Taking Citalopram And Nuvigil. Is There Any Test To Check Citalopram?

Posted on Thu, 24 Oct 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 24 Oct 2013 Answered on

Thu, 21 Nov 2013 Last reviewed on

Question : I am on 60mgHbr citalopram and 250mg Nuvigil and have been for several years. FDA came out with warning on rx more than 40mgHbr of citalopram, used lower dose for 45 days and systoms returned. MD ordered EKG and it was normal and I was put back on 60mgHbr of citalopram. FDA came out with another warning of adverse effects with the two meds. The NP at the sleep clinic called and told me to get a blood test ("celexa levels"). This did not make any sense because I don't believe you would target a "specific manufacturer". Got a call today and NP said just get blood test and EKG. Is there a blood test or testing that is correct to keep these two meds prescribed as they are but protect me from adverse affects and how frequently would the checks be recommended? I am a 65 YOF, in good health and no cardiac issue other than high tri for which I take generic Lipitor

Answered by Dr. Preeti Parakh (7 hours later)

Brief Answer: Test available for citalopram only. Detailed Answer: Hi, Welcome to Healthcare Magic! A blood test is available for testing citalopram levels in the blood but you are right in saying that it is not manufacturer specific. I feel that the NP might have said "celexa levels" instead of "citalopram levels" because it is simply easier to say. The purpose of measuring the serum levels of citalopram is mainly to ensure that the patient is compliant and not for preventing side effects. That is why it is not routinely done in all patients. Side effects can occur even in normal serum levels and so, blood level monitoring is not of much use in preventing side effects. But in your case, the reason for advising the test may have been that you are taking somewhat higher than usual dose and so, it will be better to ensure that you have levels within the normal range. Because of all these reasons, this test need not be repeated at regular intervals but should be done only when indicated. No test is available for measuring armodafinil (Nuvigil) levels in blood. I hope this answers your query. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (23 hours later)

The reason that the MD that was prescribing the Nuvigil was because a question was brought up regarding adverse effects of Nuvigil and citalopram that the FDA put out. The citalopram at 40mg which is the FDA recommended highest dosage was not enough to control the depression. My psychiatrist had me get an EKG and it was normal and she then wrote the script for the 60mgHbr. When I went to my primary for the blood test she was unaware of any blood test that would give the information the Sleep/Wake disorder MD was asking for. I guess what I would like now is the name of the appropriate test for checking the serum level of the citalopram?

Answered by Dr. Preeti Parakh (2 hours later)

Brief Answer: serum citalopram (celexa) drug level Detailed Answer: Hi, Welcome back! The test that needs to be done is just called "serum citalopram (celexa) drug level". I guess that your primary care doctor was not aware of it as it is not done routinely. Just tell her the name of the test and also inform her that the labs which do drug levels like those of valproate, phenytoin etc are likely to do this test also. She or her staff can then call your local lab if required and get the details. It will take around a week to get the results. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar