Drugs that affect heart rhythm
Cita shouldn’t be used with other drugs that affect your heart rhythm. Taking both Cita and these drugs may increase your risk of heart rhythm changes that could be dangerous. Examples of these drugs include:
Q: I take Cita and sometimes I'm so irritable. Could this medication cause this?
A: Cita is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). Cita is used to treat depression. Cita works by increasing the natural brain chemical serotonin, which assists in maintaining metal balance. The most common side effects with Cita are sleepiness; insomnia (trouble sleeping); nausea; dry mouth; excessive sweating; fatigue; diarrhea; upset stomach; sexual dysfunction; tremor; stuffy nose; and infection of the nose, throat, sinuses, and/or voice box. Agitation and anxiety are also reported side effects with Cita. According to the prescribing information for Cita, people taking Cita should let their doctor or health care provider know right away if they are experiencing: irritability; anxiety; agitation; panic attacks; insomnia (trouble sleeping); hostility; aggressiveness; impulsivity; restlessness; hypomania or mania (abnormally increased energy and mood); other unusual changes in behavior; worsening of depression; and thoughts about suicide, which may be detailed and include a plan. These symptoms should be looked for especially early during treatment and when the dose is adjusted up or down; however, people should look for these symptoms on a day-to-day basis, since these changes may be abrupt. These symptoms may be associated with an increased risk of suicidal thinking and behavior. Close monitoring by a doctor or health care professional and possibly a change in medication may be needed if these symptoms occur. This is not a complete list of the side effects associated with Cita. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. There are many causes of irritability. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD
What is Cita, and how does it work (mechanism of action)?
Cita is an antidepressant medication that affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Cita works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by Cita results in more free serotonin in the brain to stimulate nerve cells. Cita is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Cita was approved by the FDA in July 1998.
Cita is approved for treating depression. It is also used off-label for treating:
Cita side effects
Get emergency medical help if you have signs of an allergic reaction to Cita: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
a light-headed feeling, like you might pass out;
blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or
low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, feeling unsteady.
Common Cita side effects may include:
problems with memory or concentration;
dry mouth, increased sweating;
numbness or tingling;
increased appetite, nausea, diarrhea, gas;
fast heartbeats, feeling shaky;
sleep problems (insomnia), feeling tired;
cold symptoms such as stuffy nose, sneezing, sore throat;
changes in weight; or
difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
3. Who can and can't take Cita
Cita can be taken by adults and children over the age of 12 years.
Check with your doctor before starting to take Cita if you:
- have had an allergic reaction to Cita or any other medicines in the past
- have a heart problem - Cita can speed up or change your heartbeat
- have ever taken any other medicines for depression - some rarely used antidepressants can interact with Cita to cause very high blood pressure, even when they have been stopped for a few weeks
- are trying to become pregnant, already pregnant or breastfeeding
- have an eye condition called glaucoma - Cita can increase the pressure in your eye
- have epilepsy or are having electroconvulsive treatment – Cita may increase your risk of having a seizure
If you have diabetes, Cita can make it more difficult to keep your blood sugar stable.
Monitor your blood sugar more often for the first few weeks of treatment with Cita and adjust your diabetes treatment if necessary.
Other Events Observed During The Premarketing Evaluation Of Celexa (Cita HBr)
Following is a list of WHO terms that reflect treatment-emergent adverse events, as defined in the introduction to the ADVERSE REACTIONS section, reported by patients treated with Celexa at multiple doses in a range of 10 to 80 mg/day during any phase of a trial within the premarketing database of 4422 patients. All reported events are included except those already listed in Table 3 or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and those occurring in only one patient. It is important to emphasize that, although the events reported occurred during treatment with Celexa, they were not necessarily caused by it.
Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring on one or more occasions in at least 1/100 patients; infrequent adverse events are those occurring in less than 1/100 patients but at least 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients.
Cardiovascular- Frequent: tachycardia, postural hypotension, hypotension. Infrequent: hypertension, bradycardia, edema (extremities), angina pectoris, extrasystoles, cardiac failure, flushing, myocardial infarction, cerebrovascular accident, myocardial ischemia. Rare: transient ischemic attack, phlebitis, atrial fibrillation, cardiac arrest, bundle branch block.
Central And Peripheral Nervous System Disorders - Frequent: paresthesia, migraine. Infrequent: hyperkinesia, vertigo, hypertonia, extrapyramidal disorder, leg cramps, involuntary muscle contractions, hypokinesia, neuralgia, dystonia, abnormal gait, hypesthesia, ataxia. Rare: abnormal coordination, hyperesthesia, ptosis, stupor.
General - Infrequent: hot flushes, rigors, alcohol intolerance, syncope, influenza-like symptoms. Rare: hayfever.
Hemic and Lymphatic Disorders - Infrequent: purpura, anemia, epistaxis, leukocytosis, leucopenia, lymphadenopathy. Rare: pulmonary embolism, granulocytopenia, lymphocytosis, lymphopenia, hypochromic anemia, coagulation disorder, gingival bleeding.
Metabolic and Nutritional Disorders - Frequent: decreased weight, increased weight. Infrequent: increased hepatic enzymes, thirst, dry eyes, increased alkaline phosphatase, abnormal glucose tolerance. Rare: bilirubinemia, hypokalemia, obesity, hypoglycemia, hepatitis, dehydration.
Musculoskeletal System Disorders - Infrequent: arthritis, muscle weakness, skeletal pain. Rare: bursitis, osteoporosis.
Psychiatric Disorders - Frequent: impaired concentration, amnesia, apathy, depression, increased appetite, aggravated depression, suicide attempt, confusion. Infrequent: increased libido, aggressive reaction, paroniria, drug dependence, depersonalization, hallucination, euphoria, psychotic depression, delusion, paranoid reaction, emotional lability, panic reaction, psychosis. Rare: catatonic reaction, melancholia.
Reproductive Disorders /Female* - Frequent: amenorrhea. Infrequent: galactorrhea, breast pain, breast enlargement, vaginal hemorrhage.
*% based on female subjects only: 2955
Respiratory System Disorders - Frequent: coughing. Infrequent: bronchitis, dyspnea, pneumonia. Rare: asthma, laryngitis, bronchospasm, pneumonitis, sputum increased.
Urinary System Disorders - Frequent: polyuria. Infrequent: micturition frequency, urinary incontinence, urinary retention, dysuria. Rare: facial edema, hematuria, oliguria, pyelonephritis, renal calculus, renal pain.
Q: What would happen if I stopped taking my Cita all at once, without easing off it slowly?
A: Cita is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs can cause serious withdrawal side effects if you stop using them suddenly. Don't stop using Cita without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. For more information, go to //www.everydayhealth.com/drugs/Cita. Sarah Lewis, PharmD