If you’re looking at treatment options for depression, you may be interested in learning more about citalopram. It’s a generic prescription drug used to treat depression in adults.

Citalopram comes as a tablet that you swallow. It also comes in other forms taken by mouth, including a capsule and a liquid solution. But those forms are not covered in this article.

If citalopram works for you, your doctor will likely recommend that you take it long term.

This article describes citalopram’s side effects. For more information about citalopram, including its uses, see this in-depth article.

Some people may experience mild to serious side effects during their citalopram treatment. Examples of citalopram’s commonly reported side effects include:

  • nausea*
  • dry mouth
  • sexual side effects, such as problems with ejaculation or orgasm
  • weakness
  • weight loss

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects may occur from taking citalopram. Examples of mild side effects that have been reported with citalopram include:

  • nausea*
  • vomiting or diarrhea
  • dry mouth
  • sexual side effects, such as problems with ejaculation or orgasm
  • weakness
  • weight loss
  • insomnia (trouble sleeping)
  • sleepiness
  • dizziness
  • agitation
  • runny nose
  • fatigue (low energy)
  • sweating
  • mild allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking citalopram unless your doctor recommends it.

Citalopram may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with citalopram, visit MedWatch.

Although serious side effects from citalopram aren’t common, they can occur. Serious side effects that have been reported include:

If you develop serious side effects while taking citalopram, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Citalopram has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

It’s possible to experience weight changes, including weight gain, while taking citalopram. In studies, weight gain and weight loss were reported in people taking citalopram.

Keep in mind that decreased appetite can be a symptom of depression, which citalopram is used to treat. Taking citalopram may improve your appetite, which may result in weight gain. This could be a sign that the medication is working and your condition is improving.

If you’re concerned about weight gain during your treatment, talk with your doctor or pharmacist.

It’s possible to experience withdrawal symptoms if you suddenly stop taking citalopram. (Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.) Due to this risk, you should not stop taking citalopram suddenly.

Symptoms of withdrawal from citalopram may include:

  • nausea
  • sweating
  • mood changes, like agitation or irritability
  • dizziness
  • tremor
  • confusion
  • headache
  • insomnia (trouble sleeping)
  • seizures

If you’d like to stop taking citalopram, talk with your doctor. They may recommend slowly decreasing your dose, which can reduce the risk of having side effects from stopping citalopram.

In some cases, your doctor may prescribe a different treatment for your depression. They will weigh the risks and benefits of stopping citalopram and determine what the best treatment option is for you.

Get answers to some frequently asked questions about citalopram’s side effects.

Does citalopram cause sexual side effects?

Yes, it’s possible for any selective serotonin reuptake inhibitor, including citalopram, to cause sexual side effects. Examples of these side effects include:

  • delayed ejaculation in males*
  • inability to have an orgasm in females*
  • decreased libido (sex drive) in males and females
  • erectile dysfunction in males

Sexual side effects were some of the most common side effects that people taking citalopram reported in studies. Your doctor may ask you questions about sexual side effects during your citalopram treatment. If you have this kind of side effect, your doctor may prescribe a lower dose of citalopram. In some cases, they may have you stop taking citalopram and switch to a different treatment.

If you’re concerned about having sexual side effects from citalopram, talk with your doctor.

* In this article, we use the terms “males” and females” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Do citalopram’s side effects vary depending on the strength (10 mg, 20 mg, or 40 mg)?

Yes, citalopram’s side effects could vary depending on which tablet strength or overall dosage you take. You’re exposed to more medication with a higher strength or dosage, which may raise your risk of certain side effects. For example, someone taking a dose of 40 milligrams (mg) may have a higher risk of side effects than someone taking 20 mg.

Before taking citalopram, talk with your doctor about what to expect during your treatment. If you do experience side effects from the drug, your doctor can suggest ways to treat or manage them.

Does citalopram cause headaches?

No, a headache isn’t a side effect of citalopram. But headaches may be a symptom of certain side effects of the drug. For example, citalopram may cause a low level of sodium in the blood, and a headache is a symptom of this condition.

For more information about low blood sodium levels, see the “Side effects explained” section below.

In addition, stopping citalopram suddenly may cause withdrawal symptoms, including headaches. To learn more, see the “Will I have withdrawal symptoms if I stop taking citalopram?” section above.

If you have headaches during your citalopram treatment, talk with your doctor. They can help determine what may be causing your headaches. In some cases, they may recommend taking an over-the-counter drug such as Tylenol (acetaminophen) or Advil (ibuprofen) to treat your headache.

Is hair loss a side effect of citalopram?

Citalopram can cause hair loss. But this was a rare side effect reported in studies of people taking the drug.

