NHS Issues Urgent Alert for Citalopram Users Regarding Potentially Fatal Combination

The National Health Service today issued a health alert for individuals taking citalopram, a commonly prescribed antidepressant, warning of potentially fatal consequences when combined with the herbal supplement St John’s Wort.

Citalopram, a selective serotonin reuptake inhibitor (SSRI), is widely prescribed in Britain to treat depression and panic attacks. Typically taken once daily, the medication generally takes four to six weeks to reach full effectiveness, though some improvements may be noticed within a week or two. While generally well-tolerated, citalopram can cause side effects such as insomnia, dry mouth, and nausea, which often subside as the body adjusts. More serious, though less common, side effects include unexplained weight changes and signs of increased bleeding.

The NHS specifically cautions against combining citalopram with St John’s Wort, also known as Hypericum perforatum, as this combination can lead to dangerously high levels of serotonin in the brain, a condition called serotonin syndrome. Serotonin syndrome, if left untreated, can be fatal. The warning comes as increasing numbers of people are self-treating with herbal remedies alongside prescribed medications, potentially unaware of dangerous interactions. Individuals experiencing symptoms of serotonin syndrome – which can include agitation, rapid heartbeat, and confusion – should seek immediate medical attention. More information on managing mental health can be found at Mind.

Most adults and children over 12 can take citalopram, but those with heart conditions, epilepsy, or diabetes, as well as pregnant or breastfeeding women, should discuss potential risks with their doctor. Any suspected side effects from citalopram can be reported to the MHRA Yellow Card scheme. The NHS advises anyone concerned about potential interactions to consult with their GP or pharmacist.