Coping With Fatigue Caused by an Antidepressant

Side-effects from antidepressants are hard to avoid. Fatigue is one of them. This mostly is true of tricyclic antidepressants like Elavil (amitriptyline) and Tofranil (imipramine), which doctors don’t often prescribe any more.

But even the newer classes of antidepressants—including selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine) and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine)—can lay you low.

Given that depression itself can make you feel exhausted, it can be frustrating to find that the medication you’re taking to treat it isn’t helping with your fatigue. If you’re dealing with this particular problem, here are some ways you may be able to get the benefits of your medication without constantly feeling like you need a nap.

Why Antidepressants Cause Fatigue

Certain antidepressants work by acting on brain chemicals called neurotransmitters—in particular norepinephrine and serotonin—causing them to linger in the spaces between nerve cells where they carry out their job of regulating mood.

At the same time, though, these medications affect other neurotransmitters, including histamine and acetylcholine, sometimes leading to unpleasant side effects such as dry mouth, blurry vision, weight gain, and sedation. It’s this last side effect that may be responsible for the fatigue you experience when you take an antidepressant.

What to Avoid

If you’re truly fighting to keep your eyes open, there are some important things to avoid doing. Do not get behind the wheel of your car. Let someone else do the driving, call a car service or cab, or use public transportation until you’ve found a workaround for your fatigue.

Steer clear of alcohol and any medications that also tend to be sedating. The combo of either with your antidepressant could make your fatigue worse.

Strategies to Reduce Tiredness

You may be tempted to give in to exhaustion and set up camp on your couch, but there are other things you can do if your antidepressant is wiping you out. Here are some possibilities.

Nap

Make time to nap during the day. This doesn’t mean you have to climb under the covers and snooze the afternoon away. According to the National Sleep Foundation, just 20 minutes of sleep is enough to leave most people feeling refreshed and energized. In fact, more shut-eye than that can make you even groggier.

Work Out

Get some exercise. It sounds counterintuitive—how could moving possibly be helpful when the last thing you feel like doing is moving? A 2008 study at the University of Georgia found that regular low-intensity exercise could reduce fatigue by as much as 65%, for example.

This was especially true of people in the study who did low-intensity exercise as opposed to moderate-intensity activity. That means that a leisurely walk could do more to perk you up than, say, a challenging stint on an exercise bike.

Take Medications at Night

Pop your pill at bedtime. Unless there’s some reason your doctor would prefer you down your depression medication in the morning or during the day, taking it at night may help you fall asleep more easily so you get the rest you need to feel more alert during waking hours. 

Give It Time

Wait it out. For most people, the side effects of antidepressants wear off as their bodies become adjusted to the medication.

When to See Your Doctor

If after several weeks you’re still feeling zonked, you and your doctor may need to go back to the drawing board and try a different drug or supplement your medication with a second drug that’s stimulating, such as Provigil (modafinil).

Should I Take My Antidepressant at Night or in the Morning?

When It’s Better to Take In the Morning

Antidepressants are sometimes best when taken in the morning due to their potential side effects. Here are a few to consider.

Insomnia

Some selective serotonin reuptake inhibitors (SSRIs), the class of antidepressants most often used, can disrupt sleep for some people and would be best taken in the morning.

For example, the manufacturer of Prozac (fluoxetine) recommends it be taken in the morning because it can make some people feel more energized, especially at the beginning of treatment.

However, when Prozac is given in combination with Zyprexa (olanzapine)—a combination called Symbyax—as a therapy for treatment-resistant depression, it can cause sleepiness, so then it’s recommended to be taken in the evening.

Paxil (paroxetine) is generally taken in the morning in order to prevent sleeplessness at night. However, it may be given at bedtime if it is found to cause drowsiness in the person taking it. Wellbutrin (bupropion) is another antidepressant that is recommended to be taken in the morning in order to prevent insomnia at night.

Urinary Problems

When prescribed in children or adolescents, Zoloft can cause frequent urination as well as urinary incontinence. In this case, taking the pill in the morning can prevent any nighttime bedwetting.

Sexual Issues

If you experience sexual side effects (such as low libido, erectile dysfunction, or inability to ejaculate) from your antidepressant, the timing of when you take your antidepressant can make a difference.

Research indicates that it may be helpful to consider the time of day when you’re most likely to engage in sexual activity and plan to take your antidepressant shortly thereafter.

When It’s Better to Take At Night

Some side effects are better tolerated if an antidepressant is taken closer to bedtime. These are a few of the effects that fall into this category.

Drowsiness

Unlike some SSRIs, certain other antidepressants tend to make you feel drowsy, so they’re better tolerated if you take them at bedtime.  Among these medications are Luvox (fluvoxamine), Remeron (mirtazapine), and the tricyclic antidepressants, including:

• Elavil (amitriptyline)
• Norpramin (desipramine)
• Tofranil (imipramine)
• Pamelor (nortriptyline)

Nausea

Some classes of antidepressants (mostly SSRIs) can trigger nausea as well as vomiting, diarrhea, and loss of appetite. While this often resolves itself as your body adjusts to the medication, sticking to a nighttime medication schedule can also help by hopefully allowing you to sleep through any digestive woes.

