Does citalopram cause nosebleeds? (+3 factors)
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 the nosebleeds associated with citalopram, factors contributing to the increasing risk of nosebleeds in individuals taking citalopram, common side effects associated with the use of citalopram, and the management of nosebleeds if they occur while taking citalopram.
Does citalopram cause nosebleeds?
Yes, citalopram may cause nosebleeds. However, it is not a common side effect of citalopram. In rare cases, some individuals may experience nosebleeds while taking citalopram but not everyone who takes citalopram experiences nosebleeds.
Citalopram is an antidepressant medication that is indicated in the treatment and management of depression anxiety and their associated symptoms. It increases serotonin levels in the brain, primarily responsible for its therapeutic effects (1).
Serotonin is a neurotransmitter responsible for carrying out different functions in the brain, such as enhancement of mood, reducing sadness, regulation of sleep, and improvement of cognitive functions. This neurotransmitter helps regulate platelet function, contributing to the body’s ability to form blood clots when needed (2).
SSRIs, such as citalopram, elevate serotonin levels in the brain and can also impact serotonin levels in other parts of the body, including platelets, which might influence their clotting ability (5).
What factors can increase the risk of nosebleeds while taking citalopram?
The factors that can potentially increase the risk of nosebleeds while taking citalopram can be identified as:
Concurrent medication
The concurrent use of medications with citalopram that may increase the risk of nosebleeds includes drugs that affect platelet function, and blood clotting, or have potential interactions with citalopram.
These medications can increase the anticoagulant effects of citalopram which is negligible otherwise, making the blood vessels in the nasal passages more susceptible to bleeding.
Pre-existing nasal conditions
Conditions such as chronic rhinitis or sinusitis can cause persistent nasal irritation, inflammation, and dryness. When taking citalopram, this ongoing nasal irritation creates a more sensitive environment within the nasal passages.
Any minor trauma, such as blowing the nose or even slight pressure, can potentially increase the risk of nasal bleeding more easily.
Individual Sensitivity
Some individuals may be more sensitive to the side effects of citalopram, including those that affect mucous membranes inside the nose. It’s important to note that not everyone who takes citalopram experiences nosebleeds, and this side effect is relatively rare.
However, if you are taking an SSRI like citalopram and notice frequent or severe nosebleeds, it’s essential to consult with your healthcare provider as soon as possible.
How to manage nosebleeds while taking citalopram?
If nosebleeds occur while taking citalopram due to any underlying factor, its management involves the combination of preventive measures and immediate care. The following measures can be taken to manage nosebleeds:
- Maintenance of adequate nasal moisture by saline nasal spray can prevent nasal dryness and subsequent nasal bleeds.
- If a nosebleed occurs, tilt your head slightly forward to prevent blood from flowing down your throat. Use your thumb and index finger to pinch your nostrils together and breathe through your mouth.
- Avoid the known triggers that are contributing to nasal bleeding such as concurrent use of medications that can cause nosebleeds or use of tobacco smoke or alcohol.
- If recurrent or severe nosebleeds occur, discuss it with your healthcare provider. They may suggest switching to another antidepressant that doesn’t contribute to this effect.
Always consult your healthcare provider before making any changes to your medication or treatment plan, do not stop taking medication on your own, and follow the guidance of your healthcare provider to manage any side effects that may occur while taking citalopram.
What are the common side effects of citalopram?
The common side effects of citalopram are nausea, vomiting, git irritation and discomfort, and diarrhea, etc (3). Citalopram is also associated with sleep disturbances, appetite loss, dry mouth, heartburn, drowsiness, dizziness, and headaches.
Rarely citalopram can also cause sexual dysfunction, torsades de points, agitation, diabetes mellitus, and bleeding disorders (4).
If you experience any of these side effects, it is crucial to immediately contact your healthcare provider. This communication can assist them in choosing the most suitable medications for their specific condition.
It’s worth highlighting that not everyone experiences these side effects, and their severity may differ from person to person.
Conclusion
In this article, we have discussed the nosebleeds that may occur during treatment with citalopram, the underlying factors that may contribute to increasing the risk of a nosebleed while taking citalopram, and the management of nosebleeds if it occurs during citalopram therapy.
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References
1.-
Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. 2021 Dec 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29489221. Available from: https://pubmed.ncbi.nlm.nih.gov/29489221/
2.-
Lopez-Vilchez I, Diaz-Ricart M, White JG, Escolar G, Galan AM. Serotonin enhances platelet procoagulant properties and their activation induced during platelet tissue factor uptake. Cardiovasc Res. 2009 Nov 1;84(2):309-16. doi: 10.1093/cvr/cvp205. Epub 2009 Jun 18. PMID: 19541671.
3.-
Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A. Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110266. doi: 10.1016/j.pnpbp.2021.110266. Epub 2021 Feb 5. PMID: 33549697. https://pubmed.ncbi.nlm.nih.gov/33549697/
4.-
Milne RJ, Goa KL. Citalopram. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness. Drugs. 1991 Mar;41(3):450-77. doi: 10.2165/00003495-199141030-00008. PMID: 1711447. https://pubmed.ncbi.nlm.nih.gov/1711447/
5.-
Eslami Shahrbabki M, Eslami Shahrbabaki A. Sertraline-related bleeding tendency: could it be dose-dependent? Iran J Psychiatry Behav Sci. 2014 Fall;8(3):81-3. PMID: 25780379; PMCID: PMC4359729. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359729/
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