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Contraindications and Precautions Citalopram is contraindicated in (18): Concomitant use of: Monoamine oxidase inhibitors (MAOIs) Serotonin syndrome, including symptoms of: Myoclonus Muscle rigidity Diaphoresis Tremor Hyperreflexia Agitated delirium Hyperthermia Urokinase Pimozide Methylene blue Linezolid Dapoxetine Hypersensitivity to the drug or excipient Increases thioridazine concentrations Lead to dangerous arrhythmias Adverse Effects and Black Box Warnings Adverse effects of Citalopram include (18): Most common Drowsiness Insomnia Dizziness Headache (dose-dependent) Diaphoresis Nausea Vomiting Xerostomia Constipation Diarrhea Ejaculation disorder (dose-dependent) Less common Myocardial infarction Prolonged QT interval Torsades de pointes Hemorrhage Cerebrovascular accident Suicidal ideation Manic Serotonin syndrome Citalopram has a Black Box Warning related to increased risk of suicidal thoughts and ideation, particularly in pediatric patients and adult patients aged 18 to 24 (18)