Other Optimal Medication Strategies

In addition to discussing with your doctor the time of day that is best to take your antidepressant, it’s critical to remember that there are other strategies that affect how well your medication will work, including:

Have Patience

Antidepressants take time to work; potentially anywhere from six to 12 weeks for the full effect, although many people notice improvement within a week or two. When you start your antidepressant, keep in close contact with your doctor and stay positive. You can find a way to treat your condition, but it may take a little bit of trial and error.

Stay Consistent

Take your antidepressant as directed at the same time every day and do not stop it without first talking to your doctor.

Talk to Your Doctor

If your antidepressant is causing side effects, remember that many, if not all of them, will go away with time. If the side effects are intolerable, get in touch with your doctor right away. Finding relief may be as simple as changing the dose, switching to a different antidepressant, or adding a second medication to ease the side effect.

A Word From Verywell

Taking an antidepressant needs to be part of a well-thought-out plan with your doctor to maximize its benefits and minimize any potential side effects. Don’t make any changes to your treatment plan without consulting with your doctor first.

The recommendations noted above are general and may or may not be applicable to your own unique situation. Your doctor will be able to provide you with specific recommendations about whether your antidepressant should be taken at a particular time of day for the best results for you.

How to Know Which Antidepressant Is Best for You

The quest to find the right antidepressant medication can feel very “hit or miss.” While it might seem a bit random how doctors choose which antidepressant to prescribe for you, there really is some logic to it.

In fact, there are even flow charts, called algorithms, which outline a logical progression that doctors might follow in determining what the best antidepressant is for you. These algorithms are based on the current knowledge in the medical field about which type of antidepressant works best for which patient.

Still, there is no telling what you may or may not respond to. In fact, many people don’t respond to their first antidepressant, or they experience undesirable side effects, so they have to try a second, third, or fourth option before finding what works best for them.

Up to 80% of people do eventually respond to depression treatment, so there is every reason to have hope that you will land on the right one for you.

Factors to Consider

There many factors that are considered when a physician chooses an antidepressant for you—beyond the type of depression you are living with.

Your Symptoms

Some antidepressants can do double duty. For instance, if you have been losing weight because you’re not eating, your doctor might decide to put you on an antidepressant that is known to cause weight gain. If you’re having trouble sleeping, your doctor might choose one that you can take before bed that makes you sleepy.

Other examples of antidepressants that may have double-duty functions include:

• Smoking cessation: Wellbutrin (bupropion) is actually the same drug as the popular stop-smoking medication sold under the brand name Zyban.  For a smoker, Wellbutrin may be the logical choice for lifting depression and aiding in smoking cessation.
• Neuropathy: Both tricyclic antidepressants and the serotonin-norepinephrine reuptake inhibitors (SNRIs) Cymbalta (duloxetine) and Effexor (venlafaxine) have been found to be helpful. 
• Bedwetting: Though tricyclic antidepressants tend to be used less often than some of the newer formulations, for those who are struggling with bedwetting, Tofranil (imipramine) may help with both problems.
• Learning disabilities: It’s thought that some antidepressants may have a secondary benefit of helping with some learning disabilities. If this is you, talk to your physician about whether or not one of these medications may work for you.

Potential Side Effects

If you’ve been on an antidepressant before, your doctor will want to know what side effects were particularly bothersome for you. If you are on a medication that has side effects you find intolerable, you’re less likely to stay on it, so choosing one that gives you the least side effects is the goal. This can take some trial and error.

Other Medications You’re Taking

Some medications, including antibiotics and steroids, can interact with antidepressants, so your doctor needs to know what other medication (including over-the-counter, prescription, vitamins, and supplements) you’re taking to make the best decision.

Other Health Conditions You Have

Again, some antidepressants can do double duty with both physical and mental illnesses. So, for example, if you have attention-deficit/hyperactivity disorder (ADHD) and depression, taking a medication like Wellbutrin (bupropion) can help both. On the physical side, if you have fibromyalgia or chronic pain, your doctor might prescribe Cymbalta (duloxetine) because it can help with both pain and depression. 

When prescribing an antidepressant, the first goal should be treating depression.

Sometimes this may mean choosing an antidepressant that is more likely to cause weight gain even in someone who is overweight or choosing an antidepressant that doesn’t treat another condition the person has, even if that option appears to be available.

Your Family History

Especially for parents or siblings, how a medication worked for them is a good indicator of how it might work, or not, for you.

Whether You’re Pregnant or Breastfeeding

Since antidepressants can have an effect on the baby, your doctor will want to steer clear of antidepressants that have been shown to be harmful. You and your doctor will have to figure out the best plan to manage your depression while you are pregnant or thinking of becoming pregnant or breastfeeding.

Health Insurance and Cost

Some newer antidepressants don’t have a generic form available yet and maybe costly, which may influence your doctor’s choice.

On and Off-Label Uses

It’s also important to make a distinction between on-label and off-label uses of medications. On-label use means that the medication has received FDA-approval for that indication. 

Off-label use does not mean that a medication is not useful, but rather that it does not yet have FDA-approval for that indication. It’s also important for people to know that some physicians are more willing than others to consider prescribing off-label medications.

