Does Citalopram Interact With Cyproheptadine? (+3 Effects)

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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In this article, we will discuss the potential interactions between citalopram and cyrohetadine. We will also discuss the additive side effects of these medications when taken together, and how to ensure the safe and effective use of these medications.

Does Citalopram interact with Cyproheptadine?

Yes, citalopram can interact with cyproheptadine. The interaction between these drugs can potentially increase the risk of additive GIT and CNS effects in individuals.

Citalopram is a selective serotonin reuptake inhibitor and antidepressant drug that works by increasing the levels of serotonin in the brain. It is prescribed to manage and treat major depressive disorders, anxiety, and obsessive-compulsive disorders (1).

It provides comparable effectiveness to other antidepressants but with better tolerability, making it a preferred option for individuals who cannot endure the side effects of other antidepressants.

Cyproheptadine, on the other hand, is a first-generation antihistamine and a serotonin antagonist medication. It primarily antagonizes histamine, a neurotransmitter that plays a pivotal role in the body’s allergic response.

It is commonly indicated to manage symptoms associated with allergic reactions and allergic-type responses, including sneezing, runny or itchy nose, itchy or watery eyes, itching of the throat, and other manifestations of allergies (2).

What does research suggest?

According to research cyproheptadine used in depressive patients to counteract the sexual side effects of SSRIs, leads to a relapse of depression by antagonizing 5HT-2A receptors. Clinicians avoid combining cyproheptadine with SSRIs due to the concern that it may reverse the efficacy of SSRIs (3).

A study showed that cyproheptadine and citalopram intoxication was found to be the cause of death of a 42-year-old woman whose toxicology analysis indicated the presence of cyproheptadine and citalopram in postmortem blood. These substances were also found in vitreous, urine, and bile samples.

What are the additive adverse effects of citalopram and cyproheptadine?

Citalopram and cyproheptadine can be prescribed together to reduce to sexual side effects of citalopram by cyproheptadine. However, both of these medications are associated with some common adverse effects which are augmented by the combined use of citalopram and cyprohetadine. These effects are: (4,5)

CNS effects

The combination of Citalopram and cyproheptadine may lead to additive central nervous system (CNS) effects, potentially intensifying the impact on CNS when given together. The most common CNS effects associated with the combined use of citalopram and cyproheptadine can be:

enhanced sedation
dizziness
drowsiness
sleep disturbances
restlessness
irritability

It’s important to exercise caution and consult a healthcare provider when considering this combination to minimize potential adverse effects.

Gastrointestinal effects

Both citalopram and cyproheptadine have some potential gastrointestinal (GIT) side effects that may be pronounced when they are taken together. Their common additive side effects are:

nausea
vomiting
diarrhea
constipation
dry mouth
liver diseases ( more common with cyproheptadine)

If you experience any of these side effects, consult your healthcare provider to manage these effects and monitor your condition.

Miscellaneous effects

The other additive adverse effects associated with the use of citalopram and cyproheptadine are:

headaches
appetite disturbances
irregular heartbeats
dryness of nose
Fatigue

It is important to note that, not every individual who takes a combination of citalopram and cyproheptadine experiences all of these side effects. The intensity and occurrence of these effects may vary from person to person based on individual sensitivity and dosage of these medications.

However, if you experience any of these side effects, consult your healthcare provider as soon as possible to monitor and manage the interactions and side effects of these medications.

How to ensure the safe use of citalopram and cyproheptadine together?

To ensure the safe and effective use of citalopram and cyproheptadine together, follow these key considerations:

Always consult your healthcare provider before starting and combining these medications.
Do not consume alcohol with these medications as it may intensify the adverse effects.
Make positive lifestyle changes and adjust your sleep pattern.
Stay hydrated to avoid dry mouth and other GIT effects.
Do not stop taking any of these medications on your own. Prompt cyproheptadine discontinuation may lead to serotonin syndrome.
Be aware of the potential interactions and side effects of citalopram and cyproheptadine and report them to your healthcare provider as soon as you start experiencing them.

Conclusion

In this article, we have discussed the concurrent use of citalopram and cyproheptadine and the interactions between these medications. We have also discussed the potential additive effects of these medications when given together.

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References

1.-

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/

2.-

Hargrove V, Molina DK. A fatality due to cyproheptadine and citalopram. J Anal Toxicol. 2009 Oct;33(8):564-7. doi: 10.1093/jat/33.8.564. PMID: 19874671. https://pubmed.ncbi.nlm.nih.gov/19874671/

3.-

Charles DeBattista, Mehmet Sofuoglu, Alan F. Schatzberg, Serotonergic synergism: the risks and benefits of combining the selective serotonin reuptake inhibitors with other serotonergic drugs, Biological Psychiatry, Volume 44, Issue 5, 1998, Pages 341-347, ISSN 0006-3223, https://doi.org/10.1016/S0006-3223(98)00161-9. https://www.sciencedirect.com/science/article/pii/S0006322398001619

4.-

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/087056s045lbl.pdf

5.-

Nemeroff CB. Overview of the safety of citalopram. Psychopharmacol Bull. 2003 Winter;37(1):96-121. PMID: 14561952. https://pubmed.ncbi.nlm.nih.gov/14561952/

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Does Citalopram interact with Cyproheptadine? (+3 effects)