People should not take more than 40 milligrams a day of the antidepressant citalopram (Celexa and generic) because higher doses appear to trigger potentially fatal heart rhythm problems, the Food and Drug Administration said Wednesday. People at greatest risk include those with heart conditions or low potassium or magnesium levels.
The FDA's warning is based on reports it received of people taking the drug who developed abnormal changes in the electrical activity of the heart that could lead to deadly heart rhythm conditions. In addition, a study involving 119 adults found that higher doses of citalopram (up to 60 mg per day) increased the abnormal heart activity.
Other research suggests that doses over 40 milligrams are no more effective than lower doses.
Bottom line: If you’re taking more than 40 mg of citalopram a day talk with your doctor about reducing the dose. But don't stop taking it or change the dose on your own, since that could lead to significant problems. Avoid citalopram if you have a heart condition or are at risk of low potassium and magnesium levels due to an illness or other medications you take.
For more information, see our Best Buy Drugs report on antidepressants.
FDA Drug Safety Communication: Abnormal heart rhythms associated with high doses of Celexa (citalopram hydrobromide) [Food and Drug Administration]