Can citalopram cause orthostatic hypotension or can it interact with nadolol?

Question

Hello, I have been taking citalopram 2.5 mg for 2 weeks and my blood pressure is dropping a lot. I must say that I suffer from severe orthostatic hypotension, I take midodrine 10 mg 3X a day as well as 10 mg of nadolol. Yes I measured it and lots of orthostatic hypotension of systolic drops between 25 and 34 one day. My cardiologist told me to lower the nadolol to 5 mg but I really feel it's worse since the tiny dose of citalopram...is this an effect that is more pronounced early in the treatment usually?

Naji-tom Samaha · Accepted Answer

Good morning, ma'am, Citalopram can indeed cause dizziness, especially at the beginning of treatment. Have you measured your blood pressure since starting citalopram? Thanks for the feedback! Orthostatic hypotension is a possible side effect reported by the manufacturer of citalopram, but I don't have any concrete information if it is temporary or not. Having said that, I think it would be better to discuss it with your pharmacist, who will be able to evaluate the situation more thoroughly and, if necessary, suggest alternatives to your doctor if deemed necessary, in addition to ensuring a close follow-up with you. Sincerely, Tom Samaha, pharmacist