Citalopram interactions can include conflict with other antidepressant medications, drugs used to manage clotting disorders or cardiac problems, and some pain management medications. This drug is classified as a Selective Serotonin Reuptake Inhibitor (SSRI), used to treat depression, anxiety, and certain other conditions. Drug interactions can increase the intensity of side effects, including heart problems and increased risk of suicidal feelings. A doctor can review the specifics of a patient’s case to determine if citalopram would be safe, or if the patient’s existing medication regimen requires adjustment.
One concern with citalopram interactions is combination with other SSRIs, Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), or Monoamine Oxidase Inhibitors (MAOIs). These medications are not designed to be taken together. Patients who need to transition between different drugs in these classes need to taper off the original drug and wait to allow it to fully metabolize before taking the new medication. Other psychiatric medications including antipsychotics, sedatives, and mood stabilizers can also potentially conflict.
This drug has known effects on the heart and can combine badly with other drugs that affect heart rate. Asthma medications like albuterol, for example, can be dangerous, as can certain antibiotics. It also conflicts with medications used to manage clotting and bleeding disorders. Patients can be at risk of citalopram interactions like excessive bleeding if they take the medication with an anticoagulant like warfarin or aspirin.
Dietary supplements like tryptophan and St. John’s Wort can also cause citalopram interactions. These are sometimes recommended for treatment of depression, but shouldn’t be taken with citalopram and certain other medications because they can create conflicts. Patients preparing to start new psychiatric drugs should discuss everything they take, including supplements and herbs, in case there is a risk of interaction. While supplements are available over the counter, they are not necessarily harmless for all patients.
Alcohol can be generally safe for patients who take citalopram, but there are some concerns. In people with underlying depression, alcohol can increase the intensity of depression. For this reason, it’s not typically recommended for patients in treatment for severe depression. People taking citalopram for other reasons may be able to drink safely, and can discuss the situation with a care provider if they have questions. Recommendations involving citalopram interactions and alcohol tend to err on the side of caution to protect patients and people may find that their tolerance varies, depending on the drug and the situation.