Citalopram

Pronunciation: sit-AL-oh-pram.

Generic name
citalopram
Brand names
Celexa (United States), Cipramil (United Kingdom, New Zealand), Celapram (Australia)
Drug class
Selective serotonin reuptake inhibitor (SSRI) antidepressant
Form
Tablet / oral solution
Route
Oral
Legal status
Prescription-only medicine in all 6 standard markets reviewed.

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Celapram (5) · Full directory

What citalopram is and how it works

Citalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat major depressive disorder in adults. (1) (2)

Citalopram carries two important safety considerations that shape how it is prescribed: a boxed warning about increased suicidal thoughts and behaviors in younger patients, and a dose-dependent effect on the heart's electrical rhythm (QT-interval prolongation) that sets an exact maximum daily dose depending on your age, liver function, and other medicines you take. Any changes to dose or stopping treatment are planned with your prescriber, since abrupt changes can cause withdrawal-type symptoms.

Mechanism of action: how citalopram works

Citalopram is a selective serotonin reuptake inhibitor that increases serotonergic activity in the central nervous system by inhibiting neuronal reuptake of serotonin. (1) (2)

What citalopram is used for

Major depressive disorder

Used to treat major depressive disorder (major depressive episodes) in adults. (1) (2)

Before taking citalopram

Do not take / not appropriate for

  • Do not take citalopram if you are taking, or have taken within the last 14 days, a monoamine oxidase inhibitor (MAOI), including linezolid or intravenous methylene blue, because of a serious risk of serotonin syndrome. (all patients) (1) (2)
  • Do not take citalopram together with pimozide or other medicines that prolong the QT interval, because of an increased risk of a serious heart-rhythm problem. (all patients) (1) (2)
  • Do not take citalopram if you have a known QT-interval prolongation or congenital long QT syndrome. (all patients) (2)
  • Do not take citalopram if you have had a hypersensitivity reaction to citalopram or any of its ingredients. (all patients) (1)

Tell your clinician about

  • Whether you or a family member has a personal or family history of bipolar disorder, mania, or hypomania.
  • Whether you have a personal or family history of heart-rhythm problems, QT prolongation, low blood potassium or magnesium, or a recent heart attack.
  • Whether you have liver problems, since a lower starting dose and lower maximum dose apply.
  • Your age -- a lower maximum dose applies for patients over 60 (some markets: over 65).
  • Any history of seizures, angle-closure glaucoma, or low blood sodium.
  • Every other medicine and supplement you take, especially MAOIs, other antidepressants or serotonergic medicines, other QT-prolonging medicines, NSAIDs, aspirin, or other blood thinners.
  • Whether you are pregnant, plan to become pregnant, or are breastfeeding.
(1) (2)

How to take citalopram

  • Take exactly as prescribed, once daily, with or without food.
  • The usual starting dose is 20 mg/day, which your prescriber may increase to a maximum of 40 mg/day, at intervals of no less than one week, based on your response.
  • A lower maximum dose of 20 mg/day applies if you are over 60 (some markets: over 65), have liver impairment, are a CYP2C19 poor metaboliser, or are taking a CYP2C19-inhibiting medicine -- your prescriber will set the right maximum for you.
  • Any change in dose, including reducing or stopping citalopram, is planned with your prescriber; a gradual, clinician-directed taper is generally used rather than stopping abruptly, to reduce the chance of withdrawal-type symptoms.
  • Full antidepressant effect can take several weeks; continue taking citalopram as prescribed even if you do not notice an improvement right away, and discuss any concerns with your prescriber rather than changing your dose on your own.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

Take the missed dose as soon as you remember, unless it is almost time for your next dose, in which case skip the missed dose and continue with your regular schedule. do not take an extra dose to make up for a missed one. Ask your pharmacist or prescriber if you are unsure.

Overdose

Contact your prescriber, pharmacist, or a poison-control/emergency service if an overdose is suspected. Seek emergency medical help for any severe symptoms, including a fast or irregular heartbeat, fainting, or seizures. (1)

Side effects

Nausea, dry mouth, and sleep changes are commonly reported, particularly early in treatment. Some effects, on heart rhythm, mood, sodium levels, or serotonin balance, need prompt medical evaluation rather than waiting to see if they improve.

Nausea and dry mouth

What to notice: Commonly reported, especially in the first weeks.

What to do: Tell your prescriber if severe or persistent. (1) (2)

Sleep changes (insomnia or somnolence) and tremor

What to notice: Commonly reported effects.

What to do: Tell your prescriber if bothersome or affecting daily activities. (2)

Sexual side effects

What to notice: Decreased libido, delayed ejaculation, or impotence have been commonly reported.

What to do: Tell your prescriber if bothersome; a clinician can discuss options. (1)

Worsening mood or new suicidal thoughts

What to notice: New or worsening depression, agitation, unusual behaviour change, or thoughts of self-harm, especially in the first few months of treatment or after a dose change.

