Gabapentin and Celexa: Is there any interaction?

In this blog post, we are going to talk about the possible interactions between gabapentin and Celexa. Celexa is an antidepressant which is used to treat a variety of mental health conditions. This blog will cover the safety and efficacy of the concomitant use of these two agents. 

Is there any interaction between Gabapentin and Celexa? 

Gabapentin and celexa do not usually interact together but the concomitant use at high doses may cause sodium deficiency, a condition called hyponatremia. Although it does not hold much clinical importance, if the sodium deficiency becomes severe, it may require proper replenishing treatment. 

Gabapentin and celexa can be used together for the treatment of anxiety and depression in epileptic patients. Gabapentin can also be taken for neuropathic pain. 

What is gabapentin and how does it work? 

Gabapentin is a gamma aminobutyric acid (GABA) analog. Gabapentin mimics the actions of GABA, which is an inhibitory neurotransmitter. GABA works by inhibiting the excessive neuronal firing in the brain which reduces the frequency of epileptic seizures. 

Gabapentin is also used to reduce the intensity of neuropathic pain by inhibiting nociceptors (pain receptors). This medication is a prescription medication and should be taken only at doses determined by your healthcare professional. 

It is not recommended to start or stop using any medication, especially while you’re being an antidepressant, with your doctor’s approval. 

What is celexa and how does it work? 

Celexa, brand name for Citalopram, is a selective serotonin reuptake inhibitor (SSRI). It works by inhibiting the reuptake of serotonin from the synaptic cleft back to the presynaptic neuron, which released this excitatory neurotransmitter in the first place. 

Celexa does that by blocking serotonin transporters (SERT) which are responsible to move serotonin back into the neuron. This results in increased amounts of active serotonin in your body which binds to its respective receptors present throughout the body.

Serotonin is a neurotransmitter responsible for modulating mood, cognition, reward, learning, memory, and various other psychological processes. 

Celexa is not just used for the treatment of anxiety and depression, but it is also used to treat several other mental health conditions including obsessive compulsive disorder (OCD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), eating disorders and premenstrual dysphoric disorder (PMDD).

If we look closely, both of these drugs have opposite mechanisms of action. One is responsible for increasing the amounts of excitatory neurotransmitters in your brain, while the other one works in the opposite way and decreases the availability of such neurotransmitters. 

It is extremely important to make sure if the concomitant use is absolutely required and there’s no other way around, because it is not recommended to use medications in combination when you can benefit from a single agent.

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

There’s no such medication that does not come with side effects. These two, being no exception, also possess some adverse effects. Common side effects of gabapentin include: 

• Xerostomia or dry mouth 
• Weight gain 
• Dizziness 
• Somnolence
• Swollen hands and feet
• Headache
• Vision problems 
• Cloudy mind
• Fatigue
• Confusion
• Joint pain 
• Difficulty in remembering things
• Abdominal pain 
• Muscle twitching 

Gabapentin can cause some serious side effects. These include:

• Suicidal behavior 
• Impaired motor coordination 
• Thrombocytopenia or decreased levels of platelets
• Water retention
• Rhabdomyolysis, a condition associated with abnormal breakdown of muscles
• Hypersensitive allergic reaction which may cause difficulty in breathing, tightening of chest skin rash, redness, blisters, etc. 

Although SSRIs are considered the safest antidepressants, they are still associated with a number of side effects. Common side effects 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.

Now, as you can clearly see, there are several side effects that are similar, including weight gain, dizziness, sleepiness, muscle twitching, fatigue etc. We can also clearly see some of the serious side effects being similar, including suicidal behavior, confusion, vision problems etc.

This clearly indicates that the use of these two agents together can cause something known as synergistic side effects. The concomitant use can highly increase the incidence of suicidal attempts in younger population. 

Make sure these two meds are used together only when your doctor has advised it. Using two medications together which affect your brain is not something ideal and should not be encouraged unless it is absolutely necessary to do so. 

Make sure you discuss everything in detail with your healthcare provider and ask if you’re at the best possible doses if you’re using these two together. 

