Citalopram (Celexa)

This article provides an overview of citalopram, including its benefits and indications, side effects, precautions, and drug interactions.

Key Takeaways:

• Citalopram is an antidepressant medication within the SSRI drug class. It is primarily used to treat depression, and it is also used off-label for certain anxiety disorders and other conditions.
• Citalopram has many possible side effects, some of which may be severe. These risks are increased in individuals with certain medical conditions, children, and elderly individuals.
• Citalopram has several potentially harmful drug interactions, especially with other drugs that also increase serotonin; this increases the risk of serotonin syndrome.

Citalopram Overview

Citalopram is a prescription antidepressant medication that belongs to the class of selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most common type of antidepressants and include many other medications, such as escitalopram and sertraline. ^[1]

Like other SSRIs, citalopram is generally deemed safer than some of the older antidepressants and may be more effective at helping individuals manage depression and low mood. In turn, this can help individuals feel better and function more effectively regularly, such as with school, work, and relationships. ^{[1] [2]}

Brand Names

The most common brand name of citalopram in the United States is Celexa®. ^[1]

Other brand names of citalopram in various countries include:

• Cipramil®
• Celapram®
• Elopram®

This is not the full list of all brand names.

How Does Citalopram Work?

Citalopram works by increasing the effects of serotonin, which is a neurotransmitter involved in mood, appetite, sleep, anxiety, sexual function, and other key areas related to mental health. ^[3]

Citalopram does this by inhibiting the reuptake of serotonin by nerve cells, which allows more serotonin to be available in the brain. Among all SSRIs, citalopram seems to be the most selective for serotonin reuptake inhibition. ^[4]

When is it prescribed?

Citalopram is approved to treat major depressive disorder (MDD) in adults aged 18 and over. It has been shown to help reduce some of the primary symptoms of MDD, such as intense sadness, hopelessness, guilt, sleep issues, suicidality, and fatigue. ^[3]

Citalopram may also be used for general symptoms of depression, as well as several other mental health conditions, including:

• Obsessive-compulsive disorder (OCD)
• Social anxiety disorder (SAD)
• Alcoholism
• Panic disorder
• Premenstrual dysphoric disorder (PMDD)
• Post-traumatic stress disorder (PTSD)

These citalopram uses are considered off-label since it is not officially approved to treat these conditions.

What to Know Before Taking Citalopram

There are several important points you should know before taking citalopram. Citalopram can interact with many medications, including potentially serious ones with other SSRIs, monoamine oxidase inhibitors (MAOIs), and certain antipsychotics. Make sure to read the label of citalopram to make sure you are not allergic to the medication or any of its ingredients.

Citalopram can cause changes in thoughts and behaviors, including an increased risk of suicide and depression. This risk is greatest in children and young adults under 25. ^{[1] [3]}

It’s important to tell your doctor if you drink, have a history of consuming large amounts of alcohol, have a history of using illicit drugs, or if you’ve ever misused prescription medications. Due to the way citalopram works in the body, it’s also important to let your doctor know if you have a history of any of the following conditions: ^{[1] [5]}

• QT prolongation.
• Heart attack.
• Slow or irregular heartbeat.
• Heart failure.
• Other heart conditions.
• High blood pressure.
• Bleeding problems.
• Stroke.
• Low levels of magnesium, sodium, or potassium in the blood.
• Seizures.
• Liver or kidney disease.

Tell your doctor if you’re pregnant or planning to become pregnant. Citalopram may increase the risk of birth complications, especially if it is taken in the third trimester. ^{[1] [3]}

You should also know that citalopram may cause drowsiness, which may make it unsafe to drive, operate machinery, or perform other complex mental or physical tasks. Do not engage in these activities after taking citalopram until you know how it affects you and you receive your doctor’s approval to do so. ^[1]

Dosage

Citalopram comes as tablets or liquid. Listed below are the typical dosages for the treatment of depression in adults: ^{[3] [4]}

• Initial dose: 20 mg orally, once per day.
• Maintenance dose: 20 to 40 mg orally, once per day.
• Maximum dose: 40 mg orally, once per day.

Doses greater than 40 mg per day are associated with an increased risk of QT prolongation, which is why this is the maximum dose.

Citalopram can be taken in the morning or evening, with or without food. Once a routine is established, it's important to take it the same way each time.

Precautions

Some individuals may require a lower dose of citalopram. Adults aged 60 and over typically receive a maximum dose of 20 mg, due to a greater risk of side effects. ^[6]

You may need a lower dose of citalopram if you have any of the health conditions mentioned above (e.g. heart problems, low electrolyte levels, high blood pressure).

Citalopram has not been approved for use in children. It is also not recommended for individuals with hepatic (liver) impairments. ^[3]

Individuals who are pregnant or breastfeeding should be monitored very closely when taking citalopram, especially during the last trimester.

Side Effects

There are many possible side effects of citalopram. Some side effects of citalopram will go away as your body adjusts to the medication, while others may not get better over time. Always talk to your doctor about any side effects or unusual symptoms you notice after taking citalopram.

Common Side Effects

The most common side effects of citalopram are: ^{[2] [3]}

• Dry mouth.
• Sweating.
• Trouble sleeping.
• Agitation.
• Sleepiness/drowsiness/tiredness.
• Weakness.
• Headache.
• Nausea/feeling sick.

