What is Celexa? What does it do?

Celexa is the brand name of the drug citalopram. Celexa is a selective serotonin uptake inhibitor or SSRI.¹

SSRIs prevent serotonin—a chemical produced in the nervous system, the vascular system and the gastrointestinal tract that is thought to affect mood—from being transferred between cells.²

Does Celexa work?

Researchers, physicians and patients are divided on whether Celexa and other SSRI anti-depressants are effective.

Some patients reported satisfaction with Celexa. Other patients reported that Celexa was ineffective for them.³

In a 2007 review of 74 anti-depressant studies, it was found they were used to get FDA approval of SSRI anti-depressants while not being published accurately. The review reported that unfavorable results were not published and in some cases published in a way that made them falsely appear to be favorable, leading to “unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.” ⁴

In February 2012, a suit was flied against Celexa’s maker, Forest Pharmaceuticals, alleging that the company paid a bribe to the principal investigator of a federally funded anti-depressant study to fix the results of the study in favor of Celexa. The study was “Sequenced Treatment Alternatives to Relieve Depression”, commonly called STAR*D. It was funded by the National Institute of Mental Health and conducted at the University of Texas. STAR*D involved more than 4,000 patients over twelve months, at a cost of $35M. STAR*D’s purpose was “to determine the effectiveness of different treatments for people with major depression who have not responded to initial treatment with an antidepressant” and it was the most significant study on this subject ever conducted.

A psychologist who participated in review of the study’s materials has alleged that Forest Pharmaceuticals paid the primary investigator in charge of the study to influence the study in favor of Celexa. The suit alleges that this caused Celexa to be chosen as the only medication used in the first part of the study and that the study’s results falsely overstated Celexa’s effectiveness.⁵

Additionally, Forest Pharmaceuticals, pled guilty in 2011 to

• Obstructing justice,
• Distributing an unapproved drug in interstate commerce,
• And distributing a misbranded drug, Celexa, in interstate commerce.

Celexa was only approved for the treatment of adults but the company targeted doctors who treated children and adolescents. They directed their sales representatives to call on them, and hired outside speakers to talk to pediatric specialists about the benefits of prescribing Celexa to children and teens. The company “aggressively publicized” a study of its own on Celexa in treating adolescents while suppressing the negative results of an independent European study on the treatment of adolescents with Celexa. Forest Pharmaceuticals was sentenced to pay a criminal fine of $150,000,000 and forfeit assets of $14,000,000.⁶

What should I go over with my doctor before deciding to take Celexa?

All SSRI anti-depressants have side effects and Celexa is no exception. SSRI anti-depressants may also cause a potentially fatal condition called Serotonin Syndrome, which causes the body to have too much serotonin and, if untreated, can be fatal.⁷

Like other drugs of this kind, it carries a warning of potential suicidal thoughts or actions, especially in children and young adults.⁸

Other potentially serious side effects of Celexa can include changes in the electrical activity of the heart such as tachycardia or rapid heart rate. It can also cause severe allergic reactions, abnormal bleeding, seizures or convulsions, manic behavior, changes in appetite or weight and low sodium levels in blood.⁹ Other side effects can include nausea, sleepiness, weakness, dizziness, feeling anxious, trouble sleeping, sexual problems, sweating, shaking, not feeling hungry, dry mouth, constipation, diarrhea and respiratory Infections.¹⁰

What if I’m already taking Celexa?

If you’re concerned about Celexa or have experienced any adverse effects, talk to your doctor. Never stop taking any prescription medication without talking to your doctor.

Learn everything you can about Celexa before you start taking it.

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¹ PubMed Health, “Citalopram” (revised 15 May 2012, retrieved 30 October 2012), http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001041/
² Michael W King, PhD,”Discover what is serotonin,” http://www.whatisserotonin.com; themedicalbiochemistrypage.org, LLC, “Table of Neurotransmitters,” (last modified 25 June 2012) http://themedicalbiochemistrypage.org/nerves.php#5ht
³ Health Boards, Patient Forums (retrieved 1 November 2012), http://www.healthboards.com/boards/depression/36227-celexa-10mg-effective-weak.html; Druglib, Patient Forums (retrieved 1 November 2012), http://www.druglib.com/ratingsreviews/celexa/; Everday Health, Patient Forums (retrieved 1 November 2012), http://www.everydayhealth.com/drugs/celexa/review
⁴ Turner EH et al. 2007, “Selective publication of antidepressant trials and its influence on apparent efficacy,” New England Journal of Medicine. 358: 252-260. http://www.ncbi.nlm.nih.gov/pubmed/18199864
⁵ Bloomberg BNA, Aquino J., ” Whistleblower Claims Forest Bribed Study’s Investigator to Favor Celexa,” (1 February 2012), http://www.bna.com/whistleblower-claims-forest-n12884907568/
⁶ Food and Drug Administration, “March 2, 2011: Forest Pharmaceuticals To Pay $164 Million For Criminal Violations” (2 March 2011), http://www.fda.gov/ICECI/CriminalInvestigations/ucm245543.htm
⁷ A.D.A.M. Medical Encyclopedia, “Hyperserotonemia; Serotonergic syndrome” (last reviewed: July 8, 2012, retrieved 6 October 2012), http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004531/
⁸ Food and Drug Administration, Celexa Medication Guide (revised August 2011, retrieved 1 November 2012), http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088568.pdf
⁹ Ibid.
¹⁰ Ibid.