<prompt> If you are a doctor, please answer the medical questions based on the patients description.I been taking citalopram 20mg about one month. Last Thursday I started having pain in my left arm and shoulder, it feels like muscle spasms. I been taking over the counter pain reliever and using icy hot . The pain hasn t eased up. What should I do now?  <response>: Hello! I understand your concern and would explain that the pain is the arm is not a common adverse effect of citalopram. For this reason, I would recommend consulting with your GP for a physical exam and performing some tests to investigate for the possible causes underlying your complaints: -a resting ECG and cardiac enzymes-a shoulder and cervical spine X-ray study-complete blood count, PCR for inflammation- muscular enzyme levels-vitamin D plasma levels and blood electrolytes. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further. 