How to ensure the proper use of gabapentin and celexa? 

Immediately talk to your healthcare provider if you experience unusual side effects while taking gabapentin and celexa together. Do not recommend this combination to someone else and use it as long as your doctor has advised. 

Inform your doctor if you’re pregnant or trying to conceive. It is extremely important to ensure safety of your meds during your pregnancy. Some meds can cross placenta and are capable of causing unwanted side effects in the growing fetus. 

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. 

Celexa may induce suicidal behavior in users 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 gabapentin 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. 

Conclusion 

In this blog, we have discussed the possible interactions between gabapentin and celexa. Hyponatremia was found to be the interaction between these two. It is a condition caused by sodium deficiency. However, this interaction is not common at lower doses. 

Both gabapentin and celexa are used for the treatment of generalised anxiety disorder (GAD). Gabapentin is believed to provide relief from the symptoms associated with GAD, including insomnia and gastrointestinal side effects like nausea, vomiting and diarrhoea. 

Celexa, on the other hand, can also be used for GAD, but it is not approved by the Food and Drug Administration (FDA) for the treatment and management of GAD. These two meds are associated with multiple side effects which affect people differently. 

FAQs: gabapentin and celexa

What should you not mix 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 

Can you take antidepressants while on gabapentin?

Gabapentin and antidepressants can be used together but the concomitant use at high doses may cause sodium deficiency, a condition called hyponatremia. 

Although it does not hold much clinical importance, if the sodium deficiency becomes severe, it may require proper replenishing treatment. 

Gabapentin and celexa can be used together for the treatment of anxiety and depression in epileptic patients. Gabapentin can also be taken for neuropathic pain. 

What drugs should not be taken with gabapentin?

• Narcotic analgesics: Both narcotic opioid analgesics and gabapentin decrease the amount of excitatory neurotransmitters in your brain. This can slow down your physiological functions including breathing rate. 
• Alcohol can also act as a central nervous system (CNS) depressant. The synergistic effects of alcohol and gabapentin can cause severe depression and suicidal behavior.
• Certain diabetic agents may react with gabapentin and cause increased water retention, which results in swelling or edema in upper and lower extremities, or any other part of the body.

Can you take gabapentin and Celexa at the same time?

Yes, you can take Gabapentin and celexa but only if prescribed by your healthcare provider. The concomitant use can help relieve the symptoms of depression and anxiety, as well as chronic pain. This combination is also quite efficacious for epilepsy comorbid with depression or anxiety. 

Make sure you don’t use any other medication with your antidepressant without your doctor’s approval. The concomitant use of these two may increase the risk of hyponatremia, a condition associated with sodium deficiency. 

What are the most common side effects of Celexa?

Common side effects 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 

Is there a medication that treats both depression and anxiety?

Yes, selective serotonin reuptake inhibitors (SSRIs) are well known for not only counteracting the symptoms associated with depression, but they also help relieve the symptoms of anxiety and several other mental health conditions including obsessive compulsive disorder (OCD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), eating disorders and premenstrual dysphoric disorder (PMDD). 

Does your brain go back to normal after antidepressants?

Your brain does go back to normal after you stop using antidepressants, but it takes time and this time taken depends on the duration of your antidepressant therapy. It could take up to 10 months to go back to your normal serotonin levels, after long-term antidepressant therapy.

References 

• Drug Interactions between Celexa and gabapentin https://www.drugs.com/drug-interactions/celexa-with-gabapentin-679-335-1147-0.html#:~:text=gabapentin%20citalopram&text=Treatment%20with%20citalopram%20may%20occasionally,anticonvulsants%20can%20increase%20that%20risk.
• Gabriel C Quintero – Review about gabapentin misuse, interactions, contraindications and side effects and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308580/
• Gabapentin https://my.clevelandclinic.org/health/drugs/21561-gabapentin
• Celexa – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-8603/celexa-oral/details
• R J Milne et al. Drugs. (1991) – Citalopram. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness https://pubmed.ncbi.nlm.nih.gov/1711447/