The best thing you can do is to work together with your doctor as a team to find the right antidepressant. Nobody knows your body better than you do or understands your preferences as well as you.

Barriers to Finding the Right Treatment

Side effects, as mentioned above, can present major barriers to finding the right medication for you. This is the point when the physician and the patient must work together to find a solution that the patient can live with.

Depression Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor’s appointment.

Options might include the following:

• Accepting the side effect as a trade-off for depression relief
• Augmenting with other medications (using more than one medication together to control depression and/or relieve side effects)
• Trying a new medication

Your doctor should always try to find the drug that gives the best depression relief with the fewest side effects for you—but keep in mind that, unfortunately, no drug is going to be perfect. There are two side effects that people seem to find the most troubling: sexual dysfunction and weight gain.

Sexual Side Effects

One of the classic symptoms of depression is a loss of sex drive. Rather ironically, many of the medications used to treat depression can also potentially cause sexual side effects.

If these problems affect you and you cannot tolerate them, Serzone (nefazodone), Trintellix (vortioxetine), Wellbutrin (bupropion), and Remeron (mirtazapine) are medications that have fewer sexual side effects. Of course, these medications may have other side effects.

Weight Gain

Weight gain on antidepressants is another commonly complained about side-effect. In this department, Paxil (paroxetine) and Remeron (mirtazapine) are two of the worst offenders. Effexor (venlafaxine), Wellbutrin (bupropion), and Prozac (fluoxetine) are antidepressants that are not as likely to cause weight gain, and many people even lose a few pounds.

But again, everyone is different. Some people gain weight on medications unlikely to cause weight gain and lose weight on those that often cause weight gain.

Side Effects Aren’t Always Bad

Believe it or not, side effects are not necessarily a bad thing. A drug like Prozac that suppresses appetite may not be desirable for someone who has an eating disorder or is too thin but may be helpful for someone who has diabetes or is overweight.

Along those same lines, a drug that increases appetite, such as Paxil (paroxetine) or Remeron (mirtazapine), could benefit someone who is underweight while potentially causing issues for someone who is overweight. The same applies to antidepressants that are stimulating and those that are sedating.

An antidepressant that tends to be stimulating such as Wellbutrin (bupropion) may be helpful for someone with a vegetative depression or someone who seems to have no energy—but could be the wrong choice for someone living with an anxiety disorder in addition to depression.

By the same token, a sedating antidepressant such as mirtazapine could work well for someone who is anxious but might be the wrong choice for someone who is already feeling a total lack of energy with their depression. Again, it is important to remember that every person is different.

A Word From Verywell

Finding the best antidepressant for you may take some trial and error. When you start a new medication, monitor your symptoms for a couple of weeks and report back to your prescribing physician. Be prepared to have an open and honest conversation about your experience—what’s working for you and what’s not. Together, you can determine the right treatment plan for you.

Side Effects of Celexa (Citalopram Hydrobromide), Warnings, Uses

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Antidepressants: Get tips to cope with side effects

Antidepressants: Get tips to cope with side effects

Most antidepressant side effects aren’t dangerous, but they can be bothersome. Here’s what to do.

By Mayo Clinic Staff

Introduction

Antidepressants can cause unpleasant side effects. Signs and symptoms such as nausea, weight gain or sleep problems can be common initially. For many people, these improve within weeks of starting an antidepressant. In some cases, however, antidepressants cause side effects that don’t go away.

Talk to your doctor or mental health professional about any side effects you’re having. For some antidepressants, monitoring blood levels may help determine the range of effectiveness and to what extent dosage can be adjusted to help reduce side effects. Rarely, antidepressants can cause serious side effects that need to be treated right away.

If side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Don’t do it. Your symptoms may return, and stopping your antidepressant suddenly may cause withdrawal-like symptoms. Talk with your doctor to help identify the best options for your specific needs.

Nausea

Nausea typically begins early after starting an antidepressant. It may go away after your body adjusts to the medication.

Consider these strategies:

• Take your antidepressant with food, unless otherwise directed.
• Eat smaller, more-frequent meals.
• Suck on sugarless hard candy.
• Drink plenty of fluids, such as cool water. Try an antacid or bismuth subsalicylate (Pepto-Bismol).
• Talk to your doctor about a dosage change or a slow-release form of the medication.

Increased appetite, weight gain

You may gain weight because of fluid retention or lack of physical activity, or because you have a better appetite when your depression symptoms ease up. Some antidepressants are more likely to cause weight gain than others. If you’re concerned about weight gain, ask your doctor if this is a likely side effect of the antidepressant being prescribed and discuss ways to address this issue.

Consider these strategies:

• Cut back on sweets and sugary drinks.
• Select lower calorie nutritious foods, such as vegetables and fruits, and avoid saturated and trans fats.
• Keep a food diary — tracking what you eat can help you manage your weight.
• Seek advice from a registered dietitian.
• Get regular physical activity or exercise most days of the week.
• Talk to your doctor about switching medications, but get the pros and cons.

Fatigue, drowsiness

Fatigue and drowsiness are common, especially during early weeks of treatment with an antidepressant.

