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  • Mixing Trazodone & Celexa | Interactions, Side Effects, & Risks

    Mixing Trazodone & Celexa | Interactions, Side Effects, & Risks

    Trazodone is an atypical antidepressant and sleep aid sold under the brand name Desyrel. Citalopram is a selective serotonin reuptake inhibitor (SSRI) sold under the brand name Celexa.

    While these medications are sometimes prescribed together in the treatment of co-occurring major depression disorder and insomnia, they may interact with unwanted or dangerous effects when they’re not used as directed.

    Drug Interactions & Serotonin Syndrome

    Taking trazodone and citalopram in combination increases the risk that you’ll experience a serious condition known as serotonin syndrome or serotonin toxicity. 

    The neurotransmitter serotonin is used by the central nervous system (CNS) to influence a wide range of physical and mental functions, including mood, digestion, sleep, blood clotting, bone density, and sexual function. 

    By increasing serotonin levels through medication, healthcare professionals are able to improve your mood and mental function. But if serotonin levels climb too high, like as a result of mixing serotonin-increasing (serotonergic) substances, the effects can be problematic. 

    Signs and symptoms of serotonin syndrome may include:

    • confusion
    • hallucinations
    • seizures
    • severe changes in blood pressure
    • increased heart rate
    • high body temperature
    • excessive sweating
    • shivering
    • muscle spasms or stiffness
    • blurred vision
    • impaired movement and coordination
    • stomach cramps
    • nausea and vomiting
    • diarrhea
    • irregular heartbeat/heart attack

    Summon immediate medical assistance if you or someone nearby begins experiencing these symptoms, especially changes in heart rhythm. Note that in severe cases, serotonin syndrome can be a life-threatening condition.

    Avoid Other Serotonin Increasing Substances

    While using one or both of these medications, it is important to avoid other serotonergic substances or supplements whenever possible. 

    This includes other SSRIs, tricyclic antidepressants, norepinephrine-serotonin reuptake inhibitors (SNRIs), St. John’s Wort, lithium, monoamine oxidase inhibitors (MAOIs), MDMA/Ecstasy, tryptophan, and others.

    Potential Side-Effects & Risks Of Mixing Antidepressants

    Potential side-effects of mixing trazodone and citalopram, as well as all other SSRI medications including escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft), may include:

    Physical Discomfort

    Minor physical side effects are a common experience among those starting treatment on a new antidepressant or changing dosage. These effects likely fade with time, and may include:

    • headaches
    • diarrhea or constipation
    • drowsiness or sleepiness
    • nervousness
    • lightheadedness
    • sleep changes
    • dry mouth
    • sweating
    • yawning

    If you notice your symptoms worsening over time, contact your health provider.

    Sexual Dysfunction

    Because elevated levels of serotonin decrease sexual desire and ability, antidepressant medications may contribute to various forms of sexual dysfunction, including: 

    • decreased sex drive
    • difficulty achieving orgasm (either alone or with a partner)
    • difficulty achieving or maintaining an erection (impotence)

    While this adverse effect likely fades as the body adapts to the new medication, lasting sexual dysfunction may occur when you continuously mix two antidepressants.

    Weight Loss Or Weight Gain

    Antidepressants may cause changes in appetite and corresponding weight gain or weight loss. 

    While weight loss is slightly more common among those taking trazodone, weight gain is more strongly associated with use of citalopram. 

    Suicidal Thoughts

    Drugs used to treat depression may, in rare cases, cause an increase in suicidal thoughts or behavior. 

    This risk primarily concerns children, teenagers, and young adults during the first few months of treatment or during dosage changes. However, some reports have cited a worrying increase in suicide and suicide attempts among veterans treated with trazodone.

    Discontinuation Syndrome

    While neither citalopram or trazodone are addictive substances, physiological dependence may develop if these drugs are taken over an extended period of time. 

    This means that when you stop taking one or both medications, you may experience withdrawal symptoms (anxiety, agitation, sleep disturbances, etc.) known as discontinuation syndrome. 

    To avoid these symptoms, doctors prescribing antidepressants will likely taper down antidepressant doses over time, before stopping your treatment entirely.

    For information on available substance abuse and addiction treatment options, please contact us today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Food and Drug Administration (FDA) - Celexa Label
    Food and Drug Administration (FDA) - Desyrel Label
    National Library of Medicine: MedlinePlus - Citalopram
    National Library of Medicine: MedlinePlus - Trazodone
    Shanghai Archives of Psychiatry - Combining antidepressants

    Medically Reviewed by
    Kimberly Langdon M.D.
    on June 24, 2022
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