Uses
What is citalopram used for?
Citalopram is commonly used to treat depression.
Citalopram may also be used for other conditions as determined by your healthcare provider.
How does citalopram work (mechanism of action)?
Citalopram is an antidepressant that belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of a natural chemical called serotonin in the brain.
How is citalopram supplied (dosage forms)?
Citalopram is available in the following dosage forms that are taken by mouth.
- 30 mg oral capsules
- 10 mg/5mL oral solution
- 10 mg, 20 mg, 40 mg oral tablets
How should I store citalopram?
Oral Capsules and Tablets. Citalopram oral capsules or oral tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). They can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting them. Store in a cool, dry place.
Oral Liquid. Citalopram oral solution should be stored at room temperature, between 68 F to 77 F (20 C to 25 C).
Side Effects
What are the most common side effects of citalopram?
The most common side effects of citalopram are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Stomach problems such as nausea, constipation, or diarrhea
- Sleepiness
- Weakness
- Dizziness
- Sexual problems, including delayed ejaculation
- Fever
- Muscle aches and pain
- Agitation
- Infection in the nose or throat, sinus swelling
- Stiff joints
- Not feeling hungry
- Yawning
- Anxiety
- Trouble sleeping
- Sweating
- Shaking
- Dry mouth
There may be other side effects of citalopram that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of citalopram?
While less common, the most serious side effects of citalopram are described below, along with what to do if they happen.
Severe Allergic Reactions. Citalopram may cause allergic reactions, which can be serious. Stop using citalopram and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Heart Rhythm Changes. Citalopram may cause a rare dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Suicidal Thoughts or Actions. Citalopram or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior
Serotonin syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Citalopram can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.
- Sweating, fever, or flushing
- Confusion
- Feeling agitated or restless
- Seeing or hearing unusual things
- Dizziness
- Fast or racing heartbeat
- Nausea, vomiting, or diarrhea
- Muscle twitching, stiffness, or tremor
- Seizures
Extremely Elevated Mood (Mania). People with bipolar disorder have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as citalopram, may have a higher risk of having mania or a manic episode. Call your healthcare provider right away if you have any of the following symptoms of a manic episode.
- Dramatic increase in energy
- Significant trouble sleeping
- Your thoughts are racing and fast-paced
- Engaging in reckless behavior
- Having unusually grand ideas
- Feeling excessively happy or irritable
- Talking more or faster than usual
Seizures. Some people who have taken citalopram have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking citalopram and call your healthcare provider if you experience any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Glaucoma. Citalopram may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.
- Loss of vision
- Eye pain or redness
- Severe headache or vomiting
- Seeing bright, colorful circles around lights (vision halos)
Abnormal Bleeding. People taking citalopram or other antidepressants may have an increased risk of bleeding or bruising. You may be at higher risk if you are also taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, or a blood thinner such as warfarin (Coumadin, Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto). Tell your healthcare provider if you notice any changes in how easily you bruise or bleed.
Low Sodium Level (Hyponatremia). Citalopram may cause low sodium levels. Call your healthcare provider if you have any of the following symptoms of a low sodium level.
- Headache
- Drowsiness
- Muscle weakness or cramps
- Nausea, vomiting, or loss of appetite
- Tiredness or sleepiness
- Dizziness
- Weight gain
- Restlessness or irritability
- Change in your mental condition such as hallucinations, confusion, decreased awareness, or alertness
- Seizures
Sexual Problems. Taking citalopram or another selective serotonin reuptake inhibitor (SSRI) may cause sexual problems. Tell your healthcare provider if you have any of the following sexual problems.
- Decreased sex drive
- Delayed ejaculation or unable to have an ejaculation
- Problems getting or keeping an erection
- Delayed orgasm or unable to have an orgasm
Warnings & Precautions
Who should not use citalopram?
Allergies to Ingredients. People who are allergic to any of the following should not use citalopram.
- Citalopram
- Celexa
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific citalopram products they stock.
Drug Interactions. Citalopram should not be taken while you are using certain other medicines. Before taking citalopram, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about citalopram before using it?
You can take citalopram with or without food.
Do not take citalopram unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share citalopram with other people, even if they have the same condition as you. It may harm them.
Keep citalopram out of the reach of children.
People who are 60 and older can be at greater risk for some side effects from citalopram. Talk to your healthcare provider about your risks if you are in this age group.
Do not stop taking citalopram without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.
- Anxiety, irritability, or high or low mood
- Feeling restless
- Changes in sleep habits
- Headache
- Sweating or shaking
- Nausea
- Dizziness
- Electric-shock like feelings
- Confusion
Citalopram can make you feel tired or affect your thinking and reaction time. Do not drive or do other activities that require alertness and coordination until you know how citalopram affects you.
If using citalopram oral solution, use an accurate measuring device to measure the dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
What should I tell my healthcare provider before using citalopram?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if citalopram is right for you.
In particular, make sure that you discuss any of the following.
Current and past health conditions. Tell your healthcare provider if you have any of the following.
- Liver problems
- Kidney problems
- Heart problems, including heart attack, heart failure, abnormal heart rhythm, or long QT syndrome
- High blood pressure
- History of a stroke
- Low levels of potassium, magnesium, or sodium in your blood
- High pressure in the eye (glaucoma)
- Bipolar disorder, depression, suicidal thoughts or actions (or a family history of any of these conditions)
- Seizures (or a history of seizures)
- Any bleeding problems
Pregnancy. Taking citalopram later in pregnancy may lead to an increased risk of certain problems in your unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take citalopram while you are pregnant or trying to become pregnant.
If you become pregnant while taking citalopram, you can register for the National Pregnancy Registry for Antidepressants by calling 844-405-6185 or at https://womensmentalhealth.org/research/pregnancyregistry/antidepressants/. This registry collects safety information about the use of antidepressant medicines during pregnancy.
Breastfeeding. Citalopram may pass into your breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take citalopram while breastfeeding. If you breastfeed while taking citalopram, call your healthcare provider right away if your baby becomes sleepy or fussy, or is not feeding well or gaining weight.
Interactions
Does citalopram interact with foods or drinks?
There are no known interactions between citalopram and foods or drinks.
Avoid drinking alcohol while taking citalopram. The combination can increase sleepiness or affect your alertness or concentration.
Does citalopram interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking citalopram.
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease; this also includes intravenous methylene blue or the antibiotic linezolid
- Pimozide, which is a medicine used for Tourette syndrome
- A medicine used to control your heart rate or rhythm (antiarrhythmic)
- A selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI), which are medicines commonly used for anxiety and depression
- A type of medicine called a triptan, such as sumatriptan (Imitrex and others), eletriptan (Relpax), and others, which is commonly used to treat migraines
- St. John’s wort, which is a supplement that may be used to treat depression
- Tryptophan, which is a supplement that may be used to treat mental health conditions
- Lithium, which is a medicine for certain mental health conditions
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- Buspirone, which is a medicine for anxiety
- Amphetamines, such as Adderall, which are used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy
- Opioid pain medicines, such as tramadol, methadone, or fentanyl
- Medicines that affect bleeding, like a nonsteroidal anti-inflammatory drug (NSAID), warfarin, or aspirin
- Certain anticonvulsants, which are medicines used in people with epilepsy to treat and prevent seizures, such as phenytoin (Dilantin, Phenytek, and others) or carbamazepine (Tegretol)
Some other medicines may alter the blood levels of citalopram, and vice versa. Citalopram interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Overdose/Missed Dose
What should I do if I accidentally use too much citalopram?
If you or someone else has used too much citalopram, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of citalopram?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Citalopram (Celexa)?
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