Citalopram

What is citalopram used for?

Citalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It’s commonly prescribed to treat conditions like[1]: 

• Depression 

• Panic disorder 

• Anxiety disorder  

In these conditions, it helps to improve mood, sleep, appetite, and energy levels, while restoring interest in daily life. 

How does citalopram work?

Citalopram works by increasing the level of serotonin, a natural chemical in the brain that helps regulate mood. It does this by blocking the reabsorption (or reuptake) of serotonin into the nerve cells, which means more serotonin stays available to help improve communication between brain cells and support emotional balance[2].  

Who can take citalopram?

Citalopram is generally suitable for adults and for children aged 12 and over, depending on the condition being treated.  

If you take citalopram and have diabetes, it can be hard to keep your blood sugar levels stable. You’ll need to monitor your blood sugar regularly in the first few weeks of taking citalopram and make changes to your diabetes treatment if needed[1]. 

Citalopram may not be suitable if you: 

• Have had an allergic reaction to citalopram or any other medicine 

• Have a heart problem 

• Are trying to become pregnant, are pregnant, or are breastfeeding 

• Have glaucoma 

• Have epilepsy 

• Have ever had a bleeding disorder (e.g., haemophilia) 

• Have ever had a stomach ulcer[1] 

Please tell your doctor or pharmacist about any conditions you may have before starting citalopram, and always follow the instructions in the Patient Information Leaflet[3].

What is the typical dosage of citalopram?

You can get citalopram in 10mg, 20mg, and 40mg tablets. Citalopram can also come in liquid drops, with 5 drops equal to a 10mg tablet 

The standard dose is 20mg a day for adults. However, you may start on a lower dose and increase to a maximum dose of 40mg a day.  

If citalopram is prescribed for panic attacks, the starting dose will normally be 10mg daily. If you’re over 65, or have liver problems, the maximum recommended dose is 20mg daily (16mg if using oral drops). 

If citalopram is prescribed to a child, the usual dose is 10mg daily, but it can be increased to 40mg depending on the individual circumstances[1]. 

How do you take citalopram?

Citalopram is taken once daily, with or without food. You should try to take it at the same time every day. 

You should swallow the tablets whole with water. If you are taking liquid drops, these can be applied straight onto the tongue, or taken in a drink of water, orange juice or apple juice but ensure the whole dose is taken, [1][2]. 

Can you stop taking citalopram?

You should not stop taking citalopram suddenly, and without speaking to your doctor or pharmacist first.  

If you have been feeling improvements for 6 months or more, your doctor or pharmacist may suggest coming off the medicine. They will likely recommend that you taper off citalopram, reducing your dose gradually over a period of weeks, or longer if you’ve been taking it for a long time. 

This will help to reduce any withdrawal symptoms you may experience. These can include: 

• Dizziness 

• Nausea 

• Numbness or tingling in hands and/or feet 

• Trouble sleeping 

• Agitation or anxiety 

• Headaches 

• Shaking[1][2] 

What do you do if you take too much citalopram?

Taking too much citalopram can be dangerous, but the amount needed for an overdose depends on the person. Symptoms of overdose include:  

• Nausea  

• Tremor 

• Drowsiness 

• Fast heart rate 

• Seizures [1][2] 

You should call 999 or go to A&E immediately if you or someone else has taken too much and is experiencing any of the above-mentioned symptoms. 

What do you do if you forget to take citalopram?

If you miss a dose, skip it, and take your next dose at the usual time the following day. You should never take two doses to make up for forgetting one. If you frequently forget to take a dose, it may be a good idea to set alarms or speak to your pharmacist for advice on ways to help you remember to take your medication. 

What medicines can you and can't take with citalopram? 

You should speak to your doctor or pharmacist before starting citalopram if you are taking[1]:  

• Any medicines that affect your heartbeat 

• Any other medicines for depression 

• St John’s Wort, a herbal remedy used for low mood 

• Certain painkillers (e.g., tramadol)  

• Some antipsychotics 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[3]. 

What are the side effects of citalopram? 

The most common side effects of citalopram occur in more than 1 in 100 people. These include[1]: 

• Headaches and nausea  

• Dry mouth  

• Sweating  

• Sleep problems  

• Fatigue  

• Sexual dysfunction  

The rare, more serious side effects occur in less than 1 in 1,000 people. These include[1]: 

• Suicidal thoughts 

• Seizures 

• Changes in your periods 

• Unexplained bleeding and/or bruising 

• Restlessness 

• Irregular heartbeat 

• Serotonin syndrome  

You should call 999 or go to A&E immediately if you have symptoms of chest pain, breathing difficulty, seizures or fainting [1]. 

Frequently asked questions about citalopram

How long does citalopram take to work? 

You might notice improvement taking citalopram after 1 to 2 weeks, but it could take around 4 to 6 weeks to feel the full effect. 

It is recommended to trial citalopram for at least 6 weeks before deciding it isn’t working for you[1]. 

How will citalopram make me feel? 

Citalopram, like other antidepressants, should help improve your mood, sleep, and reduce your anxiety.  

It’s important to note that while it can help you feel like yourself again, it will not change your personality. You shouldn’t expect to feel better instantly either, as some people will feel worse initially before they see signs of improvement[1]. 

How does citalopram compare with other antidepressants? 

Citalopram is no better or worse than other antidepressants. The effect of each antidepressant depends on each person taking them. You should talk to your doctor or pharmacist if you’re not feeling any better after 6 weeks[1]. 

Can I drink alcohol while taking citalopram?  

You should limit or avoid alcohol, as it can increase drowsiness and side effects[1].  

Will I gain weight while taking citalopram?  

Citalopram can make you feel less hungry when you first start taking it, so you may lose weight at first. You might gain weight as your appetite returns. 

If you start having weight issues while taking citalopram, try to implement a balanced diet and regular exercise routine, but you can also speak to your doctor or pharmacist[1]. 

Is citalopram addictive?  

Citalopram is not addictive, but stopping suddenly can cause withdrawal symptoms[1].  

Will citalopram affect my contraception? 

No, citalopram should not affect any type of contraception[1]. 

Can I drive or ride a bike while taking citalopram? 

Some people experience concentration problems when they’re first taking citalopram, so it might be best to avoid driving, operating machinery or riding a bike for the first few days, until you know how it makes you feel[1]. 

Can taking recreational drugs with citalopram affect me? 

It can be dangerous to take citalopram with[1]: 

• Cannabis 

• Stimulants like MDMA or cocaine 

• Hallucinogens like LSD 

• Psychoactive substances or legal highs like mephedrone

For the official NHS guide to citalopram, visit their website.