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What is citalopram?

Citalopram is a medication used to treat depression. It is an approved treatment for major depressive disorder (MDD). Citalopram can also treat other conditions, such as posttraumatic stress disorder (PTSD) and panic disorder. It belongs to the SSRI (Selective Serotonin Reuptake Inhibitor) class of antidepressants. This medicine raises serotonin levels in the brain.

Note that citalopram is unadvised for patients with heart or liver problems.

Citalopram is available in the form of:

  • Capsule (30mg)

  • Tablet (10mg, 20mg, 40mg)

  • Oral solution (10mg/5mL)

What is citalopram’s brand name?

Celexa is a well-known brand of citalopram.

What is citalopram used to treat?

The Food and Drug Administration (FDA) approved citalopram for major depressive disorder (MDD). Symptoms of depression include:

  • Suicidal thoughts

  • Loss of interest in usual activities

  • Sadness

  • Irritability

  • Low energy or agitation

  • Sleep disturbance (difficulty falling or staying asleep)

  • Feelings of hopelessness and worthlessness

  • Trouble concentrating

Citalopram is also often used off-label (unapproved use of an approved drug) to treat the following conditions:

  • Panic disorder

  • Alcoholism

  • Obsessive-compulsive disorder (OCD)

  • Posttraumatic stress disorder (PTSD)

  • Eating disorder

  • Premenstrual dysphoric disorder (PMDD)

How do you take citalopram?

Take citalopram orally. You should take it once per day, in the morning or the evening. You can take it with or without food. The best practice is to take it at the same time every day.

You should use the liquid solution with the provided dosing syringe. You can also use a pharmacy-bought special dosing spoon or a medicinal cup. Measure carefully to prevent overdosing.

The usual dose for adults is 20mg per day, increasing to 40mg in the following weeks. For adults 60 years old and above, the dosage of 20mg is the maximum recommendation.

The use of citalopram for children is not approved. Doctors may prescribe it to children if there’s a need to but with the highest precautions.¹

The usual dose for the off-label treatment of certain conditions is 20-40mg per day.

Even if you already feel well, do not suddenly stop using citalopram. It may lead to withdrawal symptoms and worsen your condition. Always follow your doctor’s advice.

Do not take citalopram together with escitalopram (Lexapro). You should avoid taking drugs that make you sleepy when taking citalopram.

Always follow the directions on your prescription label. Consult your doctor if your symptoms are worsening.

Seeing results

You can see results in one to two weeks of taking citalopram. Energy, sleep, and appetite can improve during this time. It may take six weeks or more to see the full benefits of citalopram. Adverse effects can also happen while taking this medication.

Potential side effects of citalopram

It is common for medications to have side effects, and citalopram is no exception. Some side effects are less serious and resolve in a few days. Other side effects can be harmful and may require immediate medical attention.

These common side effects pose a minimal threat and usually fade in a short time:

  • Fatigue

  • Increased sweating

  • Sleep disturbance

  • Nausea

  • Dry mouth

  • Drowsiness

Seek help and immediately call your doctor if you experience these severe side effects:

  • Confusion

  • Hallucinations

  • Seizures

  • Anxiety

  • An allergic reaction

  • Suicidal thoughts

Note that this is not the full list of side effects caused by citalopram.

It is vital to inform your doctor about the side effects you experience while taking citalopram. This is a good preventive measure to avoid more complications from occurring.

Always consult your doctor to know what to do when side effects occur.

Long-term use of citalopram

You should continue taking citalopram even if you are already feeling better. Your doctor may prescribe you an additional six months to one year of continued usage.

So far, there have been no recorded problems with using citalopram for a long time. It is effective when used as directed.

Missed doses

If you miss a dose of citalopram, take it as soon as you remember. If it is near the next scheduled dose, skip the missed one and wait for the next dose instead. Continue with your usual dosing schedule. Do not take double doses of citalopram.

Tell your doctor if you have missed your dose multiple times. A good practice is to have a pillbox and set calendar notes or phone reminders to avoid forgetting your medication.

Overdoses

The effects of citalopram overdose vary from person to person. Symptoms of overdose include:

  • Nausea

  • Vomiting

  • Seizures

  • Muscle pain

  • Bluish color around fingernails, fingers, and mouth

  • Fast heart rate

  • Dizziness

  • Coma

Call a doctor and your local poison control center immediately if these symptoms occur. You may need emergency medical care.

