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An additional 284 patients with major depressive disorder were newly exposed to escitalopram in open-label trials.

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Neonates exposed to Celexa and other SSRIs or serotonin and norepinephrine reuptake inhibitorsSNRIslate in the third trimesterhave developed complications requiring prolonged hospitalizationrespiratory supportand tube feedingSuch complications can arise immediately upon deliveryReported clinical findings have included respiratory distresscyanosisapneaseizurestemperature instabilityfeeding difficultyvomitinghypoglycemiahypotoniahypertoniahyperreflexiatremorjitterinessirritabilityand constant cryingThese features are consistent with either a direct toxic effect of SSRIs and SNRIs orpossiblya drug discontinuation syndromeIt should be noted thatin some casesthe clinical picture is consistent with serotonin syndromesee WARNINGSSerotonin Syndrome

Although citalopram did not potentiate the cognitive and motor effects of alcohol in a clinical trialas with other psychotropic medicationsthe use of alcohol by depressed patients taking Celexa is not recommended.

Clinical experience with Celexa in patients with certain concomitant systemic illnesses is limitedDue to the risk of QT prolongationcitalopram use should be avoided in patients with certain cardiac conditionsand ECG monitoring is advised if Celexa must be used in such patientsElectrolytes should be monitored in treating patients with diseases or conditions that cause hypokalemia or hypomagnesemiasee WARNINGS

Take the missed dose as soon as you rememberSkip the missed dose if it is almost time for your next scheduled doseDo not take extra medicine to make up the missed dose.

Although in controlled studies Celexa has not been shown to impair psychomotor performanceany psychoactive drug may impair judgmentthinkingor motor skillsso patients should be cautioned about operating hazardous machineryincluding automobilesuntil they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities.

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citalopram hbr is an orally administered selective serotonin reuptake inhibitor ssri with a chemical structure unrelated to that of other ssris or of tricyclic, tetracyclic, or other available antidepressant agents.

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