Celexa and Remeron: Is there any interaction?

In this blog post, we are going to talk about the possible interactions between celexa and remeron. Celexa is an antidepressant which is used to treat a variety of mental health conditions. 

This antidepressant can often interact with other medications and may cause disturbing complications. This blog will cover the combined use of celexa and remeron. 

Is there any interaction between Celexa and Remeron? 

Celexa and Remeron may interact with each other and increase the risk of serotonin syndrome. Both agents are antidepressants and they both work by increasing the amounts of active serotonin in your system. Too much serotonergic activity can lead to disturbing symptoms including:

• Excessive sweating 
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Diarrhoea
• Bradycardia
• Tremors
• Muscle twitching and muscle pain
• Shivering and goosebumps
• Chills with fever 

These symptoms can vary from person to person. Some people may get away with mild symptoms, but some people can get life threatening complications. 

The incidence of serotonin syndrome also depends on the doses of these two meds. If you’re at high doses and continue to use this for a long period of time, you’re more likely to suffer from serotonin syndrome. 

What does research suggest? 

Several research studies have revealed the safety and efficacy of combination treatment of celexa and remeron. A 2004 study held clinical trials in order to determine the importance of the concomitant use of these two antidepressants. 

Many patients were enrolled in this study and their treatment for obsessive-compulsive disorder (OCD) was started at low doses. The study concluded that the combination treatment can be beneficial for a few initial weeks but as the treatment continued, there was no further treatment progression. 

It kind of stopped working till 12th week and the treatment was discontinued. It was noted that this combination treatment is not suitable for prolonged periods of time. Another old research study was conducted, but not on humans. 

The researchers co-administered celexa and remeron in rats and monitored the safety and efficacy. It was concluded that some rats could not tolerate the combination well while others show a good tolerability profile. 

In some rats, it was observed that remeron increased the activity of celexa, which resulted in more pronounced side effects. The study concluded that this combination may not be tolerated well by everyone. 

However, the results are inconclusive as the study was not based on human test subjects. Another 2019 research study was conducting clinical trials to determine the best possible treatment for antidepressant – resistant depression. 

The experts believed that stubborn depression can be treated with not one, but a combination of different classes of antidepressants. 

The study concluded that the combination of remeron with celexa or other antidepressants did not relieve the symptoms associated with treatment-resistant depression. 

Several other studies have indicated that the combination use at higher doses can cause serious complications and can significantly increase the risk of serotonin syndrome. Although serotonin syndrome is a rare condition, it can cause life-threatening consequences. 

Make sure you talk to your healthcare provider before using any medication along with your celexa. Do not combine meds on your own. 

How is Celexa different from Remeron? 

Celexa, brand name for Citalopram, is a selective serotonin reuptake inhibitor (SSRI). It inhibits the reuptake of serotonin from the synaptic cleft by blocking serotonin transporters (SERT). This results in increased serotonin activity in your body. 

Serotonin is a neurotransmitter responsible for modulating mood, cognition, reward, learning, memory, and various other psychological processes. Celexa is used for the treatment of the following health conditions:

• Mild to severe episodes of depression 
• Generalised anxiety disorder (GAD) 
• Obsessive compulsive disorder (OCD) 
• Post traumatic stress disorder (PTSD) 
• Social anxiety disorder (SAD) 
• Panic attacks 
• Eating disorders 
• Premenstrual Dysphoric Disorder (PMDD) 

Remeron, on the other hand, is a brand name for mirtazapine. It does not belong to any typical class of antidepressants and its mechanism of action is different from SSRIs and SNRIs. It does not block the reuptake of serotonin by any pathway. 

Remeron belongs to the tetracyclic antidepressants. It has a dual mode of action. Remeron is believed to be responsible for the activation of 5-HT1 receptors, which are one of the serotonin receptors. This antidepressant also acts on the noradrenergic system. 

Experts believe that remeron enhances the stimulatory action of the noradrenergic system which increases the secretion of serotonin. It also prevents the inhibitory action of the noradrenergic system which hinders the release of serotonin. 

This way, it actively increases the amount of this excitatory neurotransmitter in your system. Remeron can be used to treat the following health conditions:

• Depression 
• Anxiety 
• Treatment resistant depression 
• Depression in elderly patients
• Post-operative nausea
• Alcohol dependence
• Insomnia or inability to fall asleep 
• Neuropathic pain
• Inability to feel hungry/hunger suppression

Make sure you use these two meds only when the combination treatment is preferred by your mental healthcare professional. Do not start any other medication along with your prescribed antidepressant. 

Self medication is one of the most common reasons for drug interactions and excessive side effects. It is also important to rule out any possible interaction between your prescription medications. 