Consider these strategies:

• Take a brief nap during the day.
• Get some physical activity, such as walking.
• Avoid driving or operating dangerous machinery until the fatigue passes.
• Take your antidepressant at bedtime if your doctor approves.
• Talk to your doctor to see if adjusting your dose will help.

Insomnia

Some antidepressants may cause insomnia, making it difficult to get to sleep or stay asleep, so you may be tired during the day.

Consider these strategies:

• Take your antidepressant in the morning if your doctor approves.
• Avoid caffeinated food and drinks, particularly late in the day.
• Get regular physical activity or exercise — but complete it several hours before bedtime so it doesn’t interfere with your sleep.
• If insomnia is an ongoing problem, ask your doctor about taking a sedating medication at bedtime or ask whether taking a low dose of a sedating antidepressant such as trazodone or mirtazapine (Remeron) before bed might help.

Dry mouth

Dry mouth is a common side effect of many antidepressants.

Consider these strategies:

• Sip water regularly or suck on ice chips.
• Chew sugarless gum or suck on sugarless hard candy.
• Avoid tobacco, alcohol and caffeinated beverages because they can make your mouth drier.
• Breathe through your nose, not your mouth.
• Brush your teeth twice a day, floss daily and see your dentist regularly. Having a dry mouth can increase your risk of getting cavities.
• Talk to your doctor or dentist about over-the-counter or prescription medications for dry mouth.
• If dry mouth continues to be extremely bothersome despite the efforts above, ask your doctor the pros and cons of reducing the dosage of the antidepressant.

Constipation

Constipation is often associated with tricyclic antidepressants because they disrupt normal functioning of the digestive tract and other organ systems. Other antidepressants sometimes cause constipation as well.

Consider these strategies:

• Drink plenty of water.
• Eat high-fiber foods, such as fresh fruits and vegetables, brans, and whole grains.
• Get regular exercise.
• Take a fiber supplement (Citrucel, Metamucil, others).
• Ask your doctor for advice on stool softeners if other measures don’t work.

Dizziness

Dizziness is more common with tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) than with other antidepressants. These medications can cause low blood pressure, resulting in dizziness.

Consider these strategies:

• Rise slowly from sitting to standing positions.
• Use handrails, canes or other sturdy items for support.
• Avoid driving or operating machinery.
• Avoid caffeine, tobacco and alcohol.
• Drink plenty of fluids.
• Take your antidepressant at bedtime if your doctor approves.

Agitation, restlessness, anxiety

Agitation, restlessness or anxiety can result from the stimulating effect of certain antidepressants. Although having more energy can be a good thing, it may mean you can’t relax or sit still even if you want to.

Consider these strategies:

• Get regular exercise, such as jogging, biking or aerobics, or some type of physical activity, such as walking. Talk to your doctor first about what would be a good type of exercise or physical activity for you.
• Practice deep-breathing exercises, muscle relaxation or yoga.
• Consult your doctor about temporarily taking a relaxing or sedating medication or switching to an antidepressant that isn’t as stimulating.

Be alert for racing or impulsive thoughts along with high energy. If these develop, talk to your doctor right away because they may be signs of bipolar disorder or another serious disorder.

Sexual side effects

Many antidepressants cause sexual side effects. They can include reduced sex drive and difficulty reaching orgasm. Some antidepressants may cause trouble getting or keeping an erection (erectile dysfunction). Selective serotonin reuptake inhibitors (SSRIs) are more likely to cause sexual side effects than other antidepressants are.

Consider these strategies:

• Consider a medication that requires only a once-a-day dose, and schedule sexual activity before taking that dose.
• Talk to your doctor about switching to an antidepressant that may have fewer of these effects, such as bupropion (Wellbutrin, SR, Wellbutrin XL, others), or adjusting your medication to ease sexual side effects.
• Talk to your partner about your sexual side effects and how they change your needs. Adjusting your sexual routine may be helpful. For example, you may need a longer period of foreplay before having sexual intercourse.
• Talk with your doctor about options for medications, such as sildenafil (Viagra), that may temporarily ease sexual side effects or treat erectile dysfunction and any associated risks. Avoid over-the-counter herbal supplements that promise increased sexual desire and function — these are not regulated by the Food and Drug Administration (FDA) and some could be dangerous to your health.

Heart-related effects

Depending on your heart health and the type of antidepressant you take, you may need an electrocardiogram (ECG) before or periodically during treatment. The ECG is used to monitor what’s called the QT interval to make sure it’s not prolonged. A prolonged QT interval is a heart rhythm condition that can increase your risk of serious irregular heart rhythms (arrhythmias).

Certain antidepressants should not be used if you already have heart problems or if you’re taking an MAOI. Talk with your doctor about your heart health and any heart medications or other medications that you take.

Genetic variations

Some studies indicate that variations in genes may play a role in the effectiveness and risk of side effects of specific antidepressants. So your genes may, at least in part, determine whether a certain antidepressant will work well for you and whether you’re likely to have certain side effects.

Some locations already provide limited genetic testing to help determine antidepressant choice, but testing is not routine and it’s not always covered by insurance.

More studies are being done to determine what might be the best antidepressant choice based on genetic makeup. However, genetic testing is a part of — not a replacement for — a thorough psychiatric exam and clinical decisions.