If you’re concerned about hair loss during your citalopram treatment, talk with your doctor. They can help determine what may be causing your hair loss and how to manage it.

Are there any long-term side effects of taking citalopram?

Yes, citalopram may cause long-term side effects. But most side effects reported in studies of the drug were not long term.

For example, it’s possible to experience weight changes while taking citalopram. This side effect should go away after stopping the drug. But it may take some time to return to your usual weight.

Long-term sexual side effects have also been reported by some people taking antidepressants like citalopram. These have lasted weeks or months after stopping the antidepressant.

Although rare, citalopram may cause heart rhythm problems that may be long term or life threatening.

In most cases, side effects will likely improve or go away completely if you stop taking citalopram.

If you’re concerned about taking citalopram due to the risk of long-term side effects, talk with your doctor. They can recommend the best treatment plan for you.

Learn more about some of the side effects citalopram may cause.

Risk of suicidal thoughts and behaviors

Citalopram may increase the risk of suicidal thoughts or behaviors in certain people taking the drug. In fact, citalopram has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Antidepressants, including citalopram, can raise the risk of suicidal thoughts and behaviors in children and young adults ages 24 years and younger. It’s important to note that citalopram is only approved for use in adults.

This risk is higher during the first few months of treatment and after any changes to the dosage.

If you have questions or concerns about your risk of suicidal thoughts or behaviors with citalopram, talk with your doctor.

What might help

While taking citalopram, watch for worsening depression symptoms or other mood changes, especially during your first few months of citalopram treatment or if your dosage changes. Also, tell your loved ones or close family members to monitor you for mood changes or worsening depression.

Symptoms of mood changes or worsening depression may include:

  • new or worsening anxiety
  • agitation or restlessness
  • impulsiveness
  • insomnia (trouble sleeping)
  • aggression

If you have worsening depression or suicidal thoughts and behaviors during your citalopram treatment, tell your doctor right away. You can also call the National Suicide Prevention Lifeline at 988. Your doctor may recommend stopping citalopram and trying a different medication for your depression.

Nausea

Citalopram can cause nausea in some people. In studies, this was a common side effect reported in people taking the drug. Nausea was the most common reason people stopped taking citalopram in studies.

What might help

If you experience nausea during your treatment with citalopram, talk with your doctor. In some cases, nausea can be a symptom of other side effects of the drug, some of which may be serious. For example, nausea can be a symptom of serotonin syndrome. (See the section directly below for details about this condition.)

Nausea can also be a symptom of withdrawal from citalopram. (To learn more, see the “Will I have withdrawal symptoms if I stop taking citalopram?” section above.)

If you experience nausea that bothers you, your doctor can help determine what may be causing it and the best way to treat it.

Serotonin syndrome

In rare cases, citalopram can cause serotonin syndrome (high levels of serotonin, a chemical in your brain). You may have a higher risk of this condition if you also take other drugs that can increase your serotonin levels.

Examples include:

What might help

While taking citalopram, you should watch for symptoms of serotonin syndrome. You should go to the hospital right away if you develop symptoms, as this condition can be life threatening.

Symptoms of serotonin syndrome may include:

If you develop symptoms of serotonin syndrome, your doctor may recommend stopping your citalopram treatment and switching to a different drug.

Low sodium levels in the blood

Citalopram may cause low sodium levels in your blood. Although this was not a common side effect reported in studies of the drug, it can occur.

What might help

While taking citalopram, watch for symptoms of low sodium levels. These may include:

  • trouble concentrating
  • headaches
  • memory problems
  • confusion
  • unsteadiness or falling
  • hallucinations
  • seizures

If you develop symptoms of low sodium levels in the blood, go to the hospital right away. In some cases, your doctor may recommend stopping your citalopram treatment if you develop this condition.

Allergic reaction

Like most drugs, citalopram can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to citalopram, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to citalopram, they may have you switch to a different treatment.

Keeping track of side effects

During your citalopram treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how citalopram affects you. They can then use this information to adjust your treatment plan if needed.

It’s possible for your risk of side effects to be increased if you have certain medical conditions. Be sure to tell your doctor about any medical conditions before starting citalopram.

Boxed warning: Risk of suicidal thoughts and behaviors

Citalopram has a boxed warning for the risk of suicidal thoughts or behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Antidepressants, including citalopram, can raise the risk of suicidal thoughts and behaviors in children and young adults ages 24 years and younger. It’s important to note that citalopram is only approved for use in adults.

To learn more, see the “Side effects explained” section above.

Other warnings

Citalopram may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether citalopram is a good treatment option for you.

Talk with your doctor about your health history before starting citalopram. Factors to consider include those described below.

