Does citalopram cause neutropenia? (+5 Factors)

In this article, we will discuss whether citalopram causes neutropenia. We will also explore research studies linking the use of citalopram to the occurrence of neutropenia. Additionally, we will delve into factors that may increase the risk of neutropenia while using citalopram, as well as management tips for citalopram-induced neutropenia.

Does citalopram cause neutropenia?

Citalopram may cause neutropenia. However, it is a serious but uncommon side effect of this medication. While there is an association, instances of neutropenia with citalopram are rare, and the majority of individuals do not experience this side effect.

Generally, citalopram is an antidepressant frequently employed in the management of depression, anxiety, and obsessive-compulsive disorder. It is considered a safe medication with mild to moderate side effects at low doses (1).

If you are taking citalopram and have concerns about neutropenia or are experiencing symptoms such as persistent infections, fever, or other signs of a compromised immune system, seeking medical attention promptly is crucial. Your healthcare provider can assess your symptoms, conduct necessary tests, and make informed decisions about your treatment.

What does research suggest?

According to research studies, neutropenia is a rare side effect of citalopram that may occur in susceptible patients. Studies have indicated that citalopram might inhibit Rap1 activation in neutrophils, potentially leading to a possible reduction in their functionality (2).

In a research study, a patient was diagnosed with a low neutrophil count after taking citalopram, rituximab, and mirtazapine for one week. However, the study demonstrated that this effect may primarily be attributed to rituximab, although citalopram might have played a role in intensifying it (3).

What factors may increase the risk of neutropenia while on citalopram?

While citalopram, like many medications, is generally considered safe, it’s important to note that, in rare cases, it may be associated with neutropenia. The risk of neutropenia can be influenced by various factors such as:  

What to do if citalopram causes neutropenia?

 If you notice symptoms of neutropenia, such as fever, fatigue, weakness, chills, mouth sores, or persistent infections while using citalopram, it is crucial to consult your healthcare provider promptly.

They will conduct an assessment to determine if citalopram is the potential cause of these symptoms. Your healthcare provider will also evaluate any risk factors that may contribute to such side effects and address them as a priority.

If citalopram is identified as the cause of neutropenia, your healthcare provider may consider adjusting the dosage, especially if higher doses are associated with these side effects. Alternatively, they might suggest switching to a different antidepressant that is less likely to cause neutropenia as compared to citalopram.

However, it’s essential to note that stopping citalopram abruptly without consulting your healthcare provider is not advisable. Instead, discuss any side effects or concerns with your healthcare provider, who may guide managing these issues. In some cases, they may recommend additional medications to counteract specific side effects.

Which medications are used in the treatment of neutropenia?

The treatment of neutropenia depends on its underlying cause and severity. Here are some general approaches to the treatment of neutropenia: 

What precautions should you take with neutropenia?

If you are diagnosed with neutropenia, it’s important to follow your healthcare provider’s recommendations closely. Here are some general precautions and management tips for managing neutropenia:

• Attend regular appointments to monitor blood counts.
• Stay up-to-date on recommended vaccinations.
• Practice thorough handwashing to prevent infections.
• Maintain a balanced diet with an emphasis on fruits and vegetables.
• Limit contact with individuals who have contagious illnesses.
• Seek immediate medical attention if you develop signs of infection.
• Implement stress-reducing activities to support overall well-being.
• If neutropenia is severe, avoid gardening or handling soil.
• Limit alcohol intake and avoid tobacco to support overall health.

In my experience

In my experience, the occurrence of neutropenia is rarely reported with citalopram in clinical settings. However, individual variations and the medical history of patients play an important role in the occurrence of this side effect of citalopram.

Healthcare providers carefully take a complete medical and medication history of patients before prescribing citalopram to avoid the serious and uncommon side effects of this medication, including neutropenia. 

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