Does Celexa cause chest pain? (3 factors)

This article will explore whether Celexa can cause chest pain. It will explain the different mechanisms by which Celexa may cause chest pain and discuss research studies on this matter.

Furthermore, the article will mention the factors that influence the risk of experiencing chest pain while taking Celexa. Finally, it will provide suggestions on what to do if Celexa causes chest pain.

Does Celexa cause chest pain?

Yes, Celexa can cause chest pain. Celexa is a selective serotonin reuptake inhibitor (SSRI) that is known to cause QT prolongation. This is a condition that causes arrhythmia and chest pain. However, this side effect is more likely to occur at significantly high doses.

Chest pain can also occur in Celexa-induced acid reflux or Celexa-induced anaphylaxis. While these situations are not common, they can be very dangerous sometimes. Thus, if you experience chest pain while taking Celexa, you must report this to your doctor for appropriate evaluation and management.

How can Celexa cause chest pain?

Chest pain caused by Celexa may be due to citalopram-induced heartburn, acid reflux, heart problems, allergic reactions, or muscular chest pain.

How can Celexa cause QT prolongation-related chest pain?

First of all, Celexa may cause QT interval prolongation by inhibiting a component called delayed rectifier potassium current (IKr). This increases the amount of sodium ions entering the heart cells and decreases the potassium ions leaving them.

As a result, the ventricular cardiac muscle cells end up having significantly increased positively charged ions, leading to a prolongation of the ventricular action potential and a longer QT interval. This arrhythmia can cause chest pain [1].

How can Celexa cause heartburn-related chest pain?

Celexa may cause acid reflux in some people, which may lead to heartburn and chest pain, but that is not one of its common side effects. However, it is still important to understand how it may cause this side effect. 

To illustrate, Celexa, an SSRI, inhibits the receptors responsible for the uptake of serotonin. This results in increased availability of serotonin in the synapses. While serotonin mainly affects mood, it is also involved in the functioning of multiple organs, including the lower esophageal sphincter (LES) [2].

The lower esophageal sphincter plays a major role in preventing the stomach’s acidic contents from flowing back to the throat, and any structural or functional disruptions in it may decrease its ability to stay tightly closed. If the LES is relaxed or not tightly closed, acid reflux from the stomach may occur [2].

Thus, since the lower esophageal sphincter’s function can be influenced by serotonin, Celexa may decrease its ability to protect from acid reflux. Acid reflux leads to heartburn and chest pain. 

How can a Celexa allergy cause chest pain?

People react to medications differently, and some people may be allergic to Celexa. “Anaphylaxis” is a type of allergic reaction that is commonly associated with chest pain. To illustrate, when someone who’s allergic to Celexa administers it, excessive amounts of histamine are released in the body.

In the case of anaphylaxis, histamine will cause inflammation and swelling in multiple tissues, including the lungs. This leads to the presence of excess mucus in the lungs and a constriction of the bronchioles and alveoli. This is very dangerous, as it may lead to difficulty breathing and severe chest pain [3].

What does research suggest?

While there isn’t enough research that specifically discusses citalopram-induced chest pain, there are studies about citalopram-related heartburn and QT prolongation.

For instance, in the post-marketing evaluation of citalopram, it was found that it caused a dose-dependent QT prolongation. To illustrate, the 20 mg, 40 mg, and 60 mg doses led to a QT prolongation of 8.5 ms, 12.6 ms, and 18.5 ms, respectively.

Since this can lead to chest pain and various life-threatening complications, especially in old individuals or those with pre-existing cardiovascular diseases, the FDA declared that the maximum tolerable dose of citalopram is 40 mg instead of 60mg [4].

On the other hand, in citalopram’s premarketing evaluation, it caused acid reflux and heartburn in less than 0.1% of the participants. There is also one case report involving a patient who stopped taking citalopram after a few weeks of treatment due to experiencing multiple occurrences of acid reflux [5,6].

What factors influence Celexa-induced chest pain?

Several factors can increase the risk of experiencing chest pain while taking Celexa. For instance, taking very high doses of the drug or jumping to a higher dose without applying proper dose titration can increase the frequency and intensity of side effects like chest pain. 

Other factors, including comorbidities, concurrent medications, certain injuries, individual factors, and lifestyle factors, are illustrated in the table below [7]:

What to do if Celexa causes chest pain?

If you experience chest pain while taking Celexa, you must report this to a doctor. Inform them about your comorbidities, family history, and concurrent medications. They will evaluate your medical and medication history to determine the appropriate management plan for your symptoms.

If the doctor finds that Celexa is responsible for your heartburn, they will decrease your dose and monitor your symptoms. If chest pain persists, they may consider switching you to a different antidepressant.

Management of Celexa-related heartburn

If the doctor finds that you are suffering from heartburn or acid reflux, they will most probably prescribe an antacid, like Gaviscon, or a proton pump inhibitor, like omeprazole. They may also assess whether your concurrent medications may be contributing to your heartburn and recommend safer alternatives.

For example, they may recommend taking COX-2 inhibitors instead of NSAIDs. However, such a decision depends on your co-existing conditions and other conditions, as COX-2 inhibitors may worsen chest pain in people with pre-existing heart problems.

Management of Celexa-induced QT prolongation

Since QT prolongation is often caused by high doses of Celexa, the doctor will re-evaluate the appropriateness of your dose and will most likely reduce it, especially if it exceeds 40 mg per day. The doctor may also suggest that you gradually discontinue Celexa and prescribe an alternative drug.

Moreover, they will conduct certain tests, including an electrocardiogram and blood tests, to assess your electrolyte levels. If your QT prolongation causes low levels of calcium, magnesium, and potassium, these electrolyte levels must be corrected.

Based on my knowledge, Celexa may cause chest pain in some people. I found that doses higher than 40 mg can cause QT prolongation, which harms the heart and may cause chest pain. Celexa’s effects on serotonin may also impact the lower esophageal sphincter and cause acid reflux and heartburn.

Additionally, I believe that people who are allergic to Celexa are at very high risk of Celexa-induced chest pain.

From my perspective, multiple factors may influence the risk of experiencing chest pain while taking Celexa, including respiratory diseases, cardiac diseases, and certain gastrointestinal diseases. Some individual factors, lifestyle factors, and concurrent medications can also cause this side effect.

Finally, if you experience chest pain while taking Celexa, I recommend visiting a doctor as soon as possible. They will assess your condition and treat your symptoms accordingly.

References