Citalopram | Side Effects, Dosage, Uses & More
Advertisement

Generic Name:

citalopram, Oral tablet

All Brands

  • Celexa
SECTION 1 of 5

Highlights for citalopram

Oral tablet
1

Citalopram is an antidepressant drug. It’s used to treat depression. It’s available as an oral tablet and an oral solution. The tablet is available as the brand-name drug Celexa. The tablet is also available as a generic drug. The solution is only available as a generic drug.

2

This drug and other antidepressant drugs may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.

3

Don’t take a certain type of antidepressant called monoamine oxidase inhibitor (MAOI) while you’re taking or within 2 weeks of stopping citalopram. Don’t begin taking citalopram within 2 weeks after stopping an MAOI. Doing so could lead to a life-threatening condition called serotonin syndrome.

4

This drug can cause heart rhythm changes called QT prolongation or Torsade de Pointes, which can cause sudden death.

5
This drug can cause sleepiness or may affect your ability to make decisions, think clearly or react quickly. You shouldn’t drive, operate heavy machinery, or do anything that requires you to be alert until you know how citalopram affects you. Don’t use alcohol with citalopram.
IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suicidal thoughts warning. Citalopram use may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed. Watch for these changes and call your doctor right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if they’re severe.

Heart rhythm changes

Citalopram use can cause heart rhythm changes called QT prolongation or Torsade de Pointes, which can cause sudden death.

Don’t take with MAOIs

Unless directed by your doctor, don’t take a monoamine oxidase inhibitor (MAOI) while you take citalopram or within 2 weeks of stopping citalopram. Also, don’t start citalopram within 2 weeks of stopping an MAOI. Taking citalopram and an MAOI too close together in time could lead to a life-threatening condition called serotonin syndrome, which can cause high fever, uncontrolled muscle spasms, stiff muscles, sudden changes in heart rate or blood pressure, confusion, or loss of consciousness (passing out).

Don’t take pimozide

Taking citalopram and pimozide together can cause serious heart problems.

What is citaprolam?

Citalopram is a prescription drug. It’s available as an oral tablet and an oral solution. The tablet is available as the brand-name drug Celexa. It’s also available as a generic drug. The solution is only available as a generic drug.

Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Citalopram is used to treat depression.

How it works

Citalopram is part of the antidepressant drug class called selective serotonin reuptake inhibitors (SSRIs).

More Details

How it works

Citalopram is part of the antidepressant drug class called selective serotonin reuptake inhibitors (SSRIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. SSRIs act in your brain to increase levels of a substance called serotonin. Having more serotonin in your brain can improve symptoms of depression.

Advertisement
SECTION 2 of 5

citalopram Side Effects

Oral tablet

More Common Side Effects

The adult side effects for this drug are slightly different from the side effects for children.

  • Adult side effects can include:

    • nausea
    • sleepiness
    • weakness
    • dizziness
    • anxiousness
    • trouble sleeping
    • sexual problems
    • sweating
    • shaking
    • hunger
    • dry mouth
    • constipation
    • diarrhea
    • respiratory infections
    • yawning
  • Children’s side effects can include the above, plus:

    • increased thirst
    • abnormal increase in muscle movement or agitation
    • nosebleeds
    • more frequent urination
    • heavy menstrual periods
    • slowed growth rates and weight changes

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Suicidal thoughts or actions. Symptoms can include:

    • attempts to commit suicide
    • acting on dangerous impulses
    • acting aggressively or violently
    • thoughts about suicide or dying
    • new or worse depression
    • new or worse anxiety or panic attacks
    • agitation, restlessness, anger, irritability
    • trouble sleeping
  • Heart rhythm changes (QT prolongation and Torsade de Pointes). Symptoms can include:

    • chest pain
    • fast or slow heart rate
    • shortness of breath
    • dizziness or fainting
  • Serotonin syndrome. Symptoms can include:

    • agitation, hallucinations, coma, confusion, and difficulty thinking
    • coordination problems or muscle twitching (overactive reflexes)
    • racing heartbeat or high or low blood pressure
    • sweating or fever
    • nausea, vomiting, or diarrhea
    • muscle rigidity
  • Mania. Symptoms can include:

    • greatly increased energy
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
  • Seizures. Symptoms can include:

    • convulsions
    • falling down or sudden loss of muscle tone
    • sudden loss of awareness of surroundings
    • sudden loss of urine or bowel control
  • Visual problems. Symptoms can include:

    • eye pain
    • blurred vision
    • double vision
    • swelling or redness in or around your eyes
  • Low salt (sodium) levels in the blood. Symptoms can include:

    • headache
    • weakness or feeling unsteady
    • confusion, problems concentrating, or thinking or memory problems

Citalopram and Suicide

Citalopram is part of a class of drugs called selective serotonin reuptake inhibitors, and it works by increasing the levels of the chemical serotonin in your brain.