What to do: Contact your prescriber immediately, or seek emergency help for any thoughts of self-harm; a clinician will urgently assess whether treatment needs to be adjusted. (1)

Heart-rhythm symptoms

What to notice: Fast or irregular heartbeat, dizziness, or fainting.

What to do: Seek emergency medical help; a clinician will assess for QT-related heart-rhythm effects. (1) (2)

Serotonin syndrome

What to notice: Agitation, hallucinations, fast heartbeat, high fever, muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhoea.

What to do: Seek emergency medical help immediately; a clinician will decide whether citalopram or other serotonergic medicines need to be adjusted. (1)

Low blood sodium (hyponatraemia)

What to notice: Headache, confusion, weakness, unsteadiness, or severe vomiting.

What to do: Contact your prescriber promptly for assessment, especially if you are elderly or taking a diuretic. (1)

Eye pain or vision changes (possible angle-closure glaucoma)

What to notice: Eye pain, redness, and vision changes, sometimes with nausea and headache.

What to do: Seek emergency medical help for sudden eye pain or vision changes. (1)

Serious warnings

Increased suicidal thoughts and behaviors in children, adolescents, and young adults — boxed_warning

Symptoms: New or worsening depression, unusual changes in behaviour or mood, agitation, or thoughts of self-harm, especially within the first few months of treatment or after a dose change.

Action: Contact your prescriber immediately, or seek emergency help for any thoughts of self-harm; a clinician will assess whether treatment needs to be adjusted. Citalopram is not approved for use in children. (1)

Dose-dependent QT-interval prolongation and heart-rhythm disturbances — emergency

Symptoms: Fast or irregular heartbeat, dizziness, or fainting.

Action: Seek emergency medical help; a clinician will assess your heart rhythm. Risk increases above the maximum dose set for your age, liver function, and other medicines, so never exceed your prescribed dose. (1) (2) (4) (6)

Serotonin syndrome — emergency

Symptoms: Agitation, hallucinations, fast heartbeat, high fever, muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhoea, especially with other serotonergic medicines or MAOIs.

Action: Seek emergency medical help immediately; a clinician will decide on treatment adjustments. (1) (2)

Activation of mania or hypomania — high caution

Symptoms: Unusually elevated mood, racing thoughts, decreased need for sleep, or impulsive behaviour.

Action: Contact your prescriber promptly; a personal or family history of bipolar disorder should be screened for before starting citalopram. (1)

Discontinuation symptoms — high caution

Symptoms: Dizziness, sensory disturbances (including electric-shock sensations), sleep disturbance, agitation, or anxiety can occur when treatment ends, particularly after abrupt discontinuation.

Action: Any reduction or stopping of citalopram is planned with your prescriber, using a gradual, clinician-directed taper to reduce the chance of these symptoms. (1) (2)

Increased bleeding risk — high caution

Symptoms: Unusual bruising or bleeding, especially with concomitant aspirin, NSAIDs, or other blood thinners.

Action: Tell your prescriber about all other medicines you take, including over-the-counter pain relievers. (1)

Interactions

Medicine or testEffectAction
Monoamine oxidase inhibitors (MAOIs)Serious, potentially fatal serotonin syndrome risk.This combination is contraindicated; a 14-day washout period is required between stopping one and starting the other, under clinician direction. (1) (2)
Pimozide and other QT-prolonging medicinesAdditive risk of serious heart-rhythm disturbances.This combination is contraindicated; tell your prescriber about all other medicines you take. (1) (2)
CYP2C19 inhibitorsCan raise citalopram blood levels and increase QT-prolongation risk.A lower maximum dose (20 mg/day) applies if you take a CYP2C19 inhibitor; tell your prescriber about all your medicines. (1) (6)
Other serotonergic medicines (other antidepressants, triptans, tramadol, buprenorphine)Increased risk of serotonin syndrome.Tell your prescriber about all serotonergic medicines you take so the combination can be assessed. (2)
NSAIDs, aspirin, and other blood thinnersIncreased risk of bleeding.Tell your prescriber if you take these regularly. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Patients over 60 (some markets: over 65)

A lower maximum dose of 20 mg/day applies because of increased QT-prolongation risk. (1) (2)

Hepatic impairment

A lower starting dose and a maximum dose of 20 mg/day apply. (1) (2)

Pregnancy

SSRI use, particularly late in pregnancy, may increase the risk of persistent pulmonary hypertension of the newborn and of poor neonatal adaptation (respiratory distress, feeding difficulties, low muscle tone, tremor, irritability). Discuss the benefits and risks with your prescriber. (1)

Breastfeeding

Citalopram passes into breast milk at approximately 5% of the maternal weight-adjusted dose; discuss feeding options with your prescriber. (2)

Children and adolescents

Citalopram is not approved for use in pediatric patients in the United States. (1)

Monitoring

Before starting

  • Screening for personal or family history of bipolar disorder.
  • Assessment of heart-rhythm risk factors, including personal/family QT-prolongation history, electrolyte levels, and other QT-prolonging medicines.
  • Confirmation of liver function and CYP2C19 status where relevant, to set the correct maximum dose.

