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Citalopram

Also indexed as: Celexa, Cipramil

Illustration

Citalopram is used to treat mental depression and is in a class of drugs known as selective serotonin reuptake inhibitor (SSRI) antidepressants.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Ginkgo
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

5-Hydroxytryptophan (5-HTP)*

L-tryptophan*
Check Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.

Lithium
Depletion or interference

None known
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression. Taking lithium at the same time as citalopram can either increase the effectiveness of citalopram or increase the likelihood of developing side effects.1 Therefore, people taking citalopram together with lithium-containing supplements should contact their doctor if they experience side effects, such as nausea, dry mouth, or sleep disturbances.

Interactions with Herbs

Ginkgo
Ginkgo biloba extract may reduce the side effects experienced by some persons taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly, depressed persons found that 200–240 mg of ginkgo per day was effective in alleviating sexual side effects in both men and women taking SSRIs.2 One case study reported that 180 to 240 mg of GBE daily reduced genital anaesthesia and sexual side effects secondary to fluoxetine use in a 37-year-old woman.3

5-HTP and L-tryptophan

Citalopram increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with citalopram may increase citalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as citalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.4

Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with citalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with citalopram or other SSRIs.

References

1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1073–7.

2. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Therapy 1998;24:139–45.

3. Ellison JM, DeLuca P. Fluoxetine-induced genital anesthesia relieved by Ginkgo biloba extract. J Clin Psychiatry 1998;59:199–200.

4. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.