa. For more information, see “Boxed warning” at the top of this article.

Mood problems. Tell your doctor if you or a family member has a history of mood disorders. These include depression, bipolar disorder, and suicidal thoughts or actions.* This medication may increase your risk of mood problems, including suicidal thoughts or actions.

If you or a family member have a history of mood problems, Celexa may increase the risk of them occurring or worsening. In this case, your doctor may recommend monitoring your mood more frequently before you take Celexa. In some cases, they may recommend a different treatment option for you.

Heart problems. Tell your doctor if you have or have had any heart problems. These include heart failure, irregular heart rhythm, or a history of heart attack. Celexa can cause an irregular heart rhythm, called long QT syndrome. If you already have heart problems, this medication may worsen your condition. Your doctor can help determine whether Celexa is a safe treatment option for you.

Low electrolyte levels in your blood. Before taking Celexa, tell your doctor if you have a history of low electrolyte levels in your blood. These include low potassium, magnesium, or sodium levels.

Celexa may cause long QT syndrome. If you have low electrolyte levels, Celexa may increase the risk of this condition. In this case, your doctor may want to correct your electrolyte levels before you start taking Celexa. This could include giving you fluids, medication, or supplements.

Bleeding problems. Celexa may increase your risk of bleeding. This may include bruising, nosebleeds, or life threatening bleeding, such as a stomach ulcer. If you have any conditions that increase your risk of bleeding, taking Celexa may worsen your condition. Your doctor can help determine whether it’s safe for you to take Celexa in this case.

Seizures. In rare cases, it’s possible for Celexa to increase your risk of seizures. If you have a seizure disorder, this medication may further increase your risk of having a seizure. Talk with your doctor to find out whether Celexa may be a safe treatment option for you.

Glaucoma. Tell your doctor if you have glaucoma before taking Celexa. It’s possible for Celexa to increase the pressure in your eyes, which can make glaucoma worse. Your doctor can help determine whether Celexa is safe for you to take in this case.

Liver problems. Celexa is removed from your body by your liver. So if your liver isn’t working as well as it should, Celexa may build up in your body. This may increase your risk of side effects from the drug. In this case, your doctor may prescribe a lower dose of Celexa for you. They can help determine the best treatment plan. (To learn about Celexa’s dosages, see this article.)

Pregnancy. If you’re pregnant or planning to become pregnant, tell your doctor before taking Celexa. It’s not known whether the drug may be safe to take during pregnancy. And it’s possible for Celexa to cause harm to a developing fetus. Talk with your doctor about the best treatment option for you during pregnancy. (To learn more about Celexa and pregnancy, see this article.)

Breastfeeding. If you’re breastfeeding, tell your doctor before taking Celexa. It’s not known whether Celexa may pass into breast milk or what effects the drug may have on a child who is breastfed. Talk with your doctor to find out whether it’s safe for you to breastfeed during Celexa treatment. (To learn more about Celexa and breastfeeding, see this article.)

Allergic reaction. If you’ve had an allergic reaction to Celexa or any of its ingredients, your doctor will likely not prescribe Celexa. (For details, see the “When to avoid Celexa” section above.)

* Celexa has a boxed warning about the increased risk of suicidal thoughts and actions in young adults and children. This is a serious warning from the Food and Drug Administration (FDA). For more information, see “Boxed warning” at the top of this article.

Here are some frequently asked questions about Celexa and possible interactions.

Are there any interactions between Celexa and birth control?

No, there aren’t any known interactions between Celexa and birth control at this time. So it’s likely safe to take Celexa along with your birth control. Birth control is used to help prevent pregnancy. It comes in many forms, including pills, injections, and vaginal rings.

Your doctor may prescribe Celexa with other medications to help treat depression. Keep in mind that birth control may interact with the other medications. To learn more, talk with your doctor or pharmacist.

If you have concerns about taking birth control along with Celexa, talk with your doctor or pharmacist.

Is it safe for me to take L-theanine supplements while taking Celexa?

Yes, it’s likely safe for you to take L-theanine along with Celexa. Currently, there aren’t any known interactions between the two substances. L-theanine is a supplement that’s often used to treat anxiety or stress.

If you’re interested in taking any supplements to ease your symptoms of stress or anxiety, be sure to talk with your doctor or pharmacist first. They can help make sure that there aren’t any interactions between Celexa and the supplements.

You can take certain steps to help prevent interactions with Celexa. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Celexa label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Celexa doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you have questions about this information, ask your doctor or pharmacist.

You can also help prevent interactions with Celexa by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Celexa. These resources might help:

• Overview of Celexa. For a general overview of Celexa, you can see this article.
• Celexa side effects. For information about the side effects of Celexa, refer to this article. You can also view the drug’s prescribing information.
• Facts about depression. To learn more about your condition, see our depression hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.