Safety: Citalopram and cocaine suspected interaction

The MHRA has reported a possible interaction between cocaine and citalopram that could lead to subarachnoid haemorrhage, involving hypertension related to cocaine and an additive increased bleeding risk in combination with citalopram (class effect for SSRIs). 

Healthcare professionals should make an assessment of the patient’s condition before deciding to prescribe any medicine. This should consider recent use of other medicines including non-prescription medicines, herbal medicines, illicit drugs, and medicines purchased online.

Possible interactions with illicit drugs should be considered in patients who present with suspected adverse reactions to a medicine. These can be reported on a Yellow Card.