Does Citalopram Affect Heart Rate? (+5 Studies)

By Ivan Kahwa

Page last updated: 02/01/2024 | Next review date: 02/01/2026

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

Ivan Kahwa

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This article will answer the question, “Does Citalopram affect heart rate?” We will also explore FDA recommendations and precautions for managing irregular heart rate while using this medication.

Does Citalopram affect heart rate?

Yes, Citalopram can affect heart rate. It’s advised to keep a close watch on your heart rate when using this medication.

Notably, higher doses of Citalopram have been linked to irregular heart rate and rhythm disturbances, such as QT prolongation and Torsade de Pointes, which can lead to sudden, adverse outcomes.

Citalopram, often prescribed under the brand name Celexa, is commonly used to treat depression, OCD, anxiety and mood disorders.

It is a selective serotonin reuptake inhibitor (SSRI) that enhances serotonin levels in the brain. It is usually taken once daily, either in the morning or at night.

What does the research suggest?

Several researches suggest that high doses of Citalopram can affect heart rate. The FDA has issued several drug safety communications regarding the use of Citalopram and its potential effects on heart rate.

Citalopram can lead to a dose-dependent QT interval prolongation. QT interval is a crucial parameter in cardiac electrical activity. The QT interval prolongation can result in serious cardiac arrhythmias, including Torsades de Pointes, ventricular tachycardia, and even sudden death. (1)

Researchers conducted a study to investigate the effects of Citalopram on heart rate variability in women with generalised anxiety disorder. The study’s findings suggested that Citalopram had a notable impact as it significantly decreased heart rate variability, indicating a potential influence on the autonomic nervous system. (2)

In another case report, a dose-dependent bradycardia was described in an elderly patient undergoing Citalopram treatment. After the patient’s dose was increased to 20 mg/d, their mean heart rate dropped to 53 bpm. The dose was subsequently reduced to 10 mg/d to address this issue, and close monitoring of the patient’s heart rate was continued. (3)

Another study indicated that higher doses of Citalopram could lead to abnormal changes in heart rate and rhythm, emphasising the need for cautious dosage management. (4)

A population-based cohort study found that initiators of these medications faced a higher risk of severe arrhythmia, particularly during the initial 30 days of treatment and among those with pre-existing cardiovascular conditions. (5)

What is the maximum recommended dose of Citalopram?

The maximum recommended dose of Citalopram for depression is typically 40mg per day. However, the initial dose is often set at 10-20mg once a day with the possibility of increasing it to 40 mg after at least one week of therapy.

Notably, the FDA has issued a cautionary warning against prescribing Citalopram doses exceeding 20mg daily for patients aged 60 and above and for patients with heart conditions. This precautionary measure arises from concerns regarding QT prolongation. (1)

Healthcare professionals should exercise caution when prescribing higher doses of Citalopram, particularly in these groups.

Who is more susceptible to Citalopram-induced irregular heart rate?

The key groups susceptible to Citalopram-induced heart rate side effects are: (1,2,3)

Patients taking Citalopram more than 40mg a day
Patients above the age of 60 and above
Patients with congenital long QT syndrome
Patients with bradycardia (slow heart rate)
Patients with hypokalemia (low potassium levels)
Patients with hypomagnesemia (low magnesium levels)
People who have experienced acute myocardial infarction (heart attack)
Patients with uncompensated heart failure
Patients on Medications Affecting Heart Rhythm like amiodarone, chlorpromazine, and methadone
Elderly Women with Generalized Anxiety Disorder
Patients with Kidney Disease

These groups should be closely monitored when using Citalopram due to their increased susceptibility to heart rate changes.

What to do if Citalopram affects your heart rate?

If you notice any abnormal changes in your heart rate such as dizziness or palpitations while taking Citalopram, contact your healthcare professional immediately. (1)

If your current Citalopram dose exceeds 40 mg per day, consult your healthcare professional about potentially adjusting your dosage.
Your doctor may order an electrocardiogram (ECG, EKG) to monitor your heart rate.
Your healthcare professional may order blood tests to assess your electrolyte levels. Any imbalances may need correction before continuing Citalopram.
If you experience withdrawal symptoms after discontinuing Citalopram abruptly, such as mood changes, irritability, dizziness, or other symptoms, contact your healthcare professional for guidance and support.

Conclusion

In conclusion, Citalopram can affect heart rate. If you notice irregular heart rate, seek immediate medical attention. Discuss potential dose adjustments with your healthcare professional and follow their recommendations for monitoring your heart rate and electrolyte levels.