Does citalopram cause breast pain? (3 management strategies)

This article will explore whether citalopram may cause breast pain. It will discuss the research on this topic and examine studies on the potential negative impacts of citalopram on breast health.

Additionally, the article will mention the factors that may increase the risk of experiencing breast pain or gynecomastia while taking citalopram, as well as management strategies for individuals facing this side effect. 

Does Citalopram cause breast pain?

Citalopram has been found to cause breast pain in some individuals, although it is considered a rare occurrence. 

Before being marketed, citalopram was examined for its potential to cause breast pain. It was found to be an uncommon occurrence, affecting less than 1% of patients. It also caused gynecomastia in less than 0.1% of patients [1]. Thus, citalopram has several side effects, but breast pain is not a common one.

While the majority of individuals taking citalopram do not experience breast pain, it is still important to be aware of the rare possibility of this side effect. If you are taking citalopram and are experiencing breast pain, you should report this to your doctor for proper evaluation and guidance.

What does research suggest?

In one case study, a male patient suffered from right nipple pain and a noticeable lump in both breasts after being on a daily 20 mg dosage of citalopram for 5 months. It’s worth noting that the patient didn’t have any risk factors for breast cancer or gynecomastia [2].

His medication was switched from citalopram to escitalopram. After one month, the patient reported that their gynecomastia had resolved and the breast pain had decreased [2].

Another study found that women who had been using SSRIs, including citalopram, for 5 years before getting diagnosed with breast cancer were more likely to experience a worse prognosis and higher mortality rates (66% risk) compared to non-users [3].

Additionally, taking SSRIs after breast cancer diagnosis led to an 81% worsening of prognosis and an increase in mortality. Specifically, women who took SSRIs during the five years following the breast cancer diagnosis showed a significantly increased chance of death from breast cancer [3]. 

It was also found that higher doses of SSRIs are associated with a worsening of breast cancer. Although this study did not focus specifically on breast pain, it does suggest that SSRIs may have adverse effects on breast health [3].

What factors can cause breast pain while taking citalopram?

The occurrence of citalopram-induced breast pain is extremely rare. However, people with certain risk factors may experience this side effect. Some of the diseases, situations, and medications that may increase the risk of experiencing breast pain while taking citalopram are illustrated in this table [4]:

What to do if you experience breast pain while taking citalopram?

There are several ways to manage breast pain. For instance, you may use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen to help relieve breast pain. Depending on the type of pain, you may also use topical ointments or creams of NSAIDs [4,5]. 

How to manage cyclic breast pain while taking citalopram?

If you experience this pain close to the time of your menstruation, you should know that this is very normal, and the pain will most likely resolve when your menstruation period ends. Try changing the fit or type of your bra, as it may increase the pain if it’s uncomfortable [4]. 

Some herbal remedies may also help. For example, primrose or starflower were found to reduce multiple menstrual symptoms, including breast pain. Applying thermal therapies, like hot and cold compressions, can also relieve some pain and inflammation. Vitamin E may also help decrease breast pain [4,5].

Furthermore, you should reduce your intake of chocolates, carbonated drinks, coffee, tea, and fatty foods. It is also recommended that you incorporate regular, moderate exercise into your routine. This helps regulate your hormones, which may decrease cyclic breast pain [4].

If your pain is not linked to your cycle, it is recommended that you visit a doctor to determine the cause of your breast pain. They may prescribe certain medications to regulate hormone levels and protect from extreme breast pain, such as oral contraceptives, bromocriptine, tamoxifen, and danazol [4,5].

Treatment options for breast pain in females taking citalopram

Conditions that cause breast pain may require specific treatments:

• Fibrocystic breast disease-associated breast pain can be treated with OTC painkillers, like ibuprofen and acetaminophen, hormonal therapy, danazol, or fine needle aspiration.

• If the breast pain is due to mastitis, the infection should be treated with antibiotics under the supervision of a doctor.

• In costochondritis, OTC painkillers can be used to relieve breast pain, and physical therapy can strengthen chest muscles and help with treating the disease itself.

• If you notice the presence of any lumps, you must visit the doctor and have them checked.

How to manage citalopram-induced gynecomastia?

First of all, individuals experiencing breast pain or gynecomastia while taking citalopram must consult with a doctor for an accurate diagnosis and an appropriate treatment plan. The enlargement of male breast tissue can lead to breast pain, and it can be managed in several ways [6]:

• It is advisable for men suffering from breast pain as a result of citalopram-induced gynecomastia to lose weight and maintain a healthy and active lifestyle.

• Anti-estrogens can be prescribed. These include tamoxifen and clomiphene citrate.

• Your doctor may also prescribe aromatase inhibitors like letrozole and anastrozole.

• Androgens can also help in treating citalopram-related gynecomastia. These include testosterone, dihydrotestosterone, and danazol.

• Finally, your doctor may suggest performing surgery to remove the excess breast tissue.

Based on my knowledge, citalopram-induced breast pain is considered a rare occurrence. From my perspective, certain factors can increase the risk of experiencing breast pain while taking citalopram, such as certain medications, diseases, and conditions.

If you do experience breast pain while taking citalopram, I recommend using nonsteroidal anti-inflammatory drugs (NSAIDs) or topical ointments for relief. I also believe that making changes to your bra, incorporating herbal remedies, using thermal therapies, and adjusting your diet may help.

If you are experiencing breast pain due to diseases like fibrocystic breast disease, mastitis, costochondritis, angina, or gynecomastia (in males), I recommend consulting with a doctor for an accurate diagnosis and an appropriate treatment plan.

References