Does Citalopram cause palpitations? (+3 side effects)

In this article, we will briefly answer the question of whether Citalopram causes palpitations. In addition to these, we will also explore the other side effects of Citalopram, the research studies and the medical opinion about the side effects of Citalopram and the measures to take to avoid these side effects.

Does Citalopram cause palpitations?

Yes, Citalopram can occasionally cause palpitations. It is a rare side effect of using Citalopram. Although it is not frequently reported, individuals taking Citalopram should remain vigilant for any unusual changes in heart rhythm.  Palpitations caused by Citalopram can be dose-dependent.

Palpitations are basically a sensation of rapid, strong and irregular heartbeats. The side effect is more likely to occur

• in patients who are sensitive to the effects of Citalopram.
• in patients who are taking doses higher than what their bodies need.
• can also be caused by the interaction of Citalopram with some underlying health condition or medication.

What is the relationship between citalopram dosage and palpitations?

There is a direct relationship between citalopram dosage and heart palpitations. Citalopram can cause the risk of palpitations if it is taken at a dose of more than 40 mg as there are chances of increased QT prolongation in patients (1,2,3). The recommended dose of Citalopram is 20mg/day.

The proper dosage regimen for Citalopram should be as follows:

• A starting dose of 20mg once daily
• After taking it for a week, take the dose up to 40mg
• For patients older than 60 years of age should not take more than 20 mg of Citalopram (4).

Some individuals may experience palpitations at the start of the treatment. This is due to the body adjusting to the medication.

However, the timing of this side effect occurring in a patient differs from person to person. As some may experience it in the early start and others may not encounter this effect until later.

Citalopram can also lower Heart Rate Variability (HRV) in some individuals.

What does research suggest?

According to a study conducted in 2022, there were 229 events of QT prolongation after taking Citalopram during their target trials. However, it appeared to be manageable if Citalopram is taken within the recommended dosage range (5).

Another study conducted in 2023, concluded that palpitations caused by Citalopram can be dose-dependent side effects and can easily be avoided if treatment protocols are followed vigilantly (6).

A study in 2016 associated Citalopram with an increased risk of  QT prolongation (7). This can lead to severe heart conditions like arrhythmia. However, such effects are only observed in doses greater than 40mg/day which is not recommended in patients.

How does Citalopram cause palpitations?

Citalopram is an antidepressant belonging to the category of selective- Serotonin Reuptake Inhibitor. Serotonin is a neurotransmitter that controls heart rate and other bodily functions.  The disruption of balance in the serotonin levels could lead to palpitations (8,9).

Citalopram can also affect electrolyte levels, particularly magnesium and potassium levels. This also leads to effects on the electrical activity of the heart causing palpitations (10).

Citalopram is sometimes prescribed to manage anxiety or mood disorders of a patient. Anxiety and stress independently cause palpitations. Individuals experiencing anxiety as a side effect of Citalopram are more prone to palpitations.

FDA Warning for Citalopram

The US Food and Drug Administration Authority (FDA) has issued guidance to healthcare patients and professionals advising against the use of Citalopram Hydrobromide (Celexa) and that it should not be taken in doses greater than 40mg per day.

This recommendation arises from the Citalopram Hydrobromide (Celexa) potential to cause abnormal alterations in cardiac activity.

What to do if Citalopram causes palpitations?

If a patient taking Citalopram experiences palpitations, then it is crucial to inform the healthcare provider. Inform them about the severity of the condition.

The healthcare provider might suggest a reduction of the dose or an alteration of the medication with one that is less likely to cause palpitations.

In such cases, the dose of Citalopram is gradually increased to avoid the discomfort of the patient. The healthcare provider can recommend the best-suited treatment based on their evaluation and the patient’s medical history. It is crucial to not make any changes without their guidance.

How to avoid Citalopram-induced palpitations?

Some important steps to mitigate citalpram-induced palpitations include:

• Strictly follow the dosage regimen prescribed to you.
• Identify and avoid the factors that trigger your palpitations such as food, stress, medications etc.
• Dehydration and electrolyte imbalance cause palpitations so make sure you are hydrated and maintain a balanced diet.
• Reducing or eliminating caffeine, Tobacco and alcohol consumption. along with managing stress through relaxation techniques and regular exercise can also help you to avoid experiencing palpitations.

Additional Side effects of Citalopram

According to the studies conducted, the following mentioned side effects can be observed in a patient using Citalopram (11,12,13).

• Drowsiness
• Vomiting
• Diarrhea
• Nausea
• Ejaculation disorder
• Constipation
• Headache

Conclusion

While Citalopram can cause Palpitations, these palpitations can be easily avoided if the patients follow the instructed dosage regimen. It is essential to notice that not every person encounters palpitations after taking Citalopram.

In the case of palpitations, patients should consult their doctors immediately and should also work on the mentioned lifestyle modifications to avoid this complication.

References