Noosh asked
Is it OK to take Robitussin DM Cough and Congestion whilst on citalopram 20 mg?
At a glance
- Taking Celexa (citalopram) with dextromethorphan-containing products can increase the risk of a rare, but serious condition known as serotonin syndrome.
Answer
There is a potential interaction between Robitussin DM and Celexa (citalopram). Use of both together isn't recommended unless directed by your doctor.
The cough suppressant in Robitussin DM, dextromethorphan, and Celexa can increase concentrations of the neurotransmitter serotonin in the brain. This increases the risk of a rare, but serious condition known as serotonin syndrome
Serotonin Syndrome Risk
The use of one or more medications that have serotonergic properties increases the risk of serotonin syndrome, which is characterized by a variety of symptoms including:
- Increases in body temperature (hyperthermia)
- Increases in blood pressure (hypertension)
- Muscle spasms
- Mental status changes
- Seizures
- Sweating
- Nausea
- Vomiting
Celexa Info
Celexa is an SSRI (selective serotonin reuptake inhibitor) and works by via a complex mechanism of action, but increases and enhances the actions of serotonin.
The prescribing information of the drug cautions the use of other serotonergic agents with it:
"If concomitant use of Celexa with other serotonergic drugs including, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, amphetamines, trytophan and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome particularly during treatment initiation and dose increases. Treatment with Celexa and any concomitant serotonergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated."
Dextromethorphan Info
The cough suppressant in Robitussin DM is dextromethorphan, which is classified as an N-methyl-D-aspartate (NMDA) antagonist. In regard to its antitussive actions, it works by decreasing the excitability of the cough center in the brain.
Dextromethorphan isn't strongly associated with increases in serotonin.
However, studies have shown that both therapeutic and supra-therapeutic doses can increases levels and has been associated with cases of serotonin syndrome and therefore must be used cautiously with other serotonergic drugs.
Final Words
As both Celexa (citalopram) and dextromethorphan have serotonergic properties, use together should be avoided unless directed by your doctor.
At the very least, it is important to be aware of the symptoms of serotonin syndrome and seek medical attention if they occur.