Like other SSRIs, citalopram may also increase the risk for suicidal thoughts and behaviors, especially within the first few months of taking the drug, or following a change in dosage. This risk is highest for children, teenagers, and young adults. Contact your doctor immediately if you notice any unusual or concerning changes in thoughts, mood, or behavior.

Learn more about antidepressants and suicide risk here.

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy
Citalopram can cause sleepiness. It may also affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, operate heavy machinery, or do other activities that require you to be alert until you know how citalopram affects you.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

citalopram May Interact with Other Medications

Oral tablet

Citalopram can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Don’t use alcohol with citalopram. Citalopram can cause sleepiness. It may affect your ability to make decisions, think clearly or react quickly. Drinking alcohol can increase these effects.

Medications that might interact with this drug

Drugs that increase serotonin levels

A possibly life-threatening condition called serotonin syndrome can occur when citalopram is used with other drugs that can increase serotonin levels in your body. This may be more likely when one of the drugs is first started or after dose increases. Examples of these drugs include:

  • buspirone
  • fentanyl
  • linezolid
  • lithium
  • medications for migraines called triptans:
    • almotriptan
    • sumatriptan
    • zolmitriptan
  • methylene blue
  • tricyclic antidepressants:
    • amitriptyline
    • imipramine
    • nortriptyline
  • monoamine oxidase inhibitors (MAOIs):
    • isocarboxazid
    • phenelzine
    • selegiline
    • tranylcypromine
  • St. John’s wort
  • tramadol

Drugs that affect heart rhythm

Citalopram shouldn’t be used with other drugs that affect your heart rhythm. Taking both citalopram and these drugs may increase your risk of heart rhythm changes that could be dangerous. Examples of these drugs include:

  • amiodarone
  • chlorpromazine
  • methadone
  • moxifloxacin
  • pentamidine
  • procainamide
  • quinidine
  • sotalol
  • thioridazine

Drugs that increase bleeding risk

Citalopram and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you’re also taking other medicines that increase bleeding risk.

Other drugs that increase your risk of bleeding include:

  • blood thinners:
    • warfarin
    • enoxaparin
    • dalteparin
    • heparin
  • nonsteroidal anti-inflammatory drugs:
    • ibuprofen
    • naproxen
    • ketorolac
  • aspirin

Tricyclic antidepressants (TCAs)

Caution should be used when using citalopram with a TCA. This can result in higher levels of the TCA in your body and more side effects.

Tricyclic antidepressants include:

  • amitriptyline
  • imipramine
  • nortriptyline

Drugs that cause sedation or drowsiness

Taking citalopram may increase the effects of drugs that cause sedation or drowsiness. Examples of these drugs include:

  • lorazepam
  • alprazolam
  • diazepam
  • midazolam
  • temazepam
  • zolpidem

Cytochrome P450 2C19 inhibitors

Cytochrome P450 2C19 is a protein in our body that often helps to break down drugs, including citalopram. Some drugs are known to slow down, or inhibit, the actions of this protein. When citalopram and drugs that slow down the actions of this protein are taken together, it may result in an amount of citalopram in your body that is too high. Examples of cytochrome P450 2C19 inhibitors include:

  • cimetidine
  • clopidogrel
  • chloramphenicol
  • fluvoxamine
  • omeprazole
  • modafinil

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Citalopram warnings
People with heart problems
People with heart problems

Don’t take citalopram if you have a heart problem, including a condition called congenital long QT syndrome. Taking citalopram may put you at higher risk of a serious heart rhythm change called QT prolongation, which can cause sudden death. People with slow heart rate, recent heart attack, or severe heart failure should also not take citalopram.

People with low potassium levels.
People with low potassium levels

Don’t take citalopram if you have low potassium levels. Taking citalopram and having low levels of potassium may put you at higher risk of a serious heart rhythm change called QT prolongation, which can cause sudden death.

People with low magnesium levels
People with low magnesium levels

Don’t take citalopram if you have low magnesium levels. Taking citalopram and having low levels of magnesium may put you at higher risk of a serious heart rhythm change called QT prolongation, which can cause sudden death.

 People with kidney disease
People with kidney disease

Talk to your doctor before using citalopram if you have kidney disease. This drug may build up and cause more side effects in people with severe kidney disease.

People with liver disease
People with liver disease

Citalopram is processed by the liver. If you have liver disease, the levels of this drug in your body might increase. You may have more side effects. People with liver disease shouldn’t take more than 20 mg of citalopram per day.

 People with a history of seizure disorder
People with a history of seizure disorder

Citalopram can increase your risk of seizures. Talk to your doctor before using this drug if you have a history of seizures.