Sept. 12, 2019

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21. Hall-Flavin DK (expert opinion). Mayo Clinic. Aug. 28, 2019.

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Celexa Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

See also Warning and Precautions sections.

Nausea, dry mouth, loss of appetite, tiredness, drowsiness, sweating, blurred vision, and yawning may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: shaking (tremor), decreased interest in sex, changes in sexual ability, easy bruising/bleeding.

Get medical help right away if you have any very serious side effects, including: fainting, fast/irregular heartbeat, black stools, vomit that looks like coffee grounds, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Side effects, dosage, uses, and more

Celexa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Celexa. These lists don’t include all possible side effects.

For more information on the possible side effects of Celexa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Vivitrol, you can do so through MedWatch.

More common side effects

The more common side effects of Celexa can include:

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Celexa aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

• Suicidal thinking and behavior.* Symptoms can include:
  • thoughts of harming yourself
  • worsening depression or anxiety
  • feeling agitated or irritable (easily upset or frustrated)
  • aggressiveness
  • behaviors or feelings that aren’t normal for you
• Withdrawal symptoms when you stop using the drug. For details, see the “Celexa withdrawal” section below.
• Hyponatremia (low levels of sodium). Symptoms can include:
  • headache
  • brain fog
  • feeling weak or unsteady
  • fainting
• Mania or hypomania (racing thoughts or periods of high energy). Symptoms can include:
  • increased energy
  • feeling restless
  • trouble sleeping
  • racing thoughts
• Bleeding. Symptoms can include:
  • increased bruising
  • nosebleeds
  • blood in urine or stool
• QT prolongation and torsades de pointes (types of heart rhythm problems). Symptoms can include:
• Serotonin syndrome (high levels of the chemical serotonin). Symptoms can include:
  • sweating or fever
  • tremor
  • blood pressure changes
  • racing heart
  • feeling agitated
  • dizziness
• Seizures (changes in the electrical activity of your brain). Symptoms can include:
  • dizziness
  • sudden movement of your arms or legs
  • change in eyesight
  • sudden fear or feeling anxious

Another serious side effect, explained in more detail below in “Side effect details,” is allergic reaction.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255. During a crisis, people who are hard of hearing should call 1-800-799-4889.

Side effects in children

Celexa isn’t approved for use in children and can increase the risk of suicidal thoughts and behaviors in children.* For details, see “Suicidal thoughts and behaviors” in the “Side effect details” section below.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Celexa. However, there are no studies showing the frequency of allergic reactions in people using Celexa. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Celexa. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Weight gain or weight loss

Changes in appetite may occur while taking Celexa, which can lead to weight gain or weight loss. In clinical studies, weight changes were minimal and occurred in at least 1% of people who took Celexa. In some studies, people who took Celexa lost about 1 lb. In comparison, people who took a placebo (treatment with no active drug) didn’t lose weight.

It’s not known how many people gained weight while taking Celexa or how much weight they gained. And the studies didn’t include a placebo comparison for weight gain.

Keep in mind that depression itself sometimes causes changes in appetite and weight. If you’re taking Celexa and have weight loss or weight gain of more than a few pounds, it’s important to talk with your doctor. They can look at what might be causing the change in your weight and suggest helpful treatments.

Sexual side effects

Sexual problems may occur with Celexa use. Both men and women who take the drug may have a lower sex drive. Men who take Celexa may also have impotence or ejaculation changes (mostly a delay in ejaculating).

In clinical studies, 6% of men who took Celexa had changes in ejaculation, compared with 1% of men who took a placebo. Impotence occurred in 3% of men who took Celexa, compared with less than 1% of men who took a placebo.

You may not have sexual side effects while taking Celexa. But if you do, it’s important to tell your doctor if they’re bothering you. Your doctor may be able to change your dose of Celexa to ease symptoms or recommend a different medication.

Insomnia

Sleep problems may occur while taking Celexa. However, clinical studies found very similar rates of insomnia in people who took Celexa or a placebo. In the Celexa group, 15% of people had insomnia, compared with 14% of the placebo group. In addition, depression may also cause trouble with sleep.

Sleep is an important part of your overall health. If you’re having trouble sleeping during while taking Celexa, share this information with your doctor. They can suggest treatments to help you get a good night’s rest.

Diarrhea

Diarrhea is a possible side effect of taking Celexa, but it may get better over time. Studies found that about 8% of people who took Celexa had diarrhea, compared with 5% of people who took a placebo.

You may also have diarrhea if you stop taking Celexa too quickly. See the “Celexa withdrawal” section below for more details.

If you’re taking Celexa and your diarrhea doesn’t go away or is bothersome, talk with your doctor. They can suggest helpful treatment options.

Hot flashes

Hot flashes are possible when taking Celexa, but they’re not likely to occur. In early studies, less than 1% of people who took Celexa had hot flashes. The studies didn’t include a placebo comparison.

If you have hot flashes during your Celexa treatment and they’re bothersome, talk with your doctor. They can suggest tips on how to be more comfortable.

Constipation

Constipation isn’t likely to occur with Celexa. In studies, more people who took a placebo had constipation than people who took Celexa. Specific statistics aren’t available, but clinical studies found that at least 2% of people who took Celexa had constipation.

