Drug Interactions

Citalopram (Celexa®) Interactions

Taking Citalopram with:

Citalopram Drug Interactions:

Citalopram has a relatively low potential for interactions. It is a weak inhibitor of liver cytochrome P450 enzymes.

  • Anticoagulants/Antiplatelets: increased risk of bleeding.
  • Cimetidine: serum levels of citalopram may be increased 40%.
  • Serotonergic agents (antidepressants, sibutramine): risk of serotonin syndrome.
  • Beta Blockers (carvedilol, metoprolol, propranolol): inhibition of metabolism of beta blockers.

Can you take Citalopram and Bupropion (Wellbutrin®) together?

Adding bupropion to SSRI antidepressant has been a common practice when the SSRI alone does not sufficiently relieve depression. Citalopram and bupropion can be used at the same time 2. One study found that bupropion modestly increases citalopram levels 3.

Can you take Citalopram and opioid analgesics?

Possible risk of serotonin syndrome. Nevertheless, citalopram can be used along with opioid analgesics (e.g. hydrocodone, oxycodone, morphine) safely and effectively. The incidence of serotonin syndrome reactions with opioids and SSRIs is fairly rare.

Can you take Citalopram and Tramadol?

Both medications have a serotonergic action. Tramadol should be used with caution with citalopram because of the increased risk of seizures and serotonin syndrome. The lowest effective dose of tramadol should be used.

Can you take Citalopram and Escitalopram (Lexapro®) at the same time?

Combining more than one SSRI is unusual, and would be expected to increase the risk of side effects. There is very little data on combining SSRIs.

Can you take Citalopram and benzodiazepines at the same time?

Generally, no clinically significant interaction appears to occur between citalopram and the benzodiazepines 4 (e.g. alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), temazepam (Restoril)) or related medications such zolpidem (Ambien) or zaleplon (Sonata). Sedation may be increased.

Can you take Citalopram and Phentermine (Adipex®) at the same time?

No contraindications on concomitant use of citalopram and phentermine 1.

Can you take Citalopram with Methylphenidate (Ritalin®)?

No contraindications on concomitant use of citalopram and methylphenidate 1. The combination of citalopram and methylphenidate has been investigated to accelerate antidepressant response to citalopram 5.

Can you take Citalopram with Quetiapine (Seroquel®)?

Citalopram can be taken The combination of citalopram and quetiapine has been investigated to accelerate antidepressant response to citalopram 6.

Can you take Citalopram with Topiramate (Topamax®)?

There are no drug interactions between citalopram and topiramate. Limited data suggests that addition of topiramate to citalopram may be useful for treating Compulsive-Impulsive Sexual Behaviors 7.

When you should NOT take Citalopram?

Contraindications for Citalopram use:

  • Should not be coadministered with MAO inhibitors or within 2 weeks of discontinuing MAO inhibitors.
  • Concomitant use with pimozide.
  • Congenital long QT syndrome.

Citalopram during Pregnancy & Lactation:
Citalopram is pregnancy category C.

Some animal studies show adverse effects on embryo/fetal and postnatal development. There are no controlled studies in pregnant women and so far has not been proven to be harmful to the fetus. Not generally recommended for use during pregnancy, especially during first trimester.

Citalopram is excreted in human breast milk. If child becomes irritable or sedated, breast feeding or citalopram may need to be discontinued.


  • 1. U.S. Citalopram Prescribing Information
  • 2. Lam RW, Hossie H, Solomons K, Yatham LN. Citalopram and bupropion-SR: combining versus switching in patients with treatment-resistant depression. J Clin Psychiatry. 2004 Mar;65(3):337-40. PubMed
  • 3. GlaxoSmithKline. A randomized, crossover, 3-period, 2-way interaction study to evaluate potential drug interactions between Wellbutrin XL and citalopram in healthy volunteers. Study WXL103104, 2005
  • 4. Hall J, Naranjo CA, Sproule BA, Herrmann N. Pharmacokinetic and pharmacodynamic evaluation of the inhibition of alprazolam by citalopram and fluoxetine. J Clin Psychopharmacol. 2003 Aug;23(4):349-57. PubMed
  • 5. Lavretsky H, Kim MD, Kumar A, Reynolds CF. Combined treatment with methylphenidate and citalopram for accelerated response in the elderly: an open trial. J Clin Psychiatry. 2003 Dec;64(12):1410-4. PubMed
  • 6. Quante A, Regen F, Schindler F, Volkmer K, Severus E, Urbanek C, Luborzewski A, Roepke S, Anghelescu I. Quetiapine as combination treatment with citalopram in unipolar depression with prominent somatic symptoms: a randomised, double-blind, placebo-controlled pilot study. Psychiatr Danub. 2013 Sep;25(3):214-20. PubMed
  • 7. Marazziti D, Dell'Osso B. Topiramate plus citalopram in the treatment of Compulsive-Impulsive Sexual Behaviors. Clin Pract Epidemiol Ment Health. 2006 May 22;2:9. PubMed

By HealthyStock Research Group, September 2009
Medical resources reviewed: August 2018

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