Does Celexa help with psychosis? (3+ studies)

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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