However, if you have constipation while using Celexa, talk with your doctor about treatment options.

Sweating

Sweating (including night sweats) may occur when taking Celexa. However, studies showed similar rates of sweating in people who took Celexa (11%) compared with people who took a placebo (9%)

Sweating may also occur if you stop taking the drug too quickly or as a result of certain drug interactions. For more information, see the “Celexa withdrawal” and “Celexa interactions” sections.

If you’re taking Celexa and have sweating that’s bothersome, tell your doctor. They may be able to suggest treatments to help you feel more comfortable.

Suicidal thoughts and behaviors

Worsening depression or suicidal thoughts and behaviors* may occur when taking Celexa. You’re more likely to have these side effects if you’re younger than age 25 years, just started treatment, or your doctor just changed your dosage of Celexa.

Studies have looked at cases of suicide in people younger than age 18 years who took either an antidepressant or a placebo. The results showed 14 more cases of suicide in every 1,000 people who took an antidepressant compared with people who took a placebo. In people ages 18 to 24 years, studies showed 5 more cases of suicide in every 1,000 people who took an antidepressant, compared with people who took a placebo. And in people ages 25 years and older, there were fewer cases of suicide in every 1,000 people who took antidepressants, compared with people who took a placebo.

During your Celexa treatment, it’s vital to watch for changing thoughts and behaviors. Be sure to have friends and loved ones keep an eye out as well. It can take several weeks to notice whether Celexa is helping ease your depression symptoms, so it’s important to have support during this time. If you have thoughts of harming yourself while taking Celexa, tell your doctor right away or call 911.

* Celexa has a boxed warning for the risk of suicidal thinking and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Suicide and antidepressant drugs” at the beginning of this article.

90,000 💉 Celexa and alcohol: potential problems

Introduction

If you have depression, your doctor may give you medication to relieve your symptoms. One common antidepressant is Celexa. This is the proprietary version of citalopram. This drug is part of a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). They help make the neurotransmitter serotonin in your brain last longer by blocking serotonin reuptake.SSRIs like Celexa are now the most popular type of antidepressant. They work to improve your mood and outlook on life.

While Celexa is effective in treating depression, it is important to note that it contains warnings and precautions. This includes risks when the drug is used with alcohol. In fact, the US Food and Drug Administration (FDA) warns against mixing Celexa and alcohol.

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Celexa and alcohol

Can Celexa be taken with alcohol?

The FDA notes that Celexa does not increase the effects of alcohol, but the person taking the medication should still not consume alcohol.The combination of the drug with alcohol can lead to overdose and other problems.

Overdose

There are serious risks of overdose when you mix Celexa and alcohol. These effects can occur even if you are taking Celexa at the prescribed dose. Overdose symptoms include:

• nausea
• vomiting
• drowsiness
• sweating

You may have tremors in one of your limbs or a racing heart rhythm.If you have any of these symptoms, call 911 or your local emergency services right away.

In many cases of overdose, your doctor will treat and manage your symptoms. This may be the best treatment for Celexa overdose that combines alcohol. In some cases, your doctor may put you on a ventilator (breathing apparatus) to make sure your body is getting the right amount of oxygen. They can also watch your heart.

Other reactions

Alcohol and Celexa can be mixed in other dangerous and deadly ways.Side effects of combining the two may include:

• irregular heart rate
• amnesia
• coma (loss of consciousness)
• convulsions
• hyperventilation
• severe heart problems
• death

Side effects of other medicines can also be more serious if you are taking Celexa and drinking alcohol at the same time. For example, this combination can worsen the side effects of anxiety drugs, sleep aids, and prescription drugs.Talk to your doctor about all other medications and supplements you are taking.

The FDA warns that any dose of Celexa over 40 mg per day can cause heart problems. Adding alcohol to an equation can also cause strong heart effects. The combination of alcohol and Celexa can be associated with torsades de pointes, which is a severe form of irregular heart rhythm that sometimes leads to sudden death. Talk to your doctor to find out more, and be sure to tell your doctor if you have heart problems.

Learn More: Complete Drug Information For Citalopram (Celexa) Including Uses, Warnings, Interactions And More »

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What To Do

Things to do

Your doctor may tell you to avoid alcohol altogether to prevent dangerous complications. If you are in the mood for a drink, talk to your doctor. In some cases, your doctor may tell you that the side drink is safe. However, this does not apply to everyone, especially if you have other health problems.Be sure to tell your doctor if you have heart problems.

If you are thirsty, do not stop taking Celexa for that. For the drug to work, you must take it on a set schedule. Your depression may get worse if you suddenly stop taking your medication.

In addition, skipping your dose one day does not mean the drug is exiting your system. Celexa builds up in your body over time to work.Thus, even if you miss your medication during the day, you can still have side effects if you drink alcohol.

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Alcohol and depression

The effect of alcohol on depression

Alcohol can also interfere with your depression. This is because alcohol is a known depressant. Drinking alcohol can have a good effect, but the feeling won’t last long. After a while after drinking, the good feelings often wear off and you feel more depressed or anxious.

