Can Celexa cause acid reflux? (3 factors)

This article will discuss whether Celexa may cause acid reflux. It will mention the incidence of Celexa-related acid reflux, and address the therapeutic effects it may have on improving the symptoms of acid reflux. Moreover, the article will explain the mechanisms by which Celexa could cause acid reflux.

Additionally, the article will highlight research findings on this topic. Finally, it will mention factors that may influence the occurrence of acid reflux while taking Celexa and provide suggestions on what to do if you experience acid reflux symptoms.

Can Celexa cause acid reflux?

Celexa may cause acid reflux in some people, but this is a very rare side effect. The premarketing evaluation of citalopram indicates that there is a rare possibility of experiencing gastroesophageal reflux, as it occurs in only 1 out of every 1,000 patients administering the drug [1].

On the other hand, Celexa has demonstrated effectiveness in improving the symptoms of gastroesophageal acid reflux and reducing its occurrence. Celexa can cause various gastrointestinal side effects, but acid reflux is not a common one of them.

These side effects include stomach pain, bowel problems, bloating, vomiting, and abdominal pain. Moreover, while acid reflux is a very rare side effect, people respond to medications differently, and some people may be more susceptible to experiencing acid reflux while on this drug.

Thus, if you experience acid reflux while taking trazodone, it is recommended that you report this to your doctor as soon as possible. They will assess your condition and determine the primary cause of your symptoms to choose the most appropriate course of action.

How can Celexa cause acid reflux?

While acid reflux is not among Celexa’s common side effects, it is still important to understand how it may possibly lead to this condition. 

To illustrate, a healthy, intact lower esophageal sphincter (LES) opens only upon swallowing and closes after food or liquids are swallowed, preventing the stomach’s acidic contents from flowing back to the throat. The functioning of the LES is influenced by a variety of neurotransmitters, including serotonin.

Celexa is a selective serotonin reuptake inhibitor; it blocks the receptors responsible for the uptake of serotonin and increases its levels in the synapses. Thus, its effects on serotonin may impact the functioning of the LES. In rare cases, this may lead to a weaker LES that’s unable to stay tightly closed [2].

What does research suggest?

There is limited research regarding Celexa’s potential to cause acid reflux specifically. However, a case report exists involving a patient who discontinued citalopram a few weeks after starting it due to experiencing multiple occurrences of acid reflux [3].

The patient indicated that even changing the administration time did not alleviate the symptoms. Interestingly, when switched to other antidepressants like escitalopram and venlafaxine, the symptoms persisted [3].

Thus, the study concluded that the general administration of antidepressants was likely the cause of GERD in this patient [3].

On the other hand, multiple studies have investigated the therapeutic effects of Celexa in managing acid reflux. For example, one study investigated the effects of initiating citalopram treatment in patients with compromised esophagus [4].

After six months of citalopram treatment, 61.5% of participants reported significant improvement. The study also indicated a restoration of esophageal functioning [4].

What factors influence the occurrence of acid reflux while taking Celexa?

The concurrent administration of other GERD-inducing drugs while taking Celexa, or suffering from certain diseases or conditions, may increase the occurrence of Celexa-related acid reflux. Some habits and lifestyle factors may also contribute to the occurrence of acid reflux while on Celexa.

The table below shows examples of medications, diseases, and lifestyle factors that may influence Celexa-related acid reflux [5].

Medications Diseases and physiologic conditions Lifestyle factors
Non-steroidal anti-inflammatory drugs (NSAIDS) Histal hernia Smoking
Anticholinergic drugs Peptic ulcer Excessive caffeine intake
Aspirin Obesity  Excessive alcohol consumption
Nitroglycerin Pregnancy  Frequently eating very large meals
Theophylline Zollinger-Ellsion Eating a diet that is very high in saturated fats
Corticosteroids like prednisone Slow gastric emptying rate Sleeping or lying down after eating
Hormone replacement therapy (estrogenic drugs)   Eating certain triggering foods, such as spicy foods, tomatoes, chocolate, or fried foods
Other antidepressants, such as sertraline   Drinking carbonated beverages frequently

What to do if Celexa causes acid reflux?