During treatment

  • Close monitoring for clinical worsening and emergence of suicidal thoughts or behaviors, especially during the first few months and after any dose change.
  • Watch for heart-rhythm symptoms, serotonin syndrome symptoms, and signs of low blood sodium.
  • Any dose reduction or discontinuation is planned with your prescriber using a gradual taper.
(1) (2)

Storage

Store at controlled room temperature, away from moisture and excess heat.

Study the drug class: SSRI antidepressants

Professional information

Clinician-facing context only. Use the current local product information in full.

United States

Indication: Major depressive disorder

Dose summary: Initial 20 mg/day; may increase to a maximum of 40 mg/day at intervals of no less than one week. Maximum 20 mg/day for patients over 60, with hepatic impairment, CYP2C19 poor metabolisers, or those taking a CYP2C19 inhibitor, because of QT-prolongation risk.

Renal context: Not specifically detailed in the source reviewed; use current local product information for renal impairment guidance. (1)

Mechanism of action

Hepatic guidance

Hepatic impairment requires a lower initial dose (10 mg/day for the first two weeks) and a maximum dose of 20 mg/day, given reduced clearance and increased QT-prolongation risk.

Overdose note

Overdose has been associated with QT prolongation, arrhythmia, seizures, and central nervous system depression; manage per local poison-control and toxicology guidance and with cardiac monitoring. (1) (2)

Frequently asked questions

Why is there a maximum dose for citalopram?

Citalopram can prolong the QT interval, an electrical measurement of the heartbeat, in a dose-dependent way. To limit this risk, the maximum recommended dose is 40 mg/day for most adults, and a lower 20 mg/day maximum applies for people over 60 (or 65 in some countries), those with liver impairment, CYP2C19 poor metabolisers, or those taking a CYP2C19-inhibiting medicine. (1) (2)

Can I stop taking citalopram on my own if I feel better?

No. Any change to your dose, including stopping treatment, should be planned with your prescriber. Citalopram is generally reduced gradually rather than stopped abruptly, since sudden discontinuation can cause withdrawal-type symptoms such as dizziness, sensory disturbances, or anxiety. (1) (2)

Why does citalopram have a boxed warning about suicidal thoughts?

Antidepressants, including citalopram, showed an increased risk of suicidal thoughts and behavior compared with placebo in short-term studies of children, adolescents, and young adults up to 24. This is why close monitoring is recommended, especially in the first few months of treatment and after any dose change. Citalopram is not approved for use in children. (1)

What is the mechanism of action of citalopram?

Citalopram is a selective serotonin reuptake inhibitor that increases serotonergic activity in the central nervous system by inhibiting neuronal reuptake of serotonin. (1) (2)

What is the generic name of Citalopram?

The generic name is citalopram. It is sold under brand names including Celexa (United States), Cipramil (United Kingdom, New Zealand), Celapram (Australia). (1) (2)

What class of drug is citalopram?

Citalopram is classed as: Selective serotonin reuptake inhibitor (SSRI) antidepressant. (1) (2)

References

  1. CELEXA (citalopram hydrobromide) tablets -- full prescribing informationU.S. Food and Drug Administration, full prescribing information (Celexa/citalopram) · United States · accessed 2026-07-30 · source 1
  2. Citalopram 20mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-30 · source 2
  3. EU-wide harmonisation of citalopram maximum-dose and QT-prolongation warnings (CMDh, October 2011), reflected in ongoing PRAC signal monitoringEuropean Medicines Agency Pharmacovigilance Working Party / Co-ordination Group for Mutual Recognition and Decentralised Procedures (CMDh) · European Union · accessed 2026-07-30 · source 3
  4. CITALOPRAM (citalopram hydrobromide) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-30 · source 4
  5. CELAPRAM (citalopram hydrobromide) tablet -- ARTG entry, and TGA safety alert on citalopram dosingTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
  6. CIPRAMIL (citalopram) New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 6

Brand names by country

Single-ingredient citalopram names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Celexa10 mg, 40 mg, 20 mg · allergan, inc.

United Kingdom

  • Citalopram (generic) (2)MHRA licensed emc smpc confirmed · 10 mg, 20 mg, 40 mg · multiple UK generic manufacturers

Canada

  • ECL-CITALOPRAM
  • CELEXA
  • CTP
  • RAN-CITALO

Australia

  • Celapram (5)TGA ARTG registered confirmed · 10 mg, 20 mg · Alphapharm/multiple Australian manufacturers

New Zealand

  • Cipramil (6)Medsafe approved confirmed · 10 mg, 20 mg, 40 mg · Healthcare Logistics (NZ distributor)
View brands in additional countries.

European Union

Citalopram (generic, nationally authorised in each member state) (3)

This page provides general medicine information, not a diagnosis, prescription, or substitute for a prescriber, pharmacist, or the current local product information.

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