Alcohol also interferes with your mind, affects your motor skills and makes you sleepy. These effects can interfere with your ability to manage your condition. The combination of alcohol and Celexa can also prevent you from taking positive steps to treat your depression, such as exercise, eating well, and keeping up with checkups with your doctor.

This means that with or without medication, drinking alcohol when you are depressed may not be a good idea.

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Food to go

Talk to your doctor

If your doctor gave you Celexa, your symptoms of depression are likely to be serious. To help the drug work well and help treat your condition, you may be better off avoiding alcohol. Always follow your doctor’s advice.

90,000 Depression and Sleep: Communication, Research and Treatment

Depression is more common than you think, and depression and sleep problems can go hand in hand.

More than 16 million people in the United States have some form of depression, and over 75 percent of people with depression have some form of sleep disturbance. Sleep disturbances can also increase your risk of developing symptoms of depression.

But the relationship between sleep and depression is complex. Let’s dive deeper and discuss some of the treatments and lifestyle changes you can make to improve your symptoms.

What is the connection?

Depression and sleep are related in an interesting way.Symptoms of depression can affect your sleep, and symptoms of sleep disorders such as apnea or insomnia can also lead to depression.

Does Depression Affect Your Sleep?

The effect of depression on sleep is well documented. One of the most common symptoms of depression is sleep disturbance. Up to 70 percent of people with depression have some kind of sleep disorder. This can take the form:

• Insomnia . This sleep disorder makes it difficult to fall asleep or sleep for a long time.
• Hypersomnia . Also called excessive daytime sleepiness (EDS), hypersomnia makes you feel abnormally sleepy during the day, even if you get enough sleep.

Does sleep affect depression?

The link becomes clearer. For example, a 2005 study found that insomnia increased the likelihood of depression symptoms nearly 10 times. A 2009 review of sleep apnea studies found a strong correlation between obstructive sleep apnea (OSA) and symptoms of depression.

Perhaps less understood is the link in the other direction: the effect of sleep on depression.

Are insomnia and depression related?

Let’s go deeper into this connection. First, it is well known that insomnia is a common symptom of depression.

But research is increasingly showing that the link between insomnia and depression is a two-way street. A 1997 study found that both insomnia and hypersomnia were associated with higher levels of suicidal thoughts and behavior.Insomnia itself increases the risk of developing symptoms of depression by a factor of 10.

And a 2006 study of about 25,000 people found a clear link between depression and insufficient sleep (less than 6 hours) and sleep (more than 8 hours).

Are sleep apnea and depression related?

Obstructive sleep apnea (OSA) is also associated with depression.

A 2003 study of nearly 19,000 participants found that depression five times increased the risk of developing sleep disorder with breathing symptoms.A 2009 review noted that in samples of people treated in sleep clinics for OSA, 21 to 41 percent also had symptoms of depression. And a 2017 sleep study of 182 people found that of 47 participants who had depression, 44 had mild to severe OSA.

The risk of developing depression from OSA may also increase with age. A 2005 study shows that at least 26 percent of people over 65 with OSA have noticeable symptoms of depression.

Treatment

If you are depressed and experience sleep-related symptoms, it is best to seek treatment for your depression. If you have a sleep disorder and notice signs of depression, it is more helpful to treat your sleep disorder to reduce the depression that occurs.

Some effective treatments for depression include:

• Medicines, including antidepressants, such as citalopram (Celexa) or fluoxetine (Prozac)
• Visit to a therapist to help you deal with your emotions, feelings and behaviors through conversation or cognitive behavioral therapy (CBT)
• Expose to white light to help regulate your mood
• Herbal supplements such as fish oil and St. John’s wort may be helpful, but research results are mixed.

Some OSA treatments include:

• Use of Continuous Positive Airway Pressure (CPAP) – Research also shows CPAP machines can help with depression
• using a bi-level positive airway pressure machine (BiPAP or BPAP)
• Taking nasal decongestants
• weight loss to relieve pressure on your lungs and diaphragm
• uvulopalatopharyngoplasty (UPPP) to remove excess tissue from the back of your throat

Sleep deprivation therapy

Sleep deprivation therapy consists of being awake for extended periods of time.For example, you might stay awake all night until the next day, or wake up at 1 a.m. and stay awake for the next day. A 2015 study found that this treatment can give you temporary relief from depression symptoms.

Lifestyle changes

Here are some steps you can take to improve sleep and relieve symptoms of depression:

• Eat a healthy, regular diet . Aim to regularly get fruits, vegetables, whole grains, low-fat dairy products, and lean meats to maintain overall health.
• Get at least 30 minutes of moderate exercise every day . Try walking, running, or going to the gym as a routine.
• Go to bed and wake up at the same time every day . Having a regular sleep schedule can help reduce some of the symptoms of depression and sleep disorders.
• Stop using electronic devices at least two hours before bed . Blue light and irritants from phones, tablets, or televisions can disrupt your circadian rhythm and make it difficult to sleep.
• Limit your online and social media time . The flood of information from social media can make you feel overwhelmed, and research shows a link between social media usage and low self-esteem. Keep your usage to a minimum, especially right before bed.
• Keep your friends and family close to . Having strong personal relationships can help reduce the effects of depression and contribute to feelings of personal satisfaction, which can also help you fall asleep.
• Try meditating . Close your eyes, clear your mind, and breathe in and out slowly whenever you feel stressed or depressed.

