Patient/caregiver was educated on precautions to be exercised while taking citalopram as follows:
- Citalopram intake can also induce a life-threatening reaction called Neuroleptic Malignant Syndrome (NMS). Individuals with NMS can present with high fever, episodes of confusion, intense muscle rigidity and contractions, elevated blood pressure, and rapid heart rate. Uncontrolled seizure activity and intense muscle contractions from citalopram use can lead to muscle damage and breakdown. Potassium ion from within the damaged muscle cells can leak out into the blood and body fluids, thus causing an acute increase in blood potassium levels. This acute elevation of potassium levels in the blood from citalopram use can lead to life-threatening cardiac arrhythmias. Individuals can present with episodes of chest pain, intense shortness of breath, altered heartbeat, ineffective heart contractions, dizziness/loss of consciousness from arrhythmias. Report the cardiac arrhythmias to your physician promptly for any appropriate measures to be considered.
- Follow closely on the expiration date of the medication. If using a pillbox, check the expiration date on the medication container every time you fill the pillbox. If you are taking this medication for longer periods of time, set reminders on your phone, one 10 days ahead, the next a week ahead, and then every day, before you run out of the medication. This helps with securing the refill in time and making arrangements for pick-up at the pharmacy. Also, you can avoid the unpleasant withdrawal response from sudden discontinuation of medication due to running out on the medication.
- Citalopram takes some time to fairly balance the chemicals in the brain, before any improvement in mood and behavior are noted. It could take about 3 – 6 weeks to see this change in mood. So, do not discontinue taking the medication without consulting your physician, as you failed to see the improvement with depressive symptoms immediately after taking the medication
