Citalopram is a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor).
Citalopram helps many people recover from depression, and it has fewer unwanted effects than older antidepressants.
Citalopram is available on prescription as tablets and as liquid drops that you put in a drink of water.
- It usually takes 4 to 6 weeks for citalopram to work.
- Side effects such as tiredness, dry mouth and sweating are common. They are usually mild and go away after a couple of weeks.
- Citalopram can affect an unborn baby. Tell your doctor straight away if you’re trying to get pregnant or become pregnant while taking it.
- Citalopram can cause withdrawal symptoms so don't stop taking it without talking to your doctor.
- Citalopram is called by the brand name Cipramil.
Who can take citalopram
Citalopram can be taken by adults and children over the age of 12.
Check with your doctor before starting to take citalopram if you:
- have an allergy to citalopram or any of its ingredients
- have a heart problem – as citalopram can speed up or change your heartbeat
- have ever taken any other medicines for depression – some rarely used antidepressants can interact with citalopram to cause very high blood pressure even when they have been stopped for a few weeks
- are trying to become pregnant, are already pregnant or are breastfeeding – citalopram is usually not recommended in pregnancy or while breastfeeding
- have an eye condition called glaucoma because citalopram can increase the pressure in your eye
If you have diabetes, citalopram can make it more difficult to keep your blood sugar stable. Monitor your blood sugar more often for the first few weeks of treatment with citalopram and adjust your diabetes treatment if necessary.
How and when to take it
Take citalopram once a day. You can take it with or without food.
You can take citalopram at any time of day, as long as you stick to the same time every day. If you have trouble sleeping, it's best to take it in the morning.
How much will I take?
Citalopram tablets come in different strengths ranging from 10mg to 40mg.
The usual dose of citalopram is 20mg a day in adults. However, it may be started at a lower dose and increased to a maximum dose of 40mg a day. If you are over 65, or have liver problems, the maximum recommended dose is 20mg a day.
The usual dose of citalopram in children is 10mg a day but this may be increased to 40mg a day.
With liquid drops of citalopram, 4 drops is equivalent to a 10mg tablet.
What if I forget to take it?
If you occasionally forget to take a dose, don't worry. Take your next dose the next day at the usual time. Never take 2 doses at the same time to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways that are suitable for you and your medicines.
What if I take too much?
Ask your doctor for advice straight away as overdose can lead to potentially serious symptoms such as:
- feeling sleepy
- fast heart rate
Like all medicines, citalopram can cause side effects in some people, but many people have no side effects or only minor ones. Some of the common side effects of citalopram will gradually improve as your body gets used to it.
Common side effects
Common side effects happen in more than 1 in 100 people. If you have these side effects, keep taking the medicine, but tell your doctor if they bother you or don't go away:
- dry mouth
- sweating a lot
- being unable to sleep
- feeling sleepy
- feeling tired or weak
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people. Tell a doctor straight away if you get:
- low sodium levels – warning signs include headache, trouble focusing, memory problems, not thinking clearly, weakness, seizures, or losing your balance
- thoughts about harming yourself or ending your life
- chest pain or pressure or shortness of breath
- severe dizziness or passing out
- putting on or losing weight without trying to
- changes in your periods such as heavy bleeding, spotting, or bleeding between periods
- painful erections that last longer than 4 hours – this may happen even when you're not having sex
Or, if you develop any signs of abnormal bleeding including:
- bleeding from the gut – warning signs include vomiting blood or dark vomit, coughing up blood, blood in your pee, black or red poo
- bleeding from the gums or bruises that appear without a reason or that get bigger
- any bleeding that is very bad or that you cannot stop
Serious allergic reaction
The warning signs of a serious allergic reaction are:
- developing a skin rash that may include itchy, red, swollen, blistered or peeling skin
- tightness in the chest or throat
- having trouble breathing or talking
- swelling of the mouth, face, lips, tongue or throat
How to cope with side effects
What to do about:
- feeling sleepy – cut down the amount of alcohol you drink
- dry mouth – chew sugar-free gum or sugar-free sweets
- being unable to sleep – take citalopram first thing in the morning
- feeling anxious – some people who take citalopram for panic attacks find their anxiety gets worse during the first few weeks of treatment. This usually wears off after a few weeks but speak to your doctor if it bothers you – a lower dose may help reduce your symptoms
You can reduce the chance of having a side effect that bothers you if you take citalopram in the evening. That way you're asleep when the level of medicine in your body is highest.
Cautions with other medicines
Some medicines and citalopram can interfere with each other and increase the chances of you having side effects.
Tell your doctor if you're taking these medicines before you start citalopram:
- any medicines that affect your heartbeat – citalopram can speed up or change your heartbeat
- any other medicines for depression – some rarely used antidepressants can interact with citalopram to cause very high blood pressure even when they've been stopped for a few weeks
Mixing citalopram with herbal remedies and supplements
Don't take St John's wort, the herbal remedy for depression, while you are being treated with citalopram as this will increase your risk of side effects.
Pregnancy and breastfeeding
Citalopram is generally not recommended in pregnancy or while breastfeeding.
No medicines for depression are considered completely safe to take in pregnancy or while breastfeeding. Your doctor will want to prescribe citalopram only when the benefits of you taking the medicine outweigh the risks.
Citalopram and similar antidepressants have been linked with a small risk of problems for the unborn baby when they're taken in early or late pregnancy.
Citalopram and breastfeeding
Citalopram passes into breast milk and has been linked with side effects, including withdrawal symptoms, in breastfed babies.
How does citalopram work?
When will I feel better?
How will it make me feel?
How long will I take it for?
Is it safe to take it for a long time?
Is citalopram better than other antidepressants?
Will I gain or lose weight?
Can I drive or ride a bike?
Will it affect my contraception?
Will it affect my sex life?
Can I drink alcohol with it?
Will recreational drugs affect it?
Is there any food or drink I need to avoid?
Are there other treatments that will help?
What's the difference between citalopram and escitalopram?