Mood problems, such as bipolar disorder. Before taking citalopram, talk with your doctor about any mood problems, such as bipolar disorder, that you or any family member have or have had. Citalopram may cause mania or hypomania in people with bipolar disorder. Your doctor may monitor you more closely for symptoms of mania or hypomania during your treatment. In some cases, they may recommend a different treatment option for you.

Abnormal heart rhythm. If you have an abnormal heart rhythm called long QT syndrome, talk with your doctor before taking citalopram. This drug could increase your risk of long QT syndrome. If you already have this condition, taking citalopram may make it worse. Your doctor can determine whether citalopram is safe for you to take.

Low electrolyte levels in your blood. Citalopram can lower certain electrolyte levels, such as sodium. If you already have low sodium levels, taking citalopram may make your condition worse. Also, having low levels of magnesium or potassium can increase your risk of heart problems with citalopram. Your doctor may do frequent blood tests during your treatment to check your electrolyte levels. In some cases, they may recommend a different treatment option for you.

Allergic reaction. If you’ve had an allergic reaction to citalopram or any of its ingredients, your doctor will likely not prescribe citalopram. Ask them what other medications are better options for you.

Bleeding problems. If you have bleeding problems, such as hemophilia, tell your doctor before taking citalopram. This drug may increase your risk of bleeding. If you already have a condition that can cause bleeding, citalopram may worsen your condition. Your doctor can determine whether citalopram is right for you.

Seizures. If you have a seizure disorder, tell your doctor before taking citalopram. In rare cases, citalopram may increase the risk of seizures. If you have a condition that causes seizures, your risk may be even higher. If you have a seizure disorder, your doctor can determine whether citalopram is safe for you to take.

Glaucoma. Before taking citalopram, tell your doctor if you have glaucoma. This drug may make certain types of glaucoma worse. If you have glaucoma, your doctor may monitor your condition closely during your citalopram treatment. In some cases, they may recommend a different treatment option for you.

Alcohol and citalopram

There are no known interactions between alcohol and citalopram. But both citalopram and alcohol can cause some of the same side effects. Examples include:

  • nausea
  • vomiting
  • dizziness

If you drink alcohol while taking citalopram, you may have a higher risk of these side effects. Or the side effects may be worse if you do experience them.

If you drink alcohol, talk with your doctor about the amount (if any) that may be safe to drink during your citalopram treatment.

Pregnancy and breastfeeding while taking citalopram

It’s not known if citalopram is safe to take during pregnancy. There have been reports of complications at birth in people taking citalopram and other selective serotonin reuptake inhibitors during pregnancy.

But it’s important to note that stopping treatment with an antidepressant during pregnancy can cause depression symptoms to return. This may also affect your pregnancy.

If you’re pregnant or planning to become pregnant, talk with your doctor about the risk and benefits of taking citalopram.

If you do take citalopram while pregnant, consider enrolling in the drug’s pregnancy registry. Data collected from pregnancy registries help researchers better understand a drug’s risks if used during pregnancy. To sign up or learn more, visit the registry’s website or call 866-961-2388.

You should not take citalopram while breastfeeding. The drug passes into breast milk and could cause side effects in a breastfed child. Examples of these side effects include:

  • irritability
  • sleepiness
  • restlessness
  • eating less than usual
  • weight loss

If you’re breastfeeding or planning to breastfeed, talk with your doctor before taking citalopram. They can discuss your treatment options with you.

Although it’s possible for citalopram to be misused, this isn’t likely. (With misuse, a drug is taken in a way other than how it’s prescribed.) There haven’t yet been studies that look at the risk of citalopram misuse in humans. But animal studies show that there may be a low risk of misuse.

Before starting citalopram treatment, talk with your doctor about any past or present substance use disorder. They can determine whether this drug may be a safe treatment option for you.

Side effects may occur when taking citalopram, but they’re usually mild. In some cases, it’s possible to have serious side effects from citalopram.

If you have any questions about side effects that citalopram can cause, talk with your doctor. You can also ask them about Celexa, which is the brand-name version of citalopram.

Before taking citalopram, you may want to discuss the possible side effects with your doctor. Here are some questions to help get you started:

  • Do I have a higher risk of side effects because of my other medical conditions?
  • Will decreasing my dose reduce the side effects that I’m experiencing?
  • Is my risk of serotonin syndrome higher when I first start treatment with citalopram?
  • How do the side effects of citalopram compare to side effects of other drugs used to treat depression?

A generic drug and its brand-name version are expected to have the same side effects because they contain the same active ingredient. (An active ingredient is what makes a drug work.)

To learn more about citalopram or Celexa, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

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 another 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.