Patient/caregiver was educated on precautions to be exercised while taking citalopram as follows:

  1. Individuals with complaint of dehydration, secondary to history of diarrhea, vomiting, or poor fluid intake, can suffer electrolyte disturbances and be more prone to develop arrhythmias with citalopram. Also, citalopram carries the risk of increasing diarrhea, thus worsening the fluid deficit and dehydration. Electrolyte disturbances, such as, low potassium and magnesium levels, secondary to diuretic pill intake, can also act as a precipitating factor for cardiac arrhythmias with citalopram. Observing compliance with recommended supplement intake and/or hydration measures can help prevent development of arrhythmias in these individuals. Also, observe compliance with any periodical lab draws ordered for electrolyte levels and closely follow for development of signs and symptoms of cardiac arrhythmia, such as, episodes of chest pain, rapid heart rate, palpitations, dizziness, and shortness of breath. Report any such findings to your physician immediately, so that, an alternative plan of care could be considered.
  2. Citalopram can also induce frequency of urination or polyuria. Individuals with history of poorly controlled diabetes, frequent urinary tract infections, and intake of diuretics can also present with frequent urination. Such individuals taking citalopram, must be aware of this side-effect, as citalopram can aggravate the discomfort of polyuria significantly. Severely increased frequency of urination can contribute to loss of body fluid and dehydration. Dehydrated individuals can present with low blood pressure, episodes of confusion, increased risk for falls & accidents, and increased risk for urinary tract infections. Observing compliance with timed voiding recommendations and other hygienic practices can help reduce the discomfort of polyuria. Compliance with daily fluid intake recommendations and rehydration measures can help with preventing dehydration and development of any UTIs.
  3. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.
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