Can you take Ativan with Celexa?

In this blog post, we are going to talk about taking ativan and celexa together. is an antidepressant, which can take up to 4 weeks to kick in. During this time, it causes a number of side effects and your doctor may prescribe another medication as an aid to help manage these effects, including benzodiazepines. 

Can you take Ativan with Celexa? 

Yes, you can take ativan with celexa, but only if it is prescribed by your mental healthcare professional. Various studies suggest the ativan can be used to help relieve anxiety and disturbed mood until your celexa starts to work. 

In fact, this combination can be used together for the treatment of comorbid anxiety and depression. This combination is, however, used for a small period of time because of the ability of ativan to cause addiction and tolerance, which may require dose escalation to provide desired therapeutic response. 

This is exactly why ativan is gradually tapered off when celexa starts to kick in, as this antidepressant can solely manage both depression and anxiety symptoms. This combination should be used cautiously and you should stay as away from alcohol as you can. 

The concomitant use can dangerously cloud your mind and you might even start behaving abnormally. Make sure you take only as much as your doctor has recommended you to take. Higher doses can lead to dangerous consequences. 

Ativan (Lorazepam) is a benzodiazepine. It is used to help control anxiety, convulsions and panic attacks. This medication basically mimics inhibitory chemicals in your brain, like GABA, to control the excessive neuronal activity. 

Celexa (Citalopram), on the other hand, is an antidepressant. It is a selective serotonin reuptake inhibitor (SSRI) and is used to treat mild to severe episodes of depression and generalised anxiety disorder. 

Celexa inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). This results in increased serotonergic activity. Celexa and every other antidepressant take time to kick in. 

They don’t work overnight and your body may take up to 8 weeks to adjust to the medicine. This is exactly why it’s said that antidepressants might make you feel worse before making you feel better. This sensation and anxiousness is controlled by ativan. 

It helps relieve the symptoms including restlessness, extreme distress, irritability, suicidal behavior, inability to engage in daily life activities, excessive sweating, isolation, hopelessness, worthlessness, confusion and social disconnection. 

How safe is the combination of celexa and ativan? 

The side effects and interactions associated with the concomitant use of ativan and celexa are dose dependent and can vary from person to person. The concomitant use may increase the risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc. 

Side effects are not just the effects of your drug but also how your body responds to the drug. Usually ativan is well tolerated, but some people may suffer from the side effects and might even stop the treatment because of them. 

It depends on the pre-existing health conditions as well. One of the side effects of benzodiazepines include respiratory depression, which is dose dependent. 

A person with normal respiratory function might not even notice this side effect on the normal therapeutic dose, but people with chronic breathing disorders like asthma, chronic obstructive pulmonary disease (COPD) and emphysema etc, can suffer from significant breathing difficulties. 

Similarly, celexa is considered safe to be used in cardiac patients, but it could cause QT elongation and make pre-existing arrhythmia even worse. Ativan is also known for causing an addiction, which is why it is not suitable for prolonged use. 

Doctors usually recommend using it as long as your antidepressant kicks in. After that, both anxiety and depression can be managed by celexa and ativan is slowly tapered off because it is not safe to use benzodiazepines for a long period of time. 

Both pharmacodynamics (how a drug affects your body) and pharmacokinetics (how your body affects a drug) are considered. 

It is always best to consult your healthcare provider and be certain that the combination of meds you’re about to use is compatible with any underlying health condition you might have. It is also important to make sure that all of your meds are compatible with one another. 

If we specifically talk about Ativan, it is associated with the following side effects:

• Dizziness
• Tiredness or fatigue 
• Drowsiness 
• Muscle pain
• Vision problems 
• Headache 
• Hypersomnia 
• Forgetfulness 
• Troubled or intrusive thoughts
• Impairment of motor coordination 
• Constipation or diarrhoea 
• Nausea 
• Vomiting 
• Increased or decreased appetite 

Serious side effects include:

• Allergic reaction associated with symptoms like redness of skin, itching, painful blisters, blue-purple patches, burning sensation etc. 
• Serious respiratory depression which lowers down breathing rate and can decrease the availability of oxygen in the blood. It could be life-threatening for people suffering from asthma or chronic obstructive pulmonary disease (COPD) 
• Dementia 
• Abnormal behaviour
• Blackouts 

Celexa, on the other hand, is also associated with a number of side effects. These include: 

• Nausea 
• Vomiting 
• Diarrhoea or Constipation 
• Acid reflux or heartburn 
• Abdominal pain 
• Loss of appetite 
• Weight gain or loss 
• Excessive sweating or night sweating (nocturnal/night hyperhidrosis) 
• Frequent urination 
• Polydipsia or excessive thirst
• Tremors 
• Muscle twitching and pain
• Drowsiness 
• Dizziness 
• Excessive tiredness or fatigue 
• Insomnia or inability to fall asleep 
• Xerostomia or dry mouth 
• Dysmenorrhea or heavy periods
• Flu like symptoms including irritation in eyes and runny nose
• Loss of libido in both male and females. Males may suffer from inability to release, while females may suffer from inability to have a climactic experience. 

