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Citalopram (Celexa) In Pregnancy: Uses, Dosage And Side Effects

Citalopram During Pregnancy

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IN THIS ARTICLE

Citalopram (Celexa) is a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant, used to treat depression. Low levels of serotonin can lead to depression, and citalopram helps in fighting depression by increasing the activity of serotonin in the central nervous system.

In this post, MomJunction tells you about the safety of citalopram during pregnancy, the possible side effects, and a few more questions that mothers usually have about the drug.

Is It Safe To Take Citalopram During Pregnancy?

The US Food and Drug Administration (FDA) has classified citalopram as a pregnancy category C drug because animal studies have shown adverse effects on the fetus development when citalopram was given in doses greater than human therapeutic doses.

The FDA also states that neonates exposed to Celexa late in the third trimester, have developed complications such as respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hyperreflexia, tremor, jitteriness, irritability and constant crying (1). Hence, it advises taking citalopram only when the potential benefits outweigh the risks.

Also, citalopram should not be taken if you have heart rhythm problems or under medication for heart-related disorders, as citalopram can cause dose-dependent QT interval prolongation. Tell your doctor if you are on such medications (2).

Does Citalopram Cause Birth Defects?

A study by the University of Toronto found that the maternal use of citalopram during the early stages of pregnancy was not associated with any major fetal defects. However, using citalopram during the later stage of pregnancy was associated with an increased risk of poor neonatal adaptation syndrome (3).

However, various cohort studies on more than nine million births found that maternal use of citalopram during the first trimester could slightly increase the risk of neural tube defects and hypospadias (deformation of the urethra) in the newborn. Although these findings were not consistent, they cannot be ruled out.

Another cohort study concluded that septal heart defects are more common in infants whose mothers took citalopram in early pregnancy(4).

So, according to these studies, it can be stated that there is a small risk of birth defects with the maternal use of citalopram (5).

Does Taking Citalopram Increase The Chance Of Miscarriage? 

A study based on the data from the Quebec Pregnancy Registry found that the use of antidepressants during pregnancy was associated with a 68% increase in the overall risk of spontaneous abortion. It did not find any significant difference in the risk of spontaneous abortions between different types of SSRIs.

These studies have limitations, and the results could be affected by certain variables. Your doctor may prescribe this medication if the risk of depression is greater than the problems caused by the drug itself (6).

Can Taking Citalopram In Pregnancy Cause Preterm Birth Or Low Birth Weight? 

A study on the effect of SSRI antidepressants found that fetal exposure to maternal SSRI dose or maternal depression without the use of SSRI both increased the risk of preterm birth. There was no change in mean infant weight; whether the woman was on SSRI dose or had depression with no treatment with SSRIs.

The findings of the study were ultimately inconsistent. So, your doctor will assess the severity of depression and determine the risks involved (7).

What If You Have Already Taken Citalopram During Pregnancy? 

If you were already taking citalopram when you got pregnant, then consult your doctor. Discontinuing antidepressants may lead to discontinuation syndrome that might cause a relapse of depression and lead to the following problems (8):

  • Nausea
  • Vomiting
  • Diarrhea
  • Light-headedness
  • Dizziness
  • Diminished appetite
  • Sweating
  • Chills
  • Fatigue
  • Sleep disturbances

Talk to your doctor, who can gradually reduce the dosage over months. 

What Is The Recommended Dosage Of Citalopram During Pregnancy? 

According to the US FDA, the recommended dosage of citalopram can range from 20mg to 60mg a day, with a median dose of 40mg a day (2). The doctor will specify the precise dose after assessing the patient’s condition.

What Are The Possible Side Effects Of Citalopram? 

Along with the possible fetal defects, citalopram has the following side effects.

  • Drowsiness
  • Insomnia
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Dry mouth

Pregnancy is the time to be happy and joyful, and having to deal with depression during such periods can be stressful. You may try some non-drug therapies such as meditation, yoga or counseling. But if your doctor sees the need for antidepressants and prescribes citalopram, then talk to them about the possible repercussions and follow their advice without fail.

Did you take citalopram during pregnancy? Do share your experience with us in the comment section below.

This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.

References

1. Prescribing Information- Celexa; US Food and Drug Administration
3. Sivojelezova A et al., Citalopram use in pregnancy; National Center for Biotechnology Information
4. Antidepressants and pregnancy; National Health Service
6. Hamid Reza Nakhai-Pour, MD PhD, Perrine Broy, BSc, and Anick Bérard, PhD; Use of antidepressants during pregnancy and the risk of spontaneous abortion; National Center for Biotechnology Information
7. Katherine L.Wisner et all.; Major Depression and Antidepressant Treatment: Impact on Pregnancy and Neonatal Outcomes; The American Journal of Psychiatry
8. Nazila Sharbaf Shoar; Ranjit K. Padhy; Citalopram; National Center for Biotechnology Information
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