Other relatively common citalopram side effects include: ^{[1] [2] [3]}

• Diarrhea
• Constipation
• Stomach pain
• Vomiting
• Heartburn
• Runny nose
• Decreased appetite
• Weight loss
• Increased thirst
• Frequent urination
• Yawning
• Muscle or joint pain.
• Sexual problems:
• In males: erectile dysfunction, decreased libido, delayed or absent ejaculation
• In females: decreased libido, delayed orgasm, or inability to have an orgasm
• Heavy menstrual periods

Rare and Severe Side Effects

There are several rare side effects of citalopram, some of which may be severe or life-threatening. They include: ^{[1] [2] [3]}

• Severe allergic reactions (anaphylaxis): Symptoms include:
• Swollen lips, mouth, eyes, tongue, or throat
• Trouble breathing (e.g., gasping, wheezing)
• Trouble swallowing
• Rash
• Fainting
• Suicidal thoughts and behaviors in adolescents and young adults: This risk is greatest when someone first starts citalopram and when the dose is changed. Symptoms to look out for include (but aren’t limited to):
• New or worsening depression
• Thoughts of harming or killing yourself (or plans to do so)
• Aggression
• Agitation
• Extreme worry and anxiety
• Restlessness
• Other changes in mood or behavior:
• Impulsivity
• Anxiety
• Panic attacks
• Hostility
• Abnormally talkative or active
• QT Prolongation: This is a change in heart rhythm, which also increases the risk of sudden death.
• Seizures
• Trouble with thinking, concentration, or memory
• Mania or hypomania: This may occur in individuals with bipolar disorder. Symptoms include:
• Euphoria or elated mood
• Extreme energy
• Decreased need for sleep
• Reckless behaviors
• Angle closure glaucoma: This is when fluid is unable to flow out of the eye, which can lead to vision loss.
• Bleeding

Contact your doctor as soon as possible if any of these more serious citalopram side effects occur.

Serotonin Syndrome

Citalopram also increases the risk of serotonin syndrome, which is a condition in which too much serotonin builds up in the nervous system. This risk is increased when citalopram is combined with other drugs that increase serotonin or with drugs that impair serotonin metabolism, or if you take a higher dose of citalopram than you’re prescribed. ^[3]

There are various symptoms of serotonin syndrome, including: ^{[3] [6]}

• Agitation
• Hallucinations
• Confusion
• Rapid heart rate
• Dizziness
• Tremors
• Muscle rigidity
• Nausea
• Dilated pupils

In severe instances, serotonin syndrome can lead to seizures, coma, and death.

Drug Interactions with Citalopram

There are several possible drug interactions with citalopram. Taking citalopram alongside other drugs that increase serotonin increases the risk of serotonin syndrome. Examples of other serotonergic drugs and substances are: ^{[1] [3]}

• Other SSRIs (e.g., escitalopram, fluoxetine, sertraline)
• MAOIs (e.g., methylene blue, linezolid, isocarboxazid)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) (e.g., venlafaxine, duloxetine)
• St. John’s wort
• Tryptophan

Citalopram also interacts with the following medications and substances: ^{[1] [3] [6]}

• Certain antipsychotics (e.g., pimozide)
• Certain antibiotics (e.g., gatifloxacin, moxifloxacin)
• Cimetidine
• Anticoagulants (e.g., warfarin)
• Aspirin
• NSAIDs (e.g., ibuprofen)
• Alcohol

This list does not contain all possible interactions. Always tell your doctor everything you take or have taken, including prescription and non-prescription medicines, herbs, vitamins, and supplements.

Cessation and Withdrawal

Stopping citalopram can cause withdrawal symptoms, especially if you suddenly discontinue use without medical supervision. This can lead to a range of symptoms, including: ^{[1] [3]}

• Nausea
• Sweating
• Mood changes
• Irritability
• Agitation
• Dizziness
• Anxiety
• Confusion
• Ringing in the ears (tinnitus)
• Headache
• Trouble sleeping
• Tingling
• Electric shock-like sensations

To help minimize these side effects, your doctor will gradually lower the dosage over several weeks, if not longer. Always follow your doctor’s guidelines when reducing the dose of citalopram.

When to Stop Taking Citalopram

Individuals with MDD or other forms of depression typically take citalopram for at least several months to achieve the greatest benefits. Some individuals with chronic depression may need long-term treatment, while others may only need to be treated temporarily.

The decision to stop taking citalopram is made after a thorough evaluation by your doctor. It’s important to be as honest as possible to determine the most appropriate treatment route.

Citalopram FAQs

Listed below are frequently asked questions about the use of citalopram.

Is citalopram addictive?

Citalopram is not considered addictive. However, suddenly stopping citalopram can cause withdrawal-like symptoms and is not safe.

Does it cause weight gain?

Citalopram has been reported to cause weight gain in some individuals, but this is not a very common side effect.

Author

Jack Cincotta

Jack Cincotta holds a M.S. degree in Psychology. He is also a board-certified holistic health practitioner through AADP and an AFPA-certified holistic health coach and nutritionist.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

David MilesPharmD

David is a seasoned Pharmacist, natural medicines expert, medical reviewer, and pastor.

Activity History - Medically reviewed on April 9, 2026 and last checked on March 19, 2026