Citalopram, marketed under various brand names globally, is a widely prescribed antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class.
It is most commonly used for managing major depressive disorder and certain anxiety-related conditions, offering symptom relief typically within one to four weeks of consistent use.
In India, the most well-known Citalopram brand name in India includes Celica, Citrol, and Citalec, among others, ensuring broad accessibility.
What is Citalopram?
Citalopram, also known as Celexa, is an antidepressant that belongs to the selective serotonin reuptake inhibitor class. Severe depressive disorder, obsessive-compulsive disorder, panic disorder, and social phobia are all handled with it. It may take one to four weeks for the antidepressant effects to appear.
What Are the Uses of Citalopram?
Citalopram helps restore the balance of serotonin in the brain, which can uplift mood, improve concentration, and reduce anxiety. As a first-line SSRI, its tolerability profile makes it a preferred choice over older antidepressants.
Conditions Citalopram Treats
Major Depressive Disorder (MDD)
Generalized Anxiety Disorder (GAD)
Obsessive-Compulsive Disorder (OCD)
Panic Disorder and Social Anxiety Disorder
Off-label/Secondary Uses: Premenstrual Dysphoric Disorder (PMDD), post-traumatic stress disorder (PTSD), and neuropathic pain in some cases.
Secondary Uses of Citalopram
Management of chronic pain syndromes (off-label)
Adjunctive therapy in treatment-resistant depression
Citalopram selectively inhibits the reuptake of serotonin (5-HT) at the presynaptic neuronal membrane. By blocking the serotonin transporter, it increases serotonin concentration in the synaptic cleft, which enhances serotonergic neurotransmission.
In simple terms, it allows "feel-good" chemicals to remain in the brain longer, improving mood and reducing anxiety.
Because Citalopram is formulated as Citalopram hydrobromide, it dissolves readily and is absorbed efficiently when taken orally. This hydrobromide salt ensures consistent bioavailability.
How to Use Citalopram HBR
Before Taking
Read the Prescription Guide and Patient Information Leaflet.
Consult your doctor or pharmacist if you have any questions.
Directions To Take Citalopram HBR
Take the medication regularly for best results.
Take it at the same time every day to help you remember.
Keep taking the medication even if you feel well.
Do not stop taking it without consulting your doctor.
Abruptly stopping can worsen your condition and cause symptoms like mood swings, headaches, tiredness, sleep shifts, and electric shock-like sensations.
Your doctor may gradually reduce your dose to prevent these symptoms.
It can take 1 to 4 weeks to notice a difference.
Full benefits may take several weeks.
Citalopram Dosage
Citalopram dosing should always follow a healthcare provider's instructions. Improper dosing can lead to subtherapeutic response or increased risk of side effects.
Typical Dosage Instructions (as Per Doctor's Advice):
Patient Group
Indication
Starting Dose
Usual Dose Range
Maximum Dose
Key Notes
Adult
Major Depressive Disorder (MDD)
20 mg once daily
20-40 mg/day
40 mg/day
Increase after ≥1 week if needed
Generalized Anxiety Disorder (off-label)
10-20 mg once daily
20-40 mg/day
40 mg/day
Start low; adjust based on response
Pediatric (≥12 yrs)
Depression/Anxiety (off-label)
10 mg once daily
10-20 mg/day
20-40 mg/day
Use under specialist supervision; limited data
Geriatric (≥60 yrs)
Major Depression
10 mg once daily
10-20 mg/day
20 mg/day (FDA limit)
Higher doses increase QT prolongation risk; monitor ECG if needed
Starting Dose: For adults, the usual starting dose is 20 mg once daily, either in the morning or evening, with or without food.
Titration: After 1-2 weeks, the dose may be increased to a maximum of 40 mg once daily, based on clinical response and tolerability.
Lower Doses: In patients with hepatic impairment, older adults, or those taking interacting medications, a lower starting dose of 10 mg (Citalopram 10 mg) once daily may be prescribed.
Citalopram 10 mg: Often used as an initial dose in elderly patients or those at higher risk of QT prolongation.
What Should I Do If I Miss a Dose?
If you forget a dose, take it as soon as you remember-unless it's almost time for the next dose. Do not double up doses to make up for a missed one.
What Happens if an Overdose? Symptoms of Overdose
Severe drowsiness or dizziness
Rapid or irregular heartbeat
Nausea and vomiting
Tremors, confusion, or seizures
What to Avoid in Overdose
Do not induce vomiting.
Avoid taking any additional doses.
Seek immediate medical attention or contact poison control, as overdose can be life-threatening if not treated promptly.
Get a second opinion from trusted experts and makeconfident, informed decisions.
QT prolongation (may lead to arrhythmias; more common with higher doses)
Hyponatremia (low sodium levels, especially in elderly or on diuretics)
Serotonin syndrome (when combined with other serotonergic drugs; signs: agitation, confusion, rapid heart rate, hyperreflexia, shivering)
Severe allergic reactions (rash, itching, swelling)
Citalopram Side Effects in Females
Menstrual irregularities or heavier periods (rare)
Increased sweat production
Potential weight gain that may be more pronounced in some women
Patients should discuss any persistent or worsening symptoms with their doctor. If you experience chest pain, fainting spells, or irregular heartbeat, seek medical help immediately.
Essential Precautions for Using Citalopram
1. Allergies
Inform your doctor if you are allergic to Citalopram, escitalopram, or any other substances.
Inactive ingredients may cause allergic reactions or other problems.
2. Medical History
Inform your doctor about any personal or family history of:
QT prolongation can cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (e.g: extreme dizziness, fainting).
Risk may be increased with certain medical conditions or medications.
Low potassium or magnesium levels can also increase risk.
4. Drowsiness and Blurred Vision
Citalopram can cause drowsiness or blurred vision.
Alcohol or marijuana (cannabis) can exacerbate these effects.
Avoid driving, operating machinery, or performing tasks that require alertness or clear vision until you are sure you can do so safely.
Avoid alcoholic drinks and consult your doctor if using marijuana.
5. Older Adults
More susceptible to side effects such as bleeding, loss of coordination, and QT prolongation.
Higher risk of hyponatremia (salt deficiency), especially if taking diuretics.
Increased risk of falls due to lack of control.
6. Children
More vulnerable to side effects such as appetite loss and weight loss.
Monitor weight and height in children taking this medication.
7. Pregnancy
Should be taken during pregnancy only if absolutely necessary.
May harm the unborn child and cause withdrawal symptoms in newborns if taken during the last three months of pregnancy.
Consult your doctor about the risks and benefits of taking Citalopram during pregnancy.
8. Breastfeeding
Citalopram can pass into breast milk and may have adverse effects on a nursing baby.
Consult your doctor before breastfeeding.
Are There Any Age Restrictions for Using Citalopram?
Children and Adolescents (Less than 18 years): Increased risk of suicidal ideation; use only if benefits outweigh risks. Monitor closely during initiation and dose changes.
Older Adults (> 65 years): Higher sensitivity to hyponatremia, bleeding risks, falls, and QT prolongation-start at 10 mg/day.
Alcohol or Food Interactions
Alcohol: May exacerbate drowsiness, dizziness, or cognitive impairment. Strongly advised to minimize or avoid alcohol intake.
Marijuana (Cannabis): Can increase sedation or impair cognition; avoid until you know how both affect you.
Grapefruit Juice: Although not a major inhibitor of Citalopram metabolism, excessive intake may still impact blood levels. Moderation is key.
Possible Interactions with Other Medications (Drug Interactions)
Citalopram can interact with several drugs, supplements, and herbal products. Always consult your healthcare provider before combining therapies.
Common Drug Interactions
MAO Inhibitors (e.g., Phenelzine, Tranylcypromine): Contraindicated; risk of serotonin syndrome if combined.
Other SSRIs/SNRIs (e.g., Sertraline, Venlafaxine): Increased risk of serotonin syndrome; avoid overlapping therapy.
Tricyclic Antidepressants (e.g., Amitriptyline): May increase QT prolongation or anticholinergic effects.
NSAIDs/Antiplatelets (e.g., Ibuprofen, Aspirin): Elevated risk of gastrointestinal bleeding-monitor for signs of bleeding or bruising.
Warfarin: Citalopram can potentiate anticoagulant effects; monitor INR closely.
Digoxin/Lithium: May increase serum levels and monitor drug levels and clinical response.
Supplements and Herbal Products
St. John's Wort: Can cause serotonin syndrome when combined with Citalopram; best to avoid.
5-HTP or Tryptophan Supplements: Risk of excessive serotonergic activity; avoid without medical supervision.
Omega-3 Fatty Acids: Generally safe, but inform your doctor to keep track of overall drug regimen.
How Should Citalopram Be Stored?
