Does Celexa help with psychosis? (3+ studies)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether Celexa helps with psychosis. We will discuss how Celexa may help with psychosis, evidence from research, and other relevant information.
Does Celexa help with psychosis?
Celexa may help with psychosis although it is not the primary medication to treat psychosis. Celexa has the active ingredient citalopram which is an antidepressant and selective serotonin reuptake inhibitor (SSRI) (1).
Celexa is primarily used to treat depressive disorders and it is not FDA-approved to treat psychosis. However, research studies indicate that Celexa can improve some aspects of the psychosis.
Psychosis is a combination of psychological symptoms that disconnect the patient from reality. Psychosis is a characteristic feature of many psychiatric conditions like schizophrenia, mood disorders, and substance use disorders (2).
As psychosis is characterized by several symptoms, antidepressants like Celexa may improve some aspects of psychosis. Additionally, psychosis may occur with mental conditions that Celexa is known to treat so Celexa can improve overall health.
What are the symptoms of psychosis?
Psychosis is a mental health condition with a multitude of symptoms which are categorized into the following (2):
| delusions | strongly held false beliefs that an individual maintains even when provided with evidence and logic contradicting those beliefs |
| hallucinations | seeing, hearing, feeling, or smelling something that is actually not present. |
| disorganized thoughts | thought process and communication pattern that is not logical or coherent, or the ideas are not connected |
| disorganized behaviors | unpredictable and inappropriate responses that are irrelevant to the situation |
| negative symptoms | diminished emotional expressions, reduced energy, and diminished interest, concentration, and pleasure |
How does Celexa help with psychosis?
Celexa exerts its therapeutic effects by blocking serotonin reuptake which increases the levels of this neurotransmitter in the body (1). A lack of serotonin is associated with low mood, lack of energy, and other symptoms of depression.
Celexa may help with psychosis through a similar mechanism. Research suggests that some of the negative symptoms of psychosis are similar to those of depression (3).
As Celexa helps with depression, it can help with those conditions in which symptoms similar to depression are present. In psychosis, negative symptoms like lack of interest, pleasure, and energy are present that also occur in depression.
Thus, Celexa can help with psychosis by addressing the negative symptoms of psychosis and improving the mood and energy levels of the patients. This can contribute to an improved quality of life.
What does research suggest?
Research has explored the effect of Celexa in managing psychosis. In one study, Celexa was added to the treatment of patients with schizophrenia who were already taking an antipsychotic medication (3).
The results of this study indicated that Celexa was beneficial in addressing the negative symptoms of psychosis without affecting the positive symptoms (hallucinations, delusions, disorganized behavior) (3).
In another study, patients with dementia who were not depressed and showed symptoms of psychosis or behavioral disturbances were treated with Celexa. Celexa demonstrated efficacy in the short-term treatment of psychosis (4).
In one study, the efficacy of Celexa in long-term treatment of schizophrenia was investigated in patients who were not depressed. Results demonstrated that Celexa was effective in addressing the negative symptoms of psychosis in this study (5).
One study aimed to compare the efficacy of Celexa with risperidone in the treatment of psychosis in patients with dementia. Celexa was found beneficial in reducing symptoms like agitation, hallucinations, aggression, and delusions (6).
What is the recommended dose of Celexa for psychosis?
The standard dose of Celexa for psychosis is not established as Celexa is not FDA-approved to treat psychosis. To treat depression, Celexa is started at a dose of 20mg. The maximum recommended dose of Celexa is 40mg (1).
In a study, the effectiveness of Celexa was assessed in treating psychosis when used along with an antipsychotic agent. In this study, Celexa was used within the dosage range of 10-40 mg and it was effective in treating the negative symptoms (3).
Can Celexa worsen psychosis?
Although Celexa has shown efficacy in treating psychosis in several studies, it can exacerbate the symptoms of psychosis in some cases. SSRIs like Celexa have been associated with worsening the symptoms of psychosis in some individuals.
In some cases, SSRIs have been shown to trigger or worsen psychotic symptoms like hallucinations and delusions. A case was reported where a patient developed psychotic symptoms after being treated with Celexa (7).
In this case, the patient was being treated with Celexa for post-traumatic stress disorder and developed hallucinations and delusions. Symptoms were resolved once Celexa was discontinued (7).
Studies have also associated SSRIs with triggering mania and mood episodes in some individuals (8). If this happens, SSRIs can not be used for conditions like bipolar disorder.
