A selective serotonin reuptake inhibitor antidepressant used for depression and panic disorder, taken once daily, with a maximum dose set by its effect on the heart's QT interval.
Mood and suicidal thoughts in the first weeks of treatment and after dose changes; an ECG before or during treatment in people with heart disease or on other QT-prolonging medicines; sodium in older people if drowsy or confused.
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
Depression
Panic disorder
Also used for some anxiety disorders under specialist advice
How it works in the body
Citalopram blocks the serotonin transporter that carries serotonin back into the nerve ending after it has been released, so more serotonin stays in the synapse and signalling through serotonin receptors increases. Mood and anxiety improve gradually over several weeks as receptor sensitivity and downstream signalling adapt; the immediate rise in serotonin explains the early nausea and restlessness.
Common side effects
Feeling sick, dry mouth, sweating, tiredness
Difficulty sleeping, feeling restless or shaky
Reduced appetite, weight change, sexual problems
Serious: seek help
Thoughts of self-harm, especially in the first weeks and under 25 years of age
Palpitations or fainting from a prolonged QT interval, more likely at higher doses or with other QT-prolonging medicines
Bleeding, particularly with NSAIDs, aspirin or anticoagulants
Serotonin syndrome with other serotonergic medicines: agitation, fever, muscle twitching
Low sodium, especially in older people
Cautions and interactions
Maximum daily dose is lower in people over 65 and in liver impairment because of the QT effect
Not combined with other QT-prolonging medicines or with MAOI antidepressants
Bleeding risk rises with NSAIDs, aspirin and anticoagulants
Closer monitoring for suicidal thoughts when starting, especially in young people
Serotonin syndrome risk with tramadol, triptans, St John's wort and other serotonergic medicines
Interactions
Check interactions
Taking Citalopram with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
Azithromycin with citalopram, which also prolongs the QT interval, increases the risk of dangerous heart rhythms.
Why it can occur
QT prolongation
What official information says
US information advises telling a doctor about medicines for irregular heartbeat and other listed drugs, whose doses may need changing or monitoring; the BNF advises caution or avoidance depending on the drug.
What to discuss with a clinician
Official information: an alternative antibiotic where possible; otherwise ECG and electrolyte monitoring.
Therapeutic duplication. Two SSRIs together, or an SSRI with another serotonergic antidepressant, raise the risk of serotonin syndrome; switching is done with a planned cross-taper. UK
Medicines that share the class of Citalopram. They are separate medicines with their own licences, doses and interactions, not alternative names for Citalopram.
Medicines often discussed alongside Citalopram: used together, compared with it, or acting on the same problem by a different route.
Educational content. Anatomy Nexus provides medical education and does not replace professional medical advice, diagnosis, treatment, prescribing or pharmacist review. Doses, choices and monitoring are decided by a prescriber for an individual; never start, stop or change a medicine on the basis of this page.
