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Why does Celexa have a black box warning?

There is a black box warning for the antidepressant Celexa (citalopram) because a small subset of people who take the drug may experience worsened depression, suicidal thoughts and behaviors and potentially other psychiatric problems.

Celexa belongs to a category of drugs called selective serotonin reuptake inhibitors (SSRIs), which are believed to improve depression by adjusting the level of the chemical serotonin in the brain. In one review of the research on use of SSRIs in children, the Food and Drug Administration (FDA) found that about 4% of children and teens who took SSRIs experienced suicidal thinking or behavior, compared to 2% of children and teens who took placebos ("sugar" pills that did not contain active ingredients). The FDA now requires that packages of Celexa carry a black box warning, the most serious type of warning in prescription drug labeling, stating that the drug may increase suicidal thoughts and behaviors in children and adolescents.

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