Store Citalopram in its original container at controlled room temperature, protected from extremes of heat, light, and moisture. Keep all medications, including Citalopram, out of reach of children.
Recommended Storage Temperature for Citalopram
Tablets:
Store at 20°C to 25°C (68°F to 77°F).
Allowable excursions: 15°C to 30°C (59°F to 86°F).
Liquid Suspension:
Similar room temperature guidelines; tightly cap when not in use to prevent evaporation or contamination.
What Happens If Citalopram Is Not Stored Properly?
High Heat/Direct Sunlight: May degrade the active ingredient, reducing efficacy.
Excessive Moisture (e.g., Bathroom): Can cause tablets to deteriorate, change in consistency, or lose potency.
Freezing Temperatures: Liquid suspension may separate or become unusable.
Loose Containers: Increases risk of spills and accidental ingestion, especially by children.
Keep Away From
Children/Pets: Store high on a shelf or in a locked cabinet.
Sunlight: Choose a dark, cool cabinet rather than a bathroom shelf.
Moisture: Avoid storing near sinks, dishwashers, or bathtubs.
Citalopram vs Fluoxetine
Citalopram
Fluoxetine
Citalopram is sold under the brand name Celexa.
Fluoxetine is sold under the brand names Prozac and Sarafem.
Molecular Formula: C20H21F1N2O
Formula: C17H18F3N1O
Molecular Weight: 324.4 g/mol
Molecular Weight: 309.33 g/mol
Citalopram is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.
Fluoxetine is also an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.
Citalopram helps raise energy levels and improve mood. It is used to treat depression and related conditions.
Fluoxetine is used to treat major depressive disorder, bulimia nervosa, obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder.
Citalopram is an antidepressant drug. It will raise your energy levels and make you feel better. Citalopram is a serotonin reuptake inhibitor that is selective (SSRI). This medicine works by restoring the balance of a natural drug in the brain called serotonin.
When starting Citalopram, you may feel nervous, restless, nauseous, tired, or have trouble sleeping. Some people also report a temporary increase in anxiety before improvement begins. These initial effects usually subside within 1 to 2 weeks, while mood improvements may take 2 to 4 weeks.
According to a new review, Citalopram outperforms all other antidepressants except escitalopram for acute phase depression. Citalopram (brand names: Cipramil and Celexa) is an antidepressant in the class of selective serotonin reuptake inhibitors (SSRIs).
Citalopram is an antidepressant medication that is often prescribed to treat mood and anxiety disorders. Celexa is the brand name of citalopram that belongs to a class of antidepressants also known as selective serotonin reuptake inhibitors (SSRIs).
Citalopram is used for the treatment of depression. It may improve your level of energy and well-being. Citalopram is known to be a selective serotonin reuptake inhibitor (SSRI). This medicine works by restoring the balance of a certain natural substance called serotonin in the brain.
Citalopram selectively inhibits serotonin (5-hydroxytryptamine) reuptake, which enhances serotonergic neurotransmission and is associated with clinical antidepressant effects. In some cases, hair loss appears to accelerate when the antidepressant dose is increased.
Most people have been taking citalopram for 6 months. In some cases, however, the doctor may prescribe this substance for a period of 9 months. Long-term use of antidepressants may put people at risk for type 2 diabetes, and higher doses of SSRIs may cause heart rhythm abnormalities.
Liver test abnormalities have been reported to occur in less than 1% of patients with citalopram, and elevations are usually modest and rarely require dose modification or discontinuation.
Stopping Citalopram under medical guidance can help if you're no longer experiencing depression or anxiety symptoms and your doctor believes medication is no longer necessary. Benefits may include fewer side effects (like sexual dysfunction, drowsiness, or weight changes), reduced dependency, and avoiding long-term medication use. However, stopping suddenly or without supervision can cause withdrawal symptoms.
Taking Citalopram at night may help if you experience drowsiness, fatigue, or dizziness as side effects. Night-time dosing can minimize daytime sedation and may help some people sleep better. However, others may find it stimulating and prefer a morning dose—timing should be personalized.
Disclaimer: The information provided is accurate and up-to-date to the best of our knowledge. However, it should not be considered a substitute for medical advice or consultation. We do not guarantee its completeness or accuracy. The absence of specific warnings does not mean a medicine is safe for all users. We are not responsible for any outcomes based on this information and strongly recommend consulting a doctor for any medical concerns or questions.
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