When to see a doctor

Get immediate medical attention or mental health services if you have one or more of the following symptoms:

• Constant sadness for whole days, more than two weeks
• Regular thoughts of suicide, cutting yourself or hurting yourself
• Abnormal pain, aches, or digestive problems that do not respond to treatment
• inability to sleep for several days in a row
• Persistent inability to concentrate, concentrate, or remember things clearly.
• Waking up suddenly at night, choking or having difficulty breathing
• persistent headaches
• Feeling anxious or annoyed
• Feel abnormally sleepy during the day
• Loss of interest in sex
• Abnormal swelling in the legs (edema)

Essence

Depression and sleep are related in different ways. While depression can make you want to sleep more often and longer, it can also keep you awake at night with insomnia.And conditions such as insomnia and sleep apnea increase the risk of developing symptoms of depression.

The links here are not all convincing, and more research is being done to better understand how these terms relate.

See a mental health professional if you:

• Feel hopeless
• constantly tired
• have suicidal thoughts
• Concerned that you might be depressed

You can also call one of the following hotlines:

• Hotline at Suicide Prevention at 1-800-273-8255
• Hotline MentalHelp at 1-888-993-3112

90,027 90,000 Getting enough ZZZZZZZ in difficult timesPsychology World

2009 was as historic as it was stormy.It started when the United States opened its first African American president. The country quickly expanded the war into Afghanistan. And now we are facing the worst financial crisis since the Great Depression. Widespread home losses, bank failures, job losses, and rising consumer prices affect the emotional stability of many Americans. It also makes us lose sleep.

In a recent survey, 80% of people contacted by the American Psychological Association said the economy is a significant source of stress that affects their health.Almost one in five reported suffering from insomnia. “I have not slept more than four in the morning,” said one of the respondents. “I have headaches. I’m worried that my kids can’t go to college. And now my doctor has a cure for anxiety.

So, among the many types of drugs offered for the treatment of insomnia, which are effective? What is safe? Let’s take a look.

Benzodiazepines
Examples of benzodiazepines include Valium (Diazepam), Xanax (Alprazolam), Ativan (Lorazepam), and Galcion (Triazolam).Because these medications are essentially the same, the prescribing physician’s decision about which benzodiazepine to use is usually based on the treatment of the anxiety disorder, as well as the onset of the drug and the rate at which it is eliminated from the body. For the most part, these medications are safe as long as they are not mixed with alcohol or other sedatives. But they can be euphoric and addictive to susceptible people. In addition, prolonged use has adverse effects on sleep architecture, especially rapid eye smoothing (REM).Benzodiazepines can also cause “foggy thinking syndrome” as they are associated with cognitive dysfunction. The best use of these drugs is intermittent and short-lived.

Non-benzodiazepines
These drugs are likely an improvement over benzodiazepines, but there are other reasons to be careful. We’ve all seen direct consumer ads for Ambien CR (zolpidem CR) and Lunesta (eszopiclone). Some studies show that these agents are associated with less addiction and cognitive impairment than benzodiazepines.It also has less adverse effects on overall sleep architecture. But these drugs (Ambien in particular) have been associated with troubling side effects: sleepwalking, sleeping, even sleeping driving in vulnerable people. If you experience any of these effects, stop taking these medications immediately and notify your prescribing physician.

Melantonin subtype
Rozerem (ramelteon) is a relatively new prescription drug aid.It is an uncontrolled substance, unlike benzodiazepines and non-benzodiazepines. Therefore, this medication is not related to abuse or addiction. Melatonin is thought to be involved in maintaining the circadian rhythm associated with the sleep-wake cycle. There are two drawbacks: This drug is quite expensive – $ 150 or more for a 30-day meal – and it usually helps people fall asleep, but not sleep.

Good, old-fashioned antihistamines
How long has Benadryl been around? Although not approved by the FDA for insomnia, antihistamines generally induce drowsiness through their sedative effects.Like Rozerem, antihistamines can help you fall asleep, but that’s about how effective they are. In addition, antihistamine use can cause a hangover effect or residual bias.

Antidepressants
Although antidepressants are sometimes prescribed for insomnia, many actually interfere with sleep. This is especially true for first-line agents such as SSRIs (Prozac, Zoloft, Paxil, Celexa, Luvox, Lexapro) and SNRIs (Effexor, Cymbalta and Pristiq). Both SSRIs and SNRIs can suppress REM sleep, especially when stopped abruptly.If you are experiencing depression accompanied by insomnia, discuss the problem with your prescribing doctor. This will help them determine the most appropriate sleep management options.

Bottom Line
Over the past few years, there has been an explosion in the use of non-benzodiazepine drugs for the treatment of insomnia. These agents represent an improvement over the rest of the beam. But the most effective treatment for chronic sleep problems comes from research on lifestyle changes.These can include alternative aids, such as improving diet, adding exercise, and setting a regular sleep schedule – changes that we too often do not want to make.

A dose of realism
Do you think your financial problems mean the end of the world for you? Then it is worth remembering that the actual “end of the world” is an event that really happens only once.