An SSRI antidepressant
Citalopram
A commonly used SSRI antidepressant for depression and anxiety, taken once daily as a long-term tablet.
What is Citalopram?
Citalopram is a selective serotonin reuptake inhibitor (SSRI) and one of the most widely prescribed antidepressants in the UK. It is used to treat depression and a range of anxiety conditions such as panic disorder.
Education and reference only. This is a plain-language guide to Citalopram — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Citalopram is one of the most widely prescribed SSRI (selective serotonin reuptake inhibitor) antidepressants in the UK. It is used to treat depression and a range of anxiety conditions, including panic and generalised anxiety. It is taken as a long-term, once-daily tablet and is often chosen as a first-line antidepressant because it is generally well tolerated. Like all antidepressants, it does not work instantly — the benefit builds gradually over weeks, so patience and a regular routine matter more than how you feel on the first few days.
How it works
Citalopram increases the amount of serotonin — a natural chemical messenger linked to mood — available between nerve cells in the brain. Normally serotonin is released and then quickly reabsorbed ("reuptake") back into the nerve that released it; citalopram blocks that reabsorption so more serotonin stays active in the gaps between nerves. This gradual shift in brain chemistry is thought to be how SSRIs lift low mood and ease anxiety over a number of weeks.
Company & origin
Originated / developed by: Lundbeck.
Citalopram is an SSRI antidepressant developed by the Danish company Lundbeck, first synthesised in 1972. It was launched in Europe in 1989 and approved by the FDA in 1998, marketed as Cipramil/Celexa.
What it treats
Conditions Citalopram is used for
Practical use
How to take Citalopram
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Usually taken once a day, with or without food.
- Swallow the tablet with water; liquid drops are available for those who prefer them.
- It usually takes a few weeks before the full benefit is felt.
- If you miss a dose, skip it and take the next one as usual — do not double up.
- Do not stop suddenly; it should be reduced gradually to avoid withdrawal-type symptoms.
- Tell your doctor if you feel your mood worsen or have distressing thoughts, particularly early on.
Weighing it up
Advantages & disadvantages of Citalopram
Advantages
- Effective and well-established SSRI for depression and anxiety.
- Once-daily dosing with a liquid option.
- Generally well tolerated by many people.
- Cheap, widely available generic.
Disadvantages
- Can affect the heart's electrical rhythm (QT prolongation), so there are limits on how high the dose can go and caution with some other medicines.
- Can cause nausea, sleep changes and sexual side effects.
- May take several weeks to take full effect.
- Must be tapered rather than stopped abruptly.
Practical use
Good to know
It is taken once a day at a time you will remember, and it takes several weeks before the full benefit is felt — low mood often lifts before you notice it yourself. In the early weeks some people feel more restless, jittery or anxious, or have nausea or other digestive upset; this usually settles. It should not be stopped abruptly — coming off it is done by tapering the dose slowly under guidance to avoid discontinuation symptoms. Because citalopram can affect the heart's electrical rhythm (QT prolongation), there is a ceiling on how high the dose can be taken and extra caution where the heart rhythm is already a concern.
Who should not take it / use with caution
- People taking, or who have recently taken, an MAOI antidepressant — these must not be combined, and a gap is needed when switching.
- People with a known long-QT heart-rhythm problem, or taking other medicines that prolong the QT interval — used with caution or avoided.
- Used with caution in people with a history of bleeding problems, certain heart conditions, low blood sodium, epilepsy, or who are pregnant or breastfeeding — assessed individually.
Monitoring
- Mood, anxiety and any thoughts of self-harm, especially in the early weeks and after dose changes
- Blood sodium in those at risk (e.g. older people on certain other medicines)
- Heart rhythm where there is a relevant risk
Side effects
- Nausea, dry mouth, headache, sweating or disturbed sleep, especially in the first weeks; feeling more restless or anxious early on, which usually settles.
- Reduced appetite, drowsiness or sexual side effects (such as reduced desire) that can persist while taking it.
- Less commonly, a low blood sodium level (causing confusion or weakness, more often in older people), changes in heart rhythm, or — if combined with other serotonin medicines — serotonin syndrome, which needs urgent attention.
Key interactions
- Other medicines that raise serotonin (some other antidepressants, tramadol, triptans for migraine, St John's Wort) increase the risk of serotonin syndrome.
- Other medicines that prolong the QT interval, including some antibiotics, antipsychotics and antifungals, add to the heart-rhythm risk.
- NSAID painkillers, aspirin and anticoagulants increase the risk of bleeding when taken with an SSRI.
Available as: Tablets and oral drops; the drops and tablets are not directly equivalent, so a switch between them is done carefully.
Answers
Citalopram: frequently asked questions
How long does citalopram take to work?
It usually takes a few weeks before the full benefit is felt, and some improvement (such as sleep or appetite) may come before your mood lifts. It is worth persevering and keeping in touch with your prescriber rather than stopping early if it does not seem to be helping straight away.
Can I stop citalopram suddenly?
No — stopping abruptly can cause discontinuation symptoms such as dizziness, flu-like feelings, "electric shock" sensations, mood changes and sleep problems. When the time comes to stop, the dose is reduced gradually under guidance.
I feel more anxious in the first week — is that normal?
Yes, feeling more restless, jittery or anxious in the early weeks is a recognised effect that usually settles as your body adjusts. Tell your prescriber if it is severe, or if you have any thoughts of self-harm, as you should be reviewed.
Why is there a limit on the citalopram dose?
Citalopram can affect the heart's electrical rhythm (a change called QT prolongation), and this is more likely at higher doses, in older people, and with certain other medicines or heart conditions. For that reason the dose is capped and the prescriber checks for added risks before increasing it.
Is Cipramil the same as citalopram?
Yes — citalopram is the generic (active-ingredient) name and Cipramil is a brand name. Generic citalopram contains the identical active ingredient.
The wider class
About SSRIs
Citalopram belongs to the ssris class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Citalopram.
- electronic Medicines Compendium (SmPC): Citalopram.
- NICE CKS: Citalopram.
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