Celexa (Citalopram) is also associated with some serious side effects, which may include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Auditory or visual hallucinations 
• Nose bleeds
• Severe headache
• Arrhythmia or abnormal heartbeats
• Impaired memory and concentration 
• Convulsions 
• Swelling or tenderness in different parts of the body.

Make sure you look out for the above mentioned side effects of both of these medicines. As we can see that they share some of these side effects and they both together may produce much more pronounced side effects as compared to the side effects caused by the individual drug. 

When to call your doctor? 

Immediately talk to your healthcare provider if you experience unusual side effects while taking ativan and celexa together.

Inform your doctor if you’re pregnant, trying to conceive. Ativan should not be used by pregnant women and celexa can also be dangerous for the fetus, especially when used in the third trimester. 

Inform your doctor if you’re a breastfeeding mother. Both of these drugs are capable of passing into the breastmilk and may cause side effects in newborns. 

Do not stop ativan or celexa abruptly. If it’s time for you to stop one or both of these meds, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

Report any problems with bleeding or bruising to your doctor. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider. 

Conclusion 

In this blog, we have discussed the concomitant use of celexa and ativan. Various studies suggest the ativan can be used to help relieve anxiety and disturbed mood until your celexa starts to work. In fact, this combination can be used together for the treatment of comorbid anxiety and depression. 

The side effects and interactions associated with the concomitant use of ativan and celexa are dose dependent and can vary from person to person. The concomitant use may increase the risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc. 

Make sure you only take this combination if approved by your healthcare professional and do not deviate from the prescribed doses. 

FAQs: celexa and ativan

Can you take Ativan with antidepressants?

Yes, you can take ativan with celexa, but only if it is prescribed by your mental healthcare professional. Various studies suggest the ativan can be used to help relieve anxiety and disturbed mood until your celexa starts to work. In fact, this combination can be used together for the treatment of comorbid anxiety and depression. 

What anxiety med can I take with Celexa?

You can take benzodiazepines with celexa but only if prescribed by your mental healthcare professional. The treatment with benzodiazepines is usually short because of their ability to cause a serious addiction. However, this combination is pretty common at low doses and can help treat depression comorbid with anxiety. 

What should you not take with Celexa?

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 
• Alcohol 

Which is better, Ativan or Celexa?

Ativan and celexa are two separate medications and are prescribed according to your condition. Ativan (Lorazepam) is a benzodiazepine. It is used to help control anxiety, convulsions and panic attacks. This medication basically mimics inhibitory chemicals in your brain, like GABA, to control the excessive neuronal activity. 

Celexa (Citalopram), on the other hand, is an antidepressant. It is a selective serotonin reuptake inhibitor (SSRI) and is used to treat mild to severe episodes of depression and generalised anxiety disorder. 

Celexa inhibits the reuptake of serotonin by blocking serotonin transporters (SERT), which results in increased serotonergic activity.

How quickly does Ativan work for anxiety?

Ativan has a rapid onset of action and can start calming down your anxiety within 20 to 30 minutes of tablet administration. This medication can cause addiction and tolerance. It should not be used for a prolonged period of time.

What should you not mix with Ativan?

• Antifungals and antivirals. They may inhibit the metabolism of clonazepam and cause toxicity. 
• Antiepileptics. The concomitant use may decrease the beneficial effects of clonazepam. 
• Anti-allergy medications. The concomitant use increases the risk of sedation 
• Narcotic analgesics or any other controlled substance. The concomitant use can cause serious CNS side effects. 
• Sleeping pills
• Other anxiolytics and tricyclic antidepressants (TCAs). 

References 

• F Petty et al. Biol Psychiatry. (1995) – Benzodiazepines as antidepressants: does GABA play a role in depression? https://pubmed.ncbi.nlm.nih.gov/8573660/
• Yusuke Ogawa, Nozomi Takeshima, and Cochrane (2019) – Antidepressants plus benzodiazepines for adults with major depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546439/#__ffn_sectitle
• Ativan – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-6685/ativan-oral/details
• Citalopram (Oral Route) https://www.mayoclinic.org/drugs-supplements/citalopram-oral-route/precautions/drg-20062980?p=1 
• Drug Interactions between Ativan and Celexa https://www.drugs.com/drug-interactions/ativan-with-celexa-1488-899-679-335.html#:~:text=Interactions%20between%20your%20drugs&text=Using%20LORazepam%20together%20with%20citalopram,%2C%20judgment%2C%20and%20motor%20coordination.