What to discuss with your doctor before you start taking citalopram

Before you start taking citalopram, it is crucial to discuss these factors with your doctor:

  • Symptoms that are currently bothering you. This helps your doctor prescribe the proper dosage for your condition.

  • Other medical conditions you have. 

  • Medications you took previously and if they were effective or not. Your doctor may prescribe the same medicine if it generated positive results for you before.

  • All medications you are currently taking. This is so that your doctor can check if citalopram can interact with your other medicines. Citalopram has serious interactions with some drugs, so it’s crucial to coordinate with your doctor.

  • Non-medication treatments you are receiving, such as talk therapy.

  • If you are pregnant, planning to be pregnant, or are currently nursing. Citalopram can have serious effects on babies.

  • Different allergies that you have, especially if you are allergic to citalopram, escitalopram, and other medicines. Tell your doctor immediately so they can prescribe an alternative.

Stopping citalopram

Consult your doctor if you plan to stop using citalopram. Even if you think you are fine and have finished your initial prescription, do not stop using citalopram on your own.

Your doctor may prescribe citalopram for an extended period of a few more weeks or even months, but with a gradual reduction of the dosage. This “tapering” reduces the risk of withdrawal symptoms such as agitation, dizziness, anxiety, and nausea.

There is also a big risk of depressive symptoms returning if you suddenly stop taking citalopram.

Only your doctor or healthcare provider can decide if it is okay to stop taking citalopram. 

Citalopram and pregnancy

Citalopram is known to affect the baby during pregnancy and nursing. Serious lung problems like persistent pulmonary hypertension of the newborn (PPHN)² may occur in the baby. This condition can be fatal for the baby and pose serious risks to the mother. However, the risk of this condition is less than 1%.

Pregnant women who take antidepressants during their third trimester are at a greater risk of going into labor before the infant is fully developed (below 37 weeks).

Seek advice from your doctor if you are pregnant, breastfeeding, or planning to become pregnant. This will allow your doctor to weigh the risks and benefits and give you the right prescription.

Interactions with other drugs

Citalopram has a long list of interactions with other drugs. The most notable ones are:

  • Monoamine oxidase inhibitors (MAOIs) pose a dangerous and even fatal drug interaction.

  • Pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs) pose a risk of internal bleeding. The risk is even greater with the use of over-the-counter pain relievers.

  • Other drugs that increase serotonin levels can lead to the development of serotonin syndrome.

It is advisable to talk to your doctor and discuss your other medications before taking citalopram. The patient information leaflet (PIL) contains a full list of interactions.

Allergy information

Patients allergic to citalopram and escitalopram and their ingredients should not use this medication. Check the product label for a list of ingredients of citalopram.

Allergic reactions such as hives, rash, restricted breathing, difficulty swallowing, and swelling are known allergic side effects of citalopram.

Discuss your allergies with your doctor so they can adjust your prescription accordingly.

Clinical trial history

Thirty randomized, double-blind, controlled studies³ of the effectiveness of citalopram for depression were located and reviewed. Researchers compared citalopram against placebo in 11 studies. Four additional studies investigated the efficacy of citalopram in preventing depression relapse. Compared with other antidepressants, citalopram was equally effective in treating depression.

Clinical trials demonstrated that citalopram is:

  • Better than placebo for treating depression

  • Just as effective as tricyclics and tetracyclics

  • Safe and well-tolerated

Unlike some other antidepressants, citalopram has a consistent and predictable effect and minimal drug interactions. Among the elderly and people with more than one condition, these features make citalopram an attractive treat­ment for depression.

Tips and advice for taking citalopram

  • Always follow your doctor’s prescription, as your doctor has assessed your needs. 

  • Do not adjust your dose. Failure to follow your prescribed dosage can lead to the medicine becoming ineffective and more serious medical conditions. Talk to your doctor if you have concerns about your prescribed dose.

  • Side effects are common for most medications. Tell your doctor about your side effects.

  • The full effect of citalopram may take a couple of months. This is common for most antidepressants. Be patient when taking this medication and trust the process.

  • While studies haven’t shown an interaction between citalopram and alcohol, drinking alcohol with citalopram is still not recommended. Alcohol is a depressant, and it can trigger depressive episodes.

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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