Drug interactions should be an important consideration before taking two or more medicines together. Yes, drugs in combination are often used to achieve better therapeutic response but this is not the case with every interaction. 

Some drugs are highly incompatible with one another. They often cancel out each other’s effects or antagonise them. Some drugs are so incompatible that they end up changing the entire chemical composition of one another. 

Some interfere with metabolism or bioavailability (the rate and extent at which the active drug moiety enters systemic circulation/blood). This can lead to drug accumulation in different parts of the body. 

It is always advised to inform your healthcare provider of any medicine you take before getting a new prescription. Your doctor will make sure not to prescribe any such drug which might interfere with those you are already taking. 

What are the side effects associated with the use of Celexa and Remeron? 

Both celexa and remeron are associated with some side effects. It is impossible to take an antidepressant, a drug that affects your brain, without having any unwanted effects. 

The intensity of these side effects depends on how much med you’re taking. If you’re at higher doses, you are more likely to suffer from them. Side effects associated with the use of celexa 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 ejaculate, while females may suffer from inability to have an orgasm. 

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.

Remeron (Mirtazapine) is also associated with some side effects. These include:

• Sleepiness or drowsiness 
• Excessive tiredness or fatigue 
• Dizziness or lightheadedness 
• Xerostomia or dry mouth 
• Anxiety 
• Agitation 
• Confusion 
• Gain of appetite
• Weight gain 
• Gastrointestinal side effects including nausea, vomiting and diarrhoea/Constipation 

Remeron 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. 
• Convulsions 
• QT prolongation 
• Pain and tightness in chest
• Arrhythmia 
• Flu like symptoms 

In case you suffer from an overdose on any one or both of these meds, call a helpline as soon as you can. Inform them properly how much is taken and when. Make sure you keep these pills away for your children and pets, if any. In order to do that, keep the bottle out of their reach. 

Both celexa and remeron come with a suicidal warning in people younger than 24 years of age. If  you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can. 

Do not stop these meds abruptly. If it’s time for you to stop one or both of these meds, your doctor will simply make 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 post, we have discussed the possible interactions between celexa and remeron. They may interact with each other and increase the risk of serotonin syndrome. 

We have also covered what researchers have to say about this combination. Make sure you stay safe and don’t use any medication without your doctor’s approval. 

FAQs: celexa and remeron

Can you take Remeron with Celexa?

Yes, you can take Remeron with Celexa but only if prescribed by your healthcare provider. Celexa and Remeron may interact with each other and increase the risk of serotonin syndrome. Both agents are antidepressants and they both work by increasing the amounts of active serotonin in your system. Too much serotonergic activity can lead to disturbing symptoms. 

Can you take Remeron with other antidepressants?

Yes, you can take Remeron with other antidepressants if prescribed by your healthcare provider. However, some studies suggest that the combination treatment may not be effective for treatment resistant depression. 

Which is better, Celexa or Remeron?

Both celexa and remeron are antidepressants. Celexa, brand name for Citalopram, is a selective serotonin reuptake inhibitor (SSRI), whereas remeron belongs to the tetracyclic antidepressants. Your healthcare provider will determine which one of these two is the best antidepressant for you, according to your condition. 

Can I switch from mirtazapine to citalopram?

Yes, you can switch from mirtazapine to citalopram if your healthcare provider suggests that. Your doctor will properly taper off mirtazapine and start citalopram from the lowest effective dose. 

Does Remeron help with anxiety?

Yes, remeron does help with anxiety. It can also be used for the following health conditions:

• Depression 
• Treatment resistant depression 
• Depression in elderly patients
• Post-operative nausea
• Alcohol dependence
• Insomnia or inability to fall asleep 
• Neuropathic pain
• Inability to feel hungry/hunger suppression

What medications should not be taken with Celexa?

• Monoaminoxidase inhibitors (MAOIs) 
• Pimozide 
• Non-steroidal anti-inflammatory drugs (NSAIDS) 
• Antipsychotics 
• Controlled substances 
• Alcohol 

References 

• Takahiro Masuda, Takeshi Inoue, and Ichiro Kusumi (2014) – Effect of the coadministration of citalopram with mirtazapine or atipamezole on rat contextual conditioned fear https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931693/#__ffn_sectitle
• Cornelius Schüle, MD, Gregor Laakmann, MD (2004) – Mirtazapine plus citalopram has short term but not longer term benefits over citalopram alone for the symptoms of obsessive compulsive disorder https://ebmh.bmj.com/content/8/2/42
• Combining mirtazapine with other antidepressants is not effective for treatment-resistant depression https://evidence.nihr.ac.uk/alert/combining-mirtazapine-with-other-antidepressants-is-not-effective-for-treatment-resistant-depression/