If you experience acid reflux and suspect that it is caused by Celexa, you must report this to your doctor. They will assess your medical and medication history to determine the appropriate management approach for your condition.

If they find that Celexa is contributing to your symptoms, they may adjust its dosage. For instance, they may lower your dose or change the timing of your doses. The doctor will also most likely prescribe medication to help control acid reflux, such as antacids (like Gaviscon) or proton pump inhibitors.

Furthermore, if they discover that you are taking other acid reflux-inducing drugs, they will explore safer alternatives. For example, they may suggest substituting NSAIDs with COX-2 inhibitors, which are gentler on the stomach.

However, such a decision depends on multiple factors, such as any co-existing conditions and other conditions. Lastly, if acid reflux persists, the doctor may consider switching you to a different antidepressant.

What lifestyle changes can help with Celexa-related acid reflux?

Here are some examples of things that you should and shouldn’t do if you experience acid reflux, especially while taking Celexa:

What to do: What to avoid:
Eat low-acid foods, such as bananas, rice, oatmeal, vegetables (except for tomatoes), and whole grains.  Limit your intake of spicy foods, fatty foods, caffiene, and carbonated beverages.
Ensure you drink enough water; it can slightly neutralize the stomach’s increased acidity. Consider stopping smoking and reducing your alcohol intake.
Eat smaller, more frequent meals to ensure that your stomach is never very full. Avoid eating big meals, especially if your bedtime is close.
Try to stay upright for at least two hours after eating. Identify your trigger factors and avoid them.

 

Based on my research, I found that Celexa may cause acid reflux in rare cases. However, I also found that it has helped improve the symptoms of acid reflux in multiple case studies. 

Furthermore, based on my knowledge, multiple factors can contribute to acid reflux while taking trazodone. These factors include taking certain medications like NSAIDs, aspirin, or corticosteroids, or suffering from certain conditions like histal hernia or peptic ulcer.

If you experience acid reflux while taking Celexa, I recommend reporting this to your doctor. Based on your condition, they may decide to adjust the dosage of Celexa, prescribe medication to control acid reflux, or consider alternative treatment options.

Moreover, I believe that implementing lifestyle changes, such as avoiding trigger foods and eating smaller, more frequent meals, may help manage acid reflux while on Celexa.

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References

1.-

Highlights of Prescribing Information. CITALOPRAM (Citalopram) tablets, for oral use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215428s000lbl.pdf

2.-

Wang Z, Li H, Kang Y, Liu Y, Shan L, Wang F. Risks of Digestive System Side-Effects of Selective Serotonin Reuptake Inhibitors in Patients with Depression: A Network Meta-Analysis. Ther Clin Risk Manag. 2022 Aug 13;18:799-812. doi: 10.2147/TCRM.S363404. PMID: 35992228; PMCID: PMC9386738. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386738/

3.-

Brahm NC, Kelly-Rehm MC. Antidepressant-mediated gastroesophageal reflux disease. Consult Pharm. 2011 Apr;26(4):274-8. doi: 10.4140/TCP.n.2011.274. PMID: 21486738. https://pubmed.ncbi.nlm.nih.gov/21486738/

4.-

Yamasaki T, Fass R. Reflux Hypersensitivity: A New Functional Esophageal Disorder. J Neurogastroenterol Motil. 2017 Oct 30;23(4):495-503. doi: 10.5056/jnm17097. PMID: 28992673; PMCID: PMC5628981. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628981/#:~:text=At%20the%20end%20of%20the,symptoms%20(P%20%3D%200.021).&text=The%20study%20suggested%20that%20citalopram,in%20patients%20with%20reflux%20hypersensitivity

5.-

Clarrett DM, Hachem C. Gastroesophageal Reflux Disease (GERD). Mo Med. 2018 May-Jun;115(3):214-218. PMID: 30228725; PMCID: PMC6140167. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/

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