Celexa (Citalopram Hydrobromide) Drug Information: Overdosage and Contraindications

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May 26, 2012

Celexa

Prescription Anxiety Medications »

What are anxiety medications and how do they work?

Anxiety is both a normal and useful response to potentially stressful or dangerous situations. It helps by increasing our awareness of what's going on around us and in other ways. For most people, the anxiety is short lived and normally goes away once the situation has passed. But that is not the case for an estimated 40 million adults in the United States who have some type of anxiety disorder and experience ongoing and unwarranted psychological distress. That distress may also manifest itself in physical symptoms such as muscle tension, headaches, or chest pain.

Anxiety medications include multiple types of drugs that are used to treat the symptoms of anxiety disorders. The three most commonly prescribed types of anxiety medication are antidepressants, anti-anxiety medications -- also known as anxiolytics -- and beta-blockers. The first two types of anxiety medications work primarily by affecting the ba...

Read the Prescription Anxiety Medications article »

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OVERDOSE

Human Experience

In clinical trials of citalopram, there were reports of citalopram overdose, including overdoses of up to 2000mg, with no associated fatalities. During the postmarketing evaluation of citalopram, Celexa overdoses, including overdoses of up to 6000 mg, have been reported. As with other SSRIs, a fatal outcome in a patient who has taken an overdose of citalopram has been rarely reported.

Symptoms most often accompanying citalopram overdose, alone or in combination with other drugs and/or alcohol, included dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In more rare cases, observed symptoms included amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, and ECG changes (including QTc prolongation, nodal rhythm, ventricular arrhythmia, and very rare cases of torsade de pointes). Acute renal failure has been very rarely reported accompanying overdose.

Management of Overdose

Establish and maintain an airway to ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Careful observation and cardiac and vital sign monitoring are recommended, along with general symptomatic and supportive care. Due to the large volume of distribution of citalopram, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. There are no specific antidotes for Celexa.

In managing overdosage, consider the possibility of multiple-drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose.