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What do Celexa withdrawal symptoms feel like?

With proper guidance and preparation in place, a person does not have to suffer unnecessarily harsh and lingering symptoms of Celexa withdrawal. Without preparation and guidance for navigating a gradual reduction, Celexa withdrawals can oscillate from moderate to severe and debilitating.

Celexa Withdrawal Symptoms include:
  • Suicidality.28,29
  • Deep depression.28
  • Dizziness.16
  • Agitation, aggression, mood swings.16
  • Loss of appetite.30
  • Hostility.16
  • Sensory disturbances, hallucinations of sound, sight, touch, taste, etc.16
  • Brain zaps, electrical shock sensations in the head and neck, and or spine*16
  • Emotional lability, i.e., crying spells, rage, uncontrollable laughing or crying, intensely magnified emotions, reactions, etc.30
  • Dysphoria, a profound sense of unease, unhappiness, and dissatisfaction with life.16
  • Physical aches, pains, cramps, tingling, or other unwanted physical sensations.
  • Sleep disruptions, insomnia.16
  • Loss of interest in usual socializing, hobbies, and past activities that were enjoyed.28

*The FDA label (page 34) for Celexa warns that electric-shock-like sensations may result if Celexa withdrawal is done too quickly.

Up to 56% of people attempting Celexa withdrawal or coming off other antidepressants experience an antidepressant withdrawal syndrome.

This is sometimes called Celexa discontinuation syndrome. 46% of those who experience withdrawal describe the symptoms as severe.6

Do Your Symptoms Require Celexa?

weaning off celexa
Alternative to Meds has been an antidepressant withdrawal help authority for over 15 years. We would like you to review our published evidence regarding Alternative to Meds Center’s remarkable Celexa withdrawal success. Even with what might be considered the most strange or outlandish symptoms, these same symptoms are, unfortunately, quite common. Not only do we specialize in resolving these symptoms, but many of us have also had to endure them ourselves in order to become the teachers that we are.
Watch this video of a woman who overcame incredible odds and liabilities to get off of antidepressants and benzos. On entry to the program, she was barely able to walk and highly symptomatic on the medications. Not only did she get back a life worth living, but she went on to be a therapist helping people in similar ways.

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Understanding Celexa Withdrawal

A person taking Celexa may find the unwanted side effects of the drug to overshadow any perceived benefits of continuing to take the medication. Consequently, a decision may be made to stop taking Celexa. Except in the case of serotonin syndrome, a person should avoid stopping taking Celexa all at once or “cold turkey.” 27 To do so may introduce an overwhelming shock to the body, and may cause symptoms severe enough to require hospitalization and a lengthy protracted withdrawal.

Celexa withdrawal, side effects, and Celexa dependence can be better understood and managed within the greater context of how Celexa can alter brain chemistry, can disrupt CNS functions throughout the body, and can introduce physical and mental symptoms that can be debilitating. This article covers some information regarding Celexa withdrawal we hope you will find useful. If you are looking for information on safely stopping Celexa, we suggest you dive into these subjects on our website for more comprehensive information.

Safe Celexa withdrawal

holistic celexa withdrawal sedona drug rehabA person may find that developed dependence on Celexa has begun to set in and that it would be best to stop taking Celexa before the situation worsens. It could be that the severity of Celexa’s side effects has begun to intensify, or has become intolerable. There can be many reasons to consider Celexa withdrawal treatment. A person taking Celexa will likely be experiencing a set of side effects already. An onslaught of a new set of Celexa withdrawal symptoms on top of earlier challenges could be completely overwhelming. Finding safe Celexa withdrawal help is recommended.

At Alternative to Meds Center, we aim to provide adequate preparations which stabilize a person before reducing the dosage. This prevents feeling completely bowled over by unexpected Celexa withdrawal symptoms. Without correct help, Celexa withdrawal symptoms may be severe enough to incapacitate a person, perhaps causing them to give up and resume their Celexa prescription. Because of the potential severity of withdrawal, we recommend inpatient Celexa withdrawal help to achieve a full and successful recovery of physical and mental health.

We are confident that with adequate preparation, including comprehensive guidance as to what to expect, Celexa withdrawal can be accomplished comfortably within a reasonably scheduled timeline. It is possible for a person to experience a surprisingly mild withdrawal from Celexa and other antidepressant drugs with careful oversight and planning. At Alternative to Meds, lab testing is done for toxicity, to discover what diet correction, including supplementation, may be needed to normalize neurochemistry. We also plan toxicity removal therapies, orthomolecular medicine for restoring a healthy microbiome, and other strategies to make citalopram withdrawal much easier to bear.

Holistic therapies used during and post-medically managed Celexa withdrawal include:

Why are medications like Celexa called SSRIs?

Celexa is an SSRI medication. SSRI means selective serotonin reuptake inhibitor. Serotonin is a major regulating hormone affecting just about every area of human health, though it is most commonly thought of as the “happy chemical.” While there is a grain of truth to that, it’s a rather incomplete view because serotonin also regulates digestion, sleep, sexual function, body temperature, mammary glands, the liver, other organs, energy metabolism, the heart, and uncountable other functions.38 Celexa is called an SSRI antidepressant because it interrupts the normal transmission of serotonin. Drugmakers explain that this interruption is a good thing as it results in a build-up of serotonin.7 However, in pregnant women, faster metabolization rates show a reduced efficacy for SSRI medications, with unanswered questions concerning how this may relate to autism in the offspring.9 There are animal studies that indicate chronic use of SSRIs can actually create a serotonin deficit.8 A 2005 article published in PLOS Medicine talks at length about the disconnect between serotonin claims found in manufacturer direct-to-consumer advertising and what is discussed in the scientific literature.12

Tolerance is a condition where Celexa stops working and for a significant number of persons, long-term antidepressant use will not provide relief of their symptoms.13,14

Please remember that if, in fact, a serotonin deficiency does exist, there are many ways to alleviate a serotonin deficiency that are non-pharmacological.37

Do SSRIs like Celexa work for Major Depressive Disorder?

This type of serotonin-targeting antidepressant may have been prescribed without informing the patient what to expect, especially regarding the lack of evidence for long-term prescribing efficacy.10 A 2017 article published in BMC Psychiatry covering 131 clinical trials involving 27,422 participants discussed the value of treating Major Depressive Disorder (MDD) with SSRIs. They found that SSRIs might have statistically relevant effects on symptoms of depression, but that ALL of the reviewed trials “were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects.” They went on to say “trials tend to overestimate benefits and underestimate harms. The ‘true’ effect of SSRIs might not even be statistically significant.” 11 From what we have seen at Alternative to Meds Center, when other methods of holistic mental health care are available without medication side effects, most people tend to recover rapidly. This includes those who undergo Celexa withdrawal because the medication was not working and those who simply wanted to get pregnant or other reasons for stopping Celexa.

Researcher Paul Andrews, an assistant professor of Psychology, Neuroscience & Behaviour at McMaster published an article in a 2015 Neuroscience & Biobehavioral Reviews that claims that the improvement from an SSRI medication is likely a counter-reaction and an attempt to overcome antidepressant medication effects — that the body is trying to achieve balance despite the presence of the SSRI, rather than being assisted by the drug. He goes on to say that “instead of helping, the medications appear to be interfering with the brain’s own mechanisms of recovery.” 15

What do Celexa side effects feel like?

Initially, taking Celexa will begin to suspend (block) serotonin along the nerve channels, and this may produce a lift in tone or a degree of euphoria. These initial mood changes may be sudden or gradual but are temporary. It is not possible for any drug to create more serotonin. The effects are attained by manipulating or altering the rate of absorption and metabolism of natural neurochemicals such as serotonin. Drug effects are temporary because of several reasons, such as neuroadaptation, and depletion of natural hormones that degrade when not allowed to recycle as they normally would.15

All antidepressant drugs are more or less designed to lift depression in this way and can be effective for some for a time. However, other negative side effects frequently emerge and can range from moderate to severe.

Celexa side effects include: *
  • Suicidal thoughts, especially in persons under 25 years of age 16
  • Depression that worsens 18
  • Insomnia 16
  • Nausea 16
  • Weight loss or weight gain 19
  • Confusion, cognitive disruption, inability to focus attention 20
  • Sexual dysfunction 16
  • Memory loss 20
  • Abnormal Bleeding 17
  • Hyponatremia 17
  • Manic episodes17
  • Tiredness, drowsiness 16
  • Headaches 20
  • Shakiness 16
  • Sweating 20
  • Tachycardia (racing heartbeat) 20
  • Diarrhea, gas, cramps 20
  • Tingling or numbness 20

*See FDA Label for more details on Celexa side effects.

Side effects of Celexa also include the risk of upper gastrointestinal bleeding or abnormal bleeding in other areas of the body. These Celexa side effects are thought to be related to the adverse effects that Celexa can have on the coagulation of the blood. Mania is another Celexa side effect of concern. In Celexa drug trials where mania occurred in .2% of 1063 patients taking Celexa and in 0% of those in the 446 placebo group for the trial.16,22

What do I do if I am having Celexa Side Effects?

Some people may not experience severe or negative Celexa side effects, but when these do present they should be discussed with your primary caregiver, Precautions such as a reduction of dose, guided Celexa withdrawal, or other medical interventions can be initiated. Some patients may experience unpredictable changes in mood and behavior while taking Celexa. Such Celexa side effects can include a mix of both mental and physical manifestations. These may include suicidal thoughts, panic attacks, increased anxiety, and impulsive and aggressive feelings. Also reported are negative emotional reactions such as irritability, hostility, agitation, or feeling like hurting oneself.17,20 Physical side effects of Celexa may present as physical hyperactivity, muscle weakness, and a particularly troubling sensation of restlessness known as akathisia,21 from the Greek root, “akathemi,” which means to be unable to sit down or sit still. These symptoms can be relentless and impossible to tolerate.

What is Serotonin Syndrome?

celexa serotonin syndromeCelexa (citalopram) and other SSRIs are linked with serotonin syndrome.16 Serotonin syndrome is a complex set of reactions that may include seizures, motor control dysfunction, respiratory impairment, potentially fatal rise in body temperature, tremors, blood pressure fluctuations, etc., and must be treated immediately due to the life-threatening implications of this drug-induced condition. Below you will find a more comprehensive list of serotonin syndrome signs to watch for.

Serotonin syndrome or other life-threatening reactions would be the ONLY case for immediate Celexa cessation, preferably in a hospital or emergency treatment setting.

More Information on Serotonin Syndrome — Signs to Watch For:

One very troubling side effect of taking Celexa, as with any serotonin-targeted medication, is the risk of a build-up of too much serotonin. This excessive build-up of serotonin can result in “serotonin syndrome.” This is a potentially life-threatening condition that requires immediate medical intervention including Celexa withdrawal. The remedy for this syndrome is, in part, to discontinue Celexa, but this must be done under strict monitoring and only in a medical facility that can provide immediate emergency treatment including the use of serotonin blockers, intravenous hydration, safe sedation, blood pressure stabilization, and other forms of life support that may be needed.

PLEASE NOTE:  Serotonin Syndrome is one of the very few instances where the immediate cessation of Celexa is indicated. It is vital to provide support in a medical setting to save the life of the patient. Please note that gradual cessation is indicated in virtually every other scenario for safe Celexa withdrawal.

Signs of serotonin syndrome must be watched for as these require immediate medical intervention.
Serotonin Syndrome symptoms are considered life-threatening and are more likely to occur in overdose, shortly after starting to take Celexa, or when the dosage has been changed.* 23-25

Signs of Serotonin Syndrome include:
  • Confusion
  • Muscle rigidity
  • Agitation
  • A rapid rise in body temperature
  • Fever
  • Hallucination/delirium
  • Diarrhea/cramps
  • Nausea
  • Vomiting
  • Loss of coordination
  • Restlessness
  • Heart palpitations
  • Seizure
  • Coma
  • Blood pressure fluctuations

*According to Mason et al.’s 2000 review of the subject, about 75% of serotonin syndrome cases happen within 24 hours of initiation or a change in dosage, or in overdose scenarios.

Medical advice for cases of serotonin syndrome will likely be to immediately stop taking Celexa and along with proper medical intervention, monitoring, and support in place, many of these reactions will usually begin to gradually abate over a number of days.26 However, some of these symptoms may persist for quite some time, even after Celexa withdrawal. In these cases, a lengthier period of medical treatment and sometimes hospitalization may be indicated.

Notes on Celexa Dependence

Of note, in a New Zealand study, about 27% of the group that was involved in the study felt they were either severely dependent, moderately dependent, or had a mild dependence on Celexa or similar medications. Those are quite significant numbers and show there is a potential problem.3 In the US, NBC News reported one in six Americans is taking antidepressants, and a study found that 60% of those on antidepressants continue taking them for more than 2 years.4 In the UK, it was reported in the British Medical Journal in 2018 that 12% of the British population was taking antidepressant medications and that the number of antidepressant prescriptions rose from 30 million in 2008 to 71 million in 2018.5

Clearly, Celexa dependence and developed dependence on other antidepressant drugs is a growing concern all over the world, and these soaring numbers show no sign of reversing. Many persons taking antidepressants as cited earlier, continue to take them because they feel the withdrawals are too severe to manage.

Where can I get more information on safe Celexa Withdrawal?

We can provide much more detailed information on request concerning all of the techniques and therapies used in our program at Alternative to Meds Center. Find out how each program component plays a significant role in the entire process. Our program is dedicated to helping you regain natural mental health using effective treatments for gentle and comfortable Celexa withdrawal so you can live life well, without the need to continue taking prescription medications.

getting off celexa
“Over a lengthy course of 8 years, I was taking several different prescription drugs, including Lorazepam, Zoloft, Celexa (citalopram), Effexor, and Paxil, but finally, they were no longer working for me. I went with my husband to Alternative to Meds Center Where it was found that I had low Serotonin and heavy metal toxicity. After five weeks of being there, I’m feeling much, much better and I am off all the medications.”

Click here to know more about Celexa Alternatives

Celexa (citalopram) Withdrawal FAQs

Questions relating to Celexa or citalopram are best directed to one’s prescribing physician, as patient history and health matters can differ greatly from one person to another. However, here are some of the most common questions that arise. It is always safest to seek medical advice from your primary caregiver whenever possible.

</p> <h3>What is Celexa (citalopram) used for?</h3> <p>

Celexa (citalopram) is approved to treat Major Depressive Disorder (MDD).

It is also given to patients suffering from a surprising number of other conditions, which is termed “off-label” prescribing.18,31 Off-label prescribing must be carefully considered especially when multiple drugs are prescribed, due to the number of drug-drug interactions that may result.32,34

Off-label uses for Celexa include:
  • Premenstrual dysphoric syndrome (PMDD)
  • Obsessive-Compulsive Disorder (OCD)
  • Generalized Anxiety Disorder (GAD)
  • Post-traumatic Stress Disorder (PTSD)
  • Social Anxiety Disorder
  • Panic Disorder
  • Anxiety disorders
  • Eating disorders
  • Bipolar Disorder
</p> <h3>Are there patients who should avoid Celexa?</h3> <p>

Yes. Celexa is NOT recommended for patients suffering from heart conditions such as long QT syndrome, slow heartbeat, irregular heartbeat, or for patients with magnesium deficiency, potassium deficiency, high blood pressure, patients at risk of or with a history of stroke, kidney disease, or liver disease. If liver injury or impairment occurs as a result of taking citalopram, the condition is largely considered reversible by discontinuing citalopram, but in some cases, the condition may be irreversible.31-33,35,39

</p> <h3>Are there alternate names for Celexa (citalopram) around the world?</h3> <p>

Yes, citalopram (the generic name) is sold under many different brand names in different countries, including:

  • Celexa in Canada and the US
  • Humorup in Argentina
  • Szetalo/Zetalo in India
  • Estar in Pakistan
  • Elopram in Italy
  • Citalex in Iran/Turkey
  • Citalo in Egypt

Celexa should not be confused with other similar-sounding drug names, or “look-alike” names, like Celebrex, Xanax, or Lexapro. The Institute for Safe Medication Practices (ISMP) recommends that a prescription label show both a drug’s brand name and the generic name, and also the purpose for the drug so as to reduce the risk of harm or accidental injury.2,3

</p> <h3>Can I drink alcohol while taking Celexa?</h3> <p>
Citalopram magnifies the effects of alcohol, and alcohol can conversely augment or alter the effects of medications. This can produce a host of negative effects, such as cognitive impairment, lack of clarity in perception, and impaired motor and muscle control. Therefore, driving a vehicle or operating heavy machinery while under the influence of alcohol is not recommended and this would be underscored if both alcohol AND Celexa were to be taken simultaneously. Because of their synergistic effects, there is a very real risk of overdose if too much alcohol is consumed while taking any SSRI medication. Overdose can result in respiratory shutdown, coma, and death.35 Therefore, it is safest to avoid mixing alcohol and Celexa. If you are not certain you can abstain from alcohol, seek medical advice from your primary health caregiver.5
</p> <h3>Can Celexa cause weight loss or weight gain?</h3> <p>
Yes, reports are clear that Celexa is linked to both weight loss and weight gain. Appetite can be suppressed in some persons resulting in weight loss. However, in other cases, Celexa results in increased appetite which can lead to weight gain. Some persons taking Celexa do not experience such effects on weight.
</p> <h3>Is Celexa a benzodiazepine?</h3> <p>
No. Celexa is an SSRI (Selective Serotonin Reuptake Inhibitor) type of antidepressant medication. Celexa targets serotonin, an inhibitory transmitter, and largely ignores other neurotransmitters such as dopamine or GABA. Benzodiazepine drugs primarily target and affect the inhibitory neurotransmitter called GABA, which is what results in the tranquilizing effects of the benzodiazepine class of drugs.36 Celexa is primarily targeting serotonin. Though the side effects of these two types of drugs may be similar. how they are thought to work is considered dissimilar.
</p> <h3>Can Citalopram cause anxiety?</h3> <p>
Yes, serotonin reuptake inhibitors (SSRIs) may increase anxiety symptoms, especially in the early phases of treatment. The study “A Single Dose of the Selective Serotonin Reuptake Inhibitor Citalopram Exacerbates Anxiety in Humans: A Fear-Potentiated Startle Study” 4 explored the idea that anxiety increased due to fear or anxiety about taking the drug, rather than anxiety being caused by the drug itself. However, the result of the study concluded that citalopram itself does exacerbate baseline anxiety levels, and therefore can cause or worsen anxiety in some individuals in early treatment. This phenomenon and other side effects may lead to the desire for Celexa withdrawal.
</p> <h3>Can Celexa cause suicidal thinking?</h3> <p>
Yes, according to the required FDA black box packaging label. The average risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment on Celexa and a host of other antidepressant drugs was double that of placebo in drug trials. Long-term use of the drug was not tested in any extended drug trials, so it is not known whether this risk increases over time.1
</p> <h3>What is the best way to safely stop Celexa?</h3> <p>
At Alternative to Meds Center, we use holistic measures to ensure the client weans off Celexa safely and comfortably. The whole process is overseen step by step in a fully-staffed in-patient setting. Clients are carefully monitored during Celexa withdrawal by a team of over 40 dedicated specialists, including physicians, nutrition-based therapists, and a wide array of holistic practitioners to enable a thorough, gentle, and health-restoring result.


1. FDA drug info Citalopram [accessed 2022 ASpril 6]

2. Grillon C, Levenson J, Pine DS “Increased anxiety during anticipation of unpredictable aversive stimuli in posttraumatic stress disorder but not in generalized anxiety disorder” NCBI [online] 2009 Feb 12 [cited 2022 June 10]

3. Beston A “New research on antidepressant addiction and withdrawal” University of Auckland, Medical Express 2018 Jun 6 [cited 2022 June 10]

4. Moore TJ, Mattison DR. Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race. JAMA Intern Med. 2017;177(2):274–275. doi:10.1001/jamainternmed.2016.7507 [cited 2022 June 10]

5. NHS UK Patient Information “Citalopram: an antidepressant.” [Internet] 2018 Dec 18 [cited 2022 June 10]

6. James Davies, John Read, A systematic review into the incidence, severity, and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors Volume 97, 2019, Pages 111-121, ISSN 0306-4603. [cited 2022 June 10]

7. NHS Selective serotonin reuptake inhibitors (SSRIs) [cited 2022 June 10]

8. Siesser WB, Sachs BD, Ramsey AJ, et al. Chronic SSRI treatment exacerbates serotonin deficiency in humanized Tph2 mutant mice. ACS Chem Neurosci. 2013;4(1):84-88. doi:10.1021/cn300127h. [cited 2022 June 10]

9. Ornoy A, Koren G. SSRIs and SNRIs (SRI) in Pregnancy: Effects on the Course of Pregnancy and the Offspring: How Far Are We from Having All the Answers? Int J Mol Sci. 2019 May 14;20(10):2370. doi: 10.3390/ijms20102370. PMID: 31091646; PMCID: PMC6567187. [cited 2022 June 10]

10. BMJ Rapid Response: Antidepressant prescribing and informed consent 25 February 2018 Peter J. Gordon Psychiatrist for Older Adults. [cited 2022 June 10]

11. Jakobsen, J.C., Katakam, K.K., Schou, A. et al.Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis.BMC Psychiatry17, 58 (2017). [cited 2022 June 10]

12. Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature Jeffrey R Lacasse and Jonathan Leo Published online 2005 Nov 8. PLoS Med. 2005 Dec; 2(12): e392. doi: 10.1371/journal.pmed.0020392. [cited 2022 June 10]

13. Pharmacological Research The emergence of loss of efficacy during antidepressant drug treatment for major depressive disorder: An integrative review of evidence, mechanisms, and clinical implications Volume 139, January 2019, Pages 494-502. [cited 2022 June 10]

14. Mad in America Researchers Ask, ‘Why Do Antidepressants Stop Working?’ By Peter Simons December 18, 2018. [cited 2022 June 10]

15. McMaster University. “Science behind commonly used anti-depressants appears to be backwards, researchers say.” ScienceDaily. ScienceDaily, 17 February 2015. [cited 2022 June 10]

16. FDA Acess Label Celexa Label [cited 2022 June 10]

17. FDA Acess Label TRADENAME (Citalopram HBr) Orally Disintegrating Tablets [cited 2022 June 10]

18. Smith SW, Hauben M, Aronson JK. Paradoxical and bidirectional drug effects. Drug Saf. 2012 Mar 1;35(3):173-89. doi: 10.2165/11597710-000000000-00000. PMID: 22272687. [cited 2022 June 10]

19. Leonard J, Medical News Today How can antidepressants affect weight gain? Medically reviewed by Alan Carter, Pharm.D. September 25, 2017. [cited 2022 June 10]

20. Edinoff AN, Akuly HA, Hanna TA, Ochoa CO, Patti SJ, Ghaffar YA, Kaye AD, Viswanath O, Urits I, Boyer AG, Cornett EM, Kaye AM. Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurol Int. 2021 Aug 5;13(3):387-401. doi: 10.3390/neurolint13030038. PMID: 34449705; PMCID: PMC8395812. [cited 2022 June 10]

21. Basu B, Gangopadhyay T, Dutta N, Mandal B, De S, Mondal S. A case of akathisia induced by escitalopram: case report & review of literature. Curr Drug Saf. 2014 Mar;9(1):56-9. doi: 10.2174/157488630901140224104651. PMID: 24568368. [cited 2022 June 10]

22. Peet M, Peters S. Drug-induced mania. Drug Saf. 1995 Feb;12(2):146-53. doi: 10.2165/00002018-199512020-00007. PMID: 7766338. [cited 2022 June 10]

23. Bartlett D. Drug-Induced Serotonin Syndrome. Crit Care Nurse. 2017 Feb;37(1):49-54. doi: 10.4037/ccn2017169. PMID: 28148614. [cited 2022 June 10]

24. Michigan University Medicine Serotonin syndrome May 28, 2019 Medical Review: Anne C. Poinier, MD – Internal Medicine & Kathleen Romito, MD – Family Medicine & Christine R. Maldonado, PhD – Behavioral Health. [cited 2022 June 10]

25. Pape, Kate; Romanowski, Kathleen SEROTONIN SYNDROME PRESENTING AS COMA IN A PATIENT WITH SEVERE THERMAL INJURY, Critical Care Medicine: January 2018 – Volume 46 – Issue 1 – p 795 doi: 10.1097/01.ccm.0000529623.10133.16. [cited 2022 June 10]

26. MedSafe New Zealand Drug Safety Authority Advice about serotonin syndrome Published: 31 July 2015. [cited 2022 June 10]

27. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms.Ther Adv Psychopharmacol. 2015;5(6):357-368. doi:10.1177/2045125315612334. [cited 2022 June 10]

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29. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ. 2016 Jan 27;352:i65. doi: 10.1136/bmj.i65. PMID: 26819231; PMCID: PMC4729837. [cited 2022 June 10]

30. All-Party Parliamentary Group for Prescribed Drug Dependence Antidepressant Dependency and Withdrawal May 2018.[cited 2022 June 10]

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32. Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. [Updated 2021 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 June 10]

33. Cooke MJ, Waring WS. Citalopram and cardiac toxicity. Eur J Clin Pharmacol. 2013 Apr;69(4):755-60. doi: 10.1007/s00228-012-1408-1. Epub 2012 Sep 21. PMID: 22996077. [cited 2022 June 10]

34. Jannini TB, Lorenzo GD, Bianciardi E, Niolu C, Toscano M, Ciocca G, Jannini EA, Siracusano A. Off-label Uses of Selective Serotonin Reuptake Inhibitors (SSRIs). Curr Neuropharmacol. 2022;20(4):693-712. doi: 10.2174/1570159X19666210517150418. PMID: 33998993. [cited 2022 June 10]

35. Park SH, Ishino R. Liver injury associated with antidepressants. Curr Drug Saf. 2013 Jul;8(3):207-23. doi: 10.2174/1574886311308030011. PMID: 23914755. [cited 2022 June 10]

36. Alshaimaa A. Elgarf, David C. B. Siebert, Friederike Steudle, Angelika Draxler, Guanguan Li, Shengming Huang, James M. Cook, Margot Ernst, and Petra Scholze Different Benzodiazepines Bind with Distinct Binding Modes to GABAA Receptors ACS Chem. Biol. 2018, 13, 8, 2033–2039 Publication Date: May 16, 2018. [cited 2022 June 10]

37. Young SN. How to increase serotonin in the human brain without drugs. J Psychiatry Neurosci. 2007;32(6):394-399. [cited 2022 June 10]

38. Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009;60:355-366. doi:10.1146/ [cited 2022 June 10]

39. Voican CS, Corruble E, Naveau S, Perlemuter G. Antidepressant-induced liver injury: a review for clinicians. Am J Psychiatry. 2014 Apr;171(4):404-15. doi: 10.1176/appi.ajp.2013.13050709. PMID: 24362450. [cited 2022 June 10]

40. Bailey RL, West KP Jr, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab. 2015;66 Suppl 2:22-33. doi: 10.1159/000371618. Epub 2015 Jun 2. PMID: 26045325.[cited 2022 June 10]

41. Petrilli MA, Kranz TM, Kleinhaus K, et al. The Emerging Role for Zinc in Depression and Psychosis. Front Pharmacol. 2017;8:414. Published 2017 Jun 30. doi:10.3389/fphar.2017.00414 [cited 2022 June 10]

42. Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition. 2017 Mar;35:56-60. doi: 10.1016/j.nut.2016.10.014. Epub 2016 Nov 9. PMID: 28241991. [cited 2022 June 10]

43. Guerrero FA, Medina GM. Effect of a medicinal plant (Passiflora incarnata L) on sleep. Sleep Sci. 2017;10(3):96-100. doi:10.5935/1984-0063.20170018 [cited 2022 June 10]

44. Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol. 2011 Dec;21(12):841-60. doi: 10.1016/j.euroneuro.2011.04.002. Epub 2011 May 23. PMID: 21601431.[cited 2022 June 10]

Originally Published Sep 13, 2018 by Diane Ridaeus, Founder

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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