In controlled trials with Celexa, activation of mania/hypomania occurred in 2% of patients with bipolar disorder. Mania/hypomania has been reported in a small percentage of patients with major affective disorders treated with other marketed antidepressants. As with all antidepressants, Celexa should be used cautiously in patients with a history of mania. In a very small percentage of patients treated with Celexa (one patient per 98 years of exposure) siezure conditions were observed.

Although no cognitive impairment was observed during testing, patients should still be cautioned about operating hazardous machinery including automobiles, until they are certain that Celexa therapy does not affect their ability to engage in such activities.

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