Celexa Information and Birth Defects

What is Celexa?

Citalopram, marketed as Celexa, is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat major depression and is often prescribed off-label to treat a wide variety of conditions. Originally created in 1989 by the pharmaceutical company Lundbeck, Celexa is an SSRI antidepressant that is occasionally used to treat attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD).

Today, Forest Laboratories manufactures and markets Celexa, along with a very similar and a more potent SSRI antidepressant called Lexapro. Celexa (citalopram) and Lexapro (escitalopram) share a very similar pharmacological make-up.

How are Celexa and Lexapro similar? Imagine the molecular configuration below printed off on a piece of paper pressed against a mirror—Celexa is made of both the paper and the mirror image, and Lexapro is just the mirror image.  Or imagine two hands pressed together—Celexa is both hands and Lexapro is just the left hand.

Diagram of Celexa molecular configuration

Celexa Information on Birth Defects

Initially, the U.S. Food and Drug Administration (FDA) placed Celexa as a pregnancy “category C” drug. The FDA uses the category system to determine possible risks to a fetus when medicines are taken during pregnancy. When a drug is placed in category C, it means that the drug has not been studied in pregnant women, but has shown harmful side effects on fetuses in animal testing.

In 2005, the FDA released a Public Health Advisory which warned of a possible link between the use of certain SSRI antidepressants (similar to Celexa) during pregnancy and an increased risk of certain cardiovascular defects in newborns. In 2006, the FDA issued a specific warning regarding Celexa. According to the FDA, Celexa, along with other SSRI antidepressants, has been linked to a higher risk of persistent pulmonary hypertension of the newborn (PPHN), a life threatening disorder.

These and other birth defects have been associated with Celexa and Baum Hedlund and Robinson, Calcagnie & Robinson are investigating the possible connection between Celexa and other serious and life threatening congenital defects.

Detailed Celexa Information

Pharmaceutical: Celexa

Manufacturer: Forest Laboratories

Generic name: citalopram

Drug Class: Selective serotonin reuptake inhibitor (SSRI)

CAS Number: 59729-33-8

Guidelines:

Celexa (citalopram) is used to treat symptoms associated with major depression. The drug is administered orally in the form of a tablet. Warning:the Food and Drug Administration (FDA) has warned physicians against prescribing more than 40 milligrams of citalopram per day due to a risk of changing the electrical activity of the heart, which can be fatal.

Contraindications:

  • Celexa is contraindicated for people taking a monoamine oxidase inhibitor (MAOI). Use of MAOIs within two weeks of Celexa treatment can cause serotonin syndrome.
  • Celexa should also not be taken with St. John’s Wort, tryptophan.

Adverse outcomes:

  • drowsiness
  • weight changes
  • fatigue, insomnia
  • nausea
  • vivid dreaming
  • decreased libido
  • frequent urination
  • dry mouth
  • anorgasmia
  • sweating
  • increased trembling and excessive yawning
  • increased anxiety
  • mood swings
  • bruxism
  • vomiting
  • cardiac arrhythmia
  • dizziness
  • headaches
  • blood pressure fluctuation
  • dilated pupils
  • hallucinations
  • convulsions

Serious Adverse Outcome:

Suicide and serotonin syndrome

Warnings:

  • Do not take Celexa if you are allergic to active or inactive ingredients in the drug.
  • Do not take Celexa if you are taking an MAOI.
  • Allow two weeks after ending an MAOI before starting Celexa treatment.
  • Likewise, allow two weeks after ending Celexa treatment before starting an MAOI.

Medical Studies:

  • New England Journal of Medicine Study:Selective Serotonin-Reuptake Inhibitors and Risk of Persistent Pulmonary Hypertension of the Newborn
  • New England Journal of Medicine Study:First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects

Pregnancy Category:

The FDA classifies Celexa as a Pregnancy Category C drug. This means that even though the drug has not been studied in pregnant women, animal studies have demonstrated an increased risk to a fetus if Celexa is taken during pregnancy.