Pregnant women
Pregnant women

Citalopram is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding
Women who are breast-feeding

Citalopram passes into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For children
For children

Citalopram can cause changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.

When to call the doctor
When to call the doctor

Call your doctor if your depression symptoms don’t get better, or if they get worse.

Allergies
Allergies

Citalopram can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your face, tongue, eyes, or mouth
  • rash, itchy welts (hives) or blisters, along or with fever or joint pain

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take citalopram (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Treatment of depression

Brand: Celexa

Form: Oral tablet
Strengths: 10 mg, 20 mg, 40 mg

Generic: citalopram

Form: Oral tablet
Strengths: 10 mg, 20 mg, 40 mg
Form: Oral solution
Strengths: 10 mg/5 mL
Adult dosage (ages 18–60 years)
  • The starting dose is 20 mg, taken once per day.
  • Your doctor may increase the dose. Doses shouldn’t be increased more than once per week.
  • The maximum dose is 40 mg, taken once per day. Don’t take more than 40 mg per day since higher doses increase the risk of QT prolongation.
Child dosage (ages 0–17 years)

It hasn’t been confirmed that citalopram is safe and effective for use in people younger than 18 years.

Senior dosage (ages 61 years and older)
  • Don’t take more than 20 mg once per day. The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.
  • Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.
Special considerations

Cytochrome P450 2C19 poor metabolizers: Cytochrome P450 2C19 is a protein in our body that often helps to break down drugs, including citalopram. People who don’t have very many 2C19 proteins or have less activity of their 2C19 proteins are called “poor metabolizers.” These people shouldn’t take more than 20 mg of citalopram once per day.

People with liver disease: Citalopram is processed by your liver. If you have liver problems, the levels of this drug in your body might increase. You may have more side effects People with liver disease shouldn’t take more than 20 mg of citalopram once per day.

Warnings

Don’t stop citalopram without talking to your doctor. Stopping citalopram too quickly can cause serious symptoms such as anxiety, irritability, high or low mood, feeling restless, changes in sleep habits, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, or confusion. Your doctor may ask you to reduce the dose gradually instead of quickly stopping the medication if these symptoms occur.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

If you stop taking the drug or don’t take it at all

Your depression won’t get better. It may even get worse.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have symptoms of serotonin syndrome. These include:

  • agitation
  • hallucinations
  • coma
  • confusion
  • coordination problems
  • muscle twitching
  • racing heartbeat
  • sweating
  • fever
  • nausea
  • vomiting
  • diarrhea
  • muscle rigidity

If you have any of these symptoms, call your doctor or go to the nearest emergency department.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You will know that citalopram is working if you notice that your depression symptoms are less severe or happen less often. You may not notice any change in your condition for the first several weeks that you take this drug. Sometimes it can take up to 2 months to start working.

Citalopram is used for long-term treatment.

Important considerations for taking citalopram
You can take citalopram with or without food
You can take citalopram with or without food
You can cut and crush the tablet
You can cut and crush the tablet
Store this drug carefully
Store this drug carefully
See Details
A prescription for this medication is refillable
A prescription for this medication is refillable
See Details
Travel
Travel
See Details
Clinical monitoring
Clinical monitoring
See Details
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
Insurance
Insurance
See Details

Store this drug carefully

  • Store citalopram tablets at room temperature 77°F (25°C).
  • The tablets can temporarily be stored at temperatures between 59ºF and 86°F (15ºC and 30°C).
  • Store citalopram oral solution at a temperature between 68ºF and 77°F (20ºC and 25°C).
  • The solution can temporarily be stored at temperatures between 59ºF and 86°F (15ºC and 30°C).
  • Keep it away from high temperatures.
  • Don’t store this medication in moist or damp areas, such as bathrooms. Keep the bottle tightly closed.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Mental health and depression.Your doctor will monitor your symptoms of depression to make sure that citalopram is working and that you’re not having suicidal thoughts, especially during the first few months after starting citalopram or after dose changes.
  • Electrolytes. Your doctor may also check the amount of potassium, magnesium, or salt (sodium) in your body at the start of treatment and at other times while you’re taking citalopram.
  • Heart rhythm. If you’re at risk for QT prolongation, your doctor may also check your heart rhythm using a test called an electrocardiogram (ECG).

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does citalopram Cost?

Oral tablet

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

Compare prices and save up to 80% on your next refill!

Lowest price for citalopram

Walmart $4.00
Kmart $5.00
Sams Club $5.89
These prices represent the lowest priced national pharmacies for citalopram on GoodRx. They may be lower than your insurance.

Enter your zip code to find the best deal near you.

These prices represent the lowest priced national pharmacies for citalopram on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 30, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement