Citalopram is a commonly prescribed SSRI (selective serotonin reuptake inhibitor) used mainly for depression and some forms of anxiety. If you're starting it, switching to it, or helping someone who is, this page explains the essentials in plain language: how it works, realistic expectations, dosing basics, side effects to expect, and clear safety tips.
Citalopram raises serotonin levels in the brain, which can lift mood, reduce worry, and help sleep and appetite normalize. People usually start it for major depressive disorder, panic disorder, and generalized anxiety disorder. It doesn’t act instantly — most people notice some improvement in energy or sleep in 1–2 weeks, but mood and anxiety often need 4–6 weeks before real change is clear.
Typical adult dosing starts at 20 mg once daily. Doctors may increase to 40 mg if needed, but doses over 40 mg raise the risk of heart rhythm problems (QT prolongation). Older adults or people with liver problems often start at 10 mg daily. Always follow your prescriber's plan — doses and timing can vary based on other meds and health conditions.
Common side effects include nausea, dry mouth, drowsiness, sweating, and reduced sexual desire or difficulty with orgasm. Most of these settle within a few weeks. If you feel faint, have fast or irregular heartbeat, severe dizziness, or a large jump in anxiety or agitation, contact your provider right away.
Be careful with other medicines that affect serotonin — combining citalopram with MAO inhibitors, certain migraine drugs (triptans), tramadol, linezolid, or St. John’s wort can cause serotonin syndrome. Symptoms include high fever, stiff muscles, shaking, rapid heartbeat, and confusion. That’s a medical emergency.
A special warning: at higher doses citalopram can lengthen a part of the heart’s electrical cycle (QT interval). If you have heart disease, low potassium, or are on other QT-affecting drugs, your doctor may order an ECG and choose a lower dose.
Stopping suddenly can cause withdrawal-like symptoms—dizziness, electric shock sensations, sleep problems, or irritability. If you need to stop, plan a slow taper with your provider over weeks to months depending on dose and how long you’ve been taking it.
If you’re pregnant, breastfeeding, or trying to conceive, talk to your clinician about risks and benefits. Don’t change meds on your own. If you’re unsure whether citalopram is right for you, bring a list of current medications and health issues to your appointment and ask about alternatives and monitoring plans.
Quick practical tips: take it same time daily (with or without food), avoid mixing heavy alcohol with antidepressants, keep a symptom diary for the first two months, and call your doctor for severe side effects or signs of serotonin syndrome. Small changes can make treatment safer and more effective.
Jun, 13 2025