Citalopram

Sounds like 'sit-al-oh-pram'

Citalopram is used to treat depression. Find out how to take it safely and possible side effects.

What is citalopram?

Citalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). SSRIs are the antidepressants prescribed most often. 

Citalopram is used to treat depression. It is believed to work by increasing the levels of a chemical called serotonin which can help lift your mood. Read more about antidepressants and SSRIs.

Dose

In Aotearoa New Zealand citalopram is available as tablets (20 mg).

  • The dose of citalopram will be different for different people.
  • Your doctor will usually start you on a low dose and if needed, will increase your dose slowly. This allows your body to get used to the medicine and reduces side effects.
  • Always take your citalopram exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much citalopram to take, how often to take it, and any special instructions.

How to take citalopram

  • Take citalopram once a day, in the morning OR the evening. Take your dose at the same time each day. 
  • You can take citalopram with or without food but if you think it is upsetting your stomach, try taking it with food.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take it at the right time. Do not take double the dose.
  • Keep taking citalopram every day. It may take 4 to 6 weeks before you notice the full benefits of citalopram and you should start to feel better after 1 to 2 weeks. Some people feel worse in the first few weeks before they feel better. Citalopram is needed for at least a few months and your doctor will tell you how long to take it for.
  • If you think citalopram is not working for you. Do not stop taking it suddenly; talk to your doctor or nurse before stopping. It is usually best to stop taking citalopram very slowly to avoid side effects.

Things to consider while you are taking citalopram

  • Limit alcohol intake while you are taking citalopram. Alcohol can increase your chance of side effects such as drowsiness and impaired concentration.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
  • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
  • Citalopram can interact with some medications (including anticoagulants and NSAIDs), herbal supplements (such as St John's Wort), and recreational drugs, so check with your doctor or pharmacist before starting fluoxetine and before starting any new products.
  • If you have diabetes, you may need to check your blood glucose more often because citalopram can affect the levels of glucose in your blood.

Possible side effects of citalopram

Like all medicines, citalopram can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Nausea (feeling sick)
  • Vomiting (being sick)
  • Headache
  • Dry mouth
  • Increased sweating
  • Diarrhoea (runny poos)
  • This is quite common when you first start citalopram.
  • If you have nausea, try taking your dose with food.
  • Tell your doctor if they bother you.
  • Difficulty falling asleep
  • This is quite common. Try taking your dose in the morning.
  • Feeling sleepy, drowsy, dizzy or tired
  • Difficulty concentrating
  • These are quite common. 
  • Try taking your dose in the evening.
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Avoid drinking alcohol. Read more about how alcohol affects medicines.
  • Feeling less or more hungry than usual
  • Changes in weight (increase or decrease)
  • This is common.
  • Tell your doctor if they cause you problems.
  • Loss of sex drive or libido
  • Problems with keeping an erection or ejaculation
  • These are common at the start of treatment
  • Tell your doctor if they cause you problems or if they are severe.
  • Read more about medicines and sexual problems.
  • Signs of low sodium such as dizziness, confusion, agitation, cramps, unsteadiness, feeling faint or tired.
  • This is common especially in older people, women, people who are also taking diuretics (water tablets) or omeprazole and people with low body weight.
  • Let your doctor know if you get these symptoms.
  • Suicidal feelings or behaviour such as agitation, aggression, self-harm, worsening of low mood.
  • These are rare but serious side effects.
  • They are most likely to happen during the start of treatment or when doses are changed.
  • Contact your doctor immediately.
  • For urgent help contact Healthline 0800 611 116 or Lifeline 0800 543 354 (available 24/7).
  • Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heartbeat, headache, diarrhoea and rigid or twitching muscles.
  • These are rare but serious side effects.
  • You are at increased risk of serotonin syndrome if you just started taking the SSRI or increased the dose or started other medicines that can cause serotonin syndrome.
  • Tell your doctor immediately or ring Healthline 0800 611 116
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

Learn more

The following links provide further information on citalopram.

Citalopram Patient Information  (Māori) NZ Formulary, NZ
Citalopram (PSM) Medsafe Consumer Information Sheet, NZ

References

  1. Citalopram NZ Formulary, NZ, 2022
  2. Selective serotonin re-uptake inhibitors NZ Formulary, NZ, 2022
  3. The role of medicines in the management of depression in primary care BPAC, NZ, 2017
  4. Sexual Dysfunction Associated with Antidepressants and Antipsychotics Medsafe, NZ, 2015

Additional resources for healthcare professionals

Citalopram (PSM) Medsafe Product Information, NZ
Reminder – citalopram and QT prolongation Medsafe, NZ, 2015
Citalopram and escitalopram – same but different handout SafeRx, Waitemata, NZ, 2019

Credits: Health Navigator Pharmacists. Reviewed By: Sandra Ponen, Pharmacist Last reviewed: 10 Jun 2022