Thus, in some cases, SSRIs like Celexa may worsen psychosis and might be contraindicated. Thus, the decision to use or continue SSRIs like Celexa for psychosis is based on the individual response.
What other medications are used to treat psychosis?
Celexa is not an FDA-approved medication for psychosis. Psychosis is managed primarily by antipsychotics and cognitive behavioral therapy (CBT). Examples of antipsychotics include the following (9):
- perphenazine
- haloperidol
- prochlorperazine
- thiothixene
- pimozide
- risperidone
- quetiapine
- clozapine
Whether to use Celexa to manage psychosis is decided by the healthcare provider based on individual symptoms and characteristics. Celexa cannot be used instead of antipsychotic medications but it can be used along with antipsychotics.
What are the primary indications for Celexa?
Celexa is not primarily used for psychosis. Celexa is used primarily to treat the following conditions (1):
- depression
- obsessive-compulsive disorder
- poststroke depression
- generalized anxiety disorder
- post-traumatic stress disorder
- panic disorder
- social anxiety disorder
- separation anxiety disorder
As per my understanding, Celexa can help with psychosis although it is not FDA approved for this purpose. Celexa helps with psychosis because it is an antidepressant and some symptoms of psychosis overlap with depression.
Research indicates that Celexa is effective for psychosis mainly because it improves the negative symptoms without exacerbating the positive symptoms of psychosis. However, Celexa is not the primary treatment of psychosis.
Psychosis is mainly treated by antipsychotic medications and Celexa can be used as an adjunct to improve the negative symptoms. In some cases, SSRIs like Celexa can also trigger or worsen the symptoms of psychosis.
Whether to use Celexa for psychosis is decided by the healthcare provider based on individual symptoms and individual response to the medication.
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References
1.-
Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. [Updated 2023 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482222/
2.-
Calabrese J, Al Khalili Y. Psychosis. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546579/
3.-
Vahia IV, Lanouette NM, Golshan S, Fellows I, Mohamed S, Kasckow JW, Zisook S. Adding antidepressants to antipsychotics for treatment of subsyndromal depressive symptoms in schizophrenia: Impact on positive and negative symptoms. Indian J Psychiatry. 2013 Apr;55(2):144-8. doi: 10.4103/0019-5545.111452. PMID: 23825848; PMCID: PMC3696237.
4.-
Pollock BG, Mulsant BH, Rosen J, Sweet RA, Mazumdar S, Bharucha A, Marin R, Jacob NJ, Huber KA, Kastango KB, Chew ML. Comparison of citalopram, perphenazine, and placebo for the acute treatment of psychosis and behavioral disturbances in hospitalized, demented patients. Am J Psychiatry. 2002 Mar;159(3):460-5. doi: 10.1176/appi.ajp.159.3.460. PMID: 11870012.
5.-
Goff DC, Freudenreich O, Cather C, Holt D, Bello I, Diminich E, Tang Y, Ardekani BA, Worthington M, Zeng B, Wu R, Fan X, Li C, Troxel A, Wang J, Zhao J. Citalopram in first episode schizophrenia: The DECIFER trial. Schizophr Res. 2019 Jun;208:331-337. doi: 10.1016/j.schres.2019.01.028. Epub 2019 Jan 30. PMID: 30709746.
6.-
Pollock BG, Mulsant BH, Rosen J, Mazumdar S, Blakesley RE, Houck PR, Huber KA. A double-blind comparison of citalopram and risperidone for the treatment of behavioral and psychotic symptoms associated with dementia. Am J Geriatr Psychiatry. 2007 Nov;15(11):942-52. doi: 10.1097/JGP.0b013e3180cc1ff5. Epub 2007 Sep 10. PMID: 17846102.
7.-
Capaldi VF 2nd, Carr RB. Citalopram-induced hallucinations and delusions in a young adult. Gen Hosp Psychiatry. 2010 Nov-Dec;32(6):648.e1-3. doi: 10.1016/j.genhosppsych.2010.07.008. Epub 2010 Sep 15. PMID: 21112465.
8.-
Cascade EF, Reites J, Kalali AH, Ghaemi N. Antidepressants in bipolar disorder. Psychiatry (Edgmont). 2007 Mar;4(3):56-8. PMID: 20805912; PMCID: PMC2922360.
9.-
Chokhawala K, Stevens L. Antipsychotic Medications. [Updated 2023 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519503/
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