1. About citalopram

    Citalopram is a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor).

    It's often used to treat depression and also sometimes for panic attacks.

    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.

  2. Key facts

    • 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 cause withdrawal symptoms so don't stop taking it without talking to your doctor.
    • Citalopram is called by the brand name Cipramil.
  3. Who can and can't take citalopram

    Citalopram can be taken by adults and children over the age of 12 years.

    Check with your doctor before starting to take citalopram if you:

    • have had an allergic reaction to citalopram or any other medicines in the past
    • 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
    • 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.

  4. 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 to 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 forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

    What if I take too much?

    Ask your doctor for advice straight away. An overdose can lead to potentially serious symptoms such as:

    • vomiting
    • shaking
    • feeling sleepy
    • fast heart rate
    • seizures
  5. Side effects

    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. 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.

    Common side effects

    Common side effects happen in more than 1 in 100 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects 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:

    • headaches, trouble focusing, memory problems, not thinking clearly, weakness, seizures, or losing your balance - these can be signs of low sodium levels
    • 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:

    • being sick blood, coughing up blood, blood in your pee, black or red poo - these can be signs of bleeding from the gut
    • 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

    In rare cases, it’s possible to have a serious allergic reaction to citalopram.

    A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

    The warning signs of a serious allergic reaction are:

    • getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • swelling of the mouth, face, lips, tongue, or throat

    These are not all the side effects of citalopram. For a full list see the leaflet inside your medicines packet.

    You can report any suspected side effect to the UK safety scheme.

  6. How to cope with side effects

    What to do about:

    • dry mouth- chew sugar-free gum or sugar-free sweets
    • sweating a lot - Try wearing loose clothing, using a strong anti-perspirant and keep cool using a fan when it's possible. If this doesn't help, talk to your doctor as you may be able to try a different type of antidepressant.
    • being unable to sleep- take citalopram first thing in the morning
    • feeling sleepy - cut down the amount of alcohol you drink. 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.
    • feeling tired or weak - Do not drive or use tools or machinery if you're feeling tired. Do not drink alcohol as it will make you feel worse.
  7. Pregnancy and breastfeeding

    It's important for you and your baby that you stay well during your pregnancy. If you become pregnant while taking citalopram speak to your doctor. Do not stop taking your medicine unless your doctor tells you to.

    Citalopram has been linked to a very small increased risk of problems for your unborn baby. However if your depression is not treated during pregnancy this can also increase the chance of problems.

    You may need to take citalopram during pregnancy if you need it to remain well. Your doctor can explain the risks and the benefits, and will help you decide which treatment is best for you and your baby.

    For more information about how citalopram can affect you and your baby during pregnancy, read this leaflet about the best use of medicines in pregnancy (BUMPS).

    Citalopram and breastfeeding

    If your doctor or health visitor says your baby is healthy, citalopram can be used during breastfeeding.

    Citalopram passes into breast milk in small amounts, and has been linked with side-effects in very few breastfed babies.

    It is important to continue taking citalopram to keep you well. Breastfeeding will also benefit both you and your baby.

    If you notice that your baby isn’t feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your health visitor or doctor as soon as possible.

    Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

  8. 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.​

    Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

  9. Common questions