| Usage |
Citalopram is available in tablet and liquid (solution) forms for oral administration. Typically, it is taken once a day, either in the morning or evening, with or without food. Maintain a consistent schedule by taking citalopram at approximately the same time daily.
Adhere to the instructions on your prescription label meticulously, and if there are any aspects you find unclear, seek clarification from your doctor or pharmacist. It is imperative to follow your doctor's directives precisely. Do not exceed or reduce the dose or alter the frequency without your doctor's guidance.
Your doctor may initiate treatment with a low citalopram dose and gradually increase it, typically not more frequently than once a week. It may take 1 to 4 weeks before the full therapeutic effects of citalopram become noticeable. Continue taking citalopram even if you start feeling better.
Abruptly discontinuing citalopram may lead to withdrawal symptoms, including mood swings, irritability, restlessness, dizziness, numbness, tingling, or sensations akin to electric shocks in the hands or feet, anxiety, confusion, headaches, fatigue, nausea, sweating, tremors, and difficulties falling asleep or staying asleep. Do not cease citalopram without consulting your doctor. Your doctor will likely taper your dose gradually to mitigate withdrawal effects.
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| Side Effects |
Citalopram may trigger side effects. If any of the following symptoms are severe or persist, notify your doctor:
• Nausea
• Diarrhea
• Constipation
• Vomiting
• Stomach pain
• Heartburn
• Decreased appetite
• Weight loss
• Frequent urination
• Excessive fatigue
• Yawning
• Weakness
• Involuntary shaking of a body part
• Muscle or joint pain
• Dry mouth
• Alterations in sex drive or performance
• Heavy menstrual periods
Certain side effects can be serious. If you encounter any of the subsequent symptoms, or those detailed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, promptly contact your doctor or seek emergency medical attention:
• Chest pain
• Shortness of breath
• Dizziness
• Fainting
• Rapid, slow, or irregular heartbeat
• Hallucinations (perceiving things or hearing voices that are not real)
• Fever
• Profuse sweating
• Confusion
• Loss of consciousness (coma)
• Impaired coordination
• Muscles becoming stiff or twitching
• Development of hives or blisters
• Rash
• Itching
• Breathing or swallowing difficulties
• Inflammation or swelling in the facial area, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
• Hoarseness
• Unusual bleeding or bruising
• Headache
• Lack of steadiness
• Issues with thinking, concentration, or memory
• Seizures
In children, citalopram may reduce appetite and lead to weight loss. Your child's growth will be closely monitored by their doctor. If you have concerns about your child's growth or weight while they are taking this medication, discuss them with their doctor. It is essential to consult your child's doctor regarding the risks associated with administering citalopram to your child. Citalopram may also induce other side effects. Contact your doctor if you encounter any unusual issues while taking this medication. Your well-being is our priority.
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| Special Precautions |
Before starting citalopram, it's essential to:
• Inform your doctor and pharmacist about any allergies you may have, including allergies to citalopram, escitalopram (Lexapro), other medications, or any ingredients in the citalopram product you're using. Check the Medication Guide or consult your pharmacist for a list of ingredients.
• Notify your doctor if you are currently taking pimozide (Orap) or a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate), or if you have discontinued an MAO inhibitor within the past 14 days. Your doctor will likely advise against taking citalopram in these cases. If you discontinue citalopram, wait at least 14 days before starting an MAO inhibitor.
• Be aware that citalopram is closely related to another SSRI, escitalopram (Lexapro), and should not be taken together.
• Inform your doctor and pharmacist about any other prescription or nonprescription medications, as well as vitamins, that you are taking or plan to take. Mention medications such as amiodarone (Cordarone), anticoagulants (e.g., warfarin), aspirin, NSAIDs (e.g., ibuprofen, naproxen), carbamazepine (Tegretol), cimetidine (Tagamet), cisapride (Propulsid), diuretics (water pills), disopyramide (Norpace), dofetilide (Tikosyn), erythromycin (E.E.S. E-Mycin, Erythrocin), heparin, lithium (Eskalith, Lithobid), medications for various conditions (e.g., anxiety, chronic pain, mental illness, Parkinson's disease, seizures, migraines), methylene blue, metoprolol (Lopressor, Toprol XL), moxifloxacin (Avelox), omeprazole (Prilosec, Zegerid), other SSRIs or SNRIs, procainamide (Procanbid, Pronestyl), quinidine (Quinidex), sedatives, sibutramine (Meridia), sleeping pills, sotalol (Betapace), sparfloxacin (Zagam), thioridazine (Mellaril), tramadol (Ultram), tranquilizers, and tricyclic antidepressants (e.g., amitriptyline, imipramine). Your doctor may need to adjust your medication doses or closely monitor you for potential side effects. Many other medications can also interact with citalopram, so inform your doctor of all the medications you are taking, even those not listed here.
• Let your doctor know about any nutritional supplements and herbal products you are using, especially those containing St. John's wort or tryptophan.
• Disclose any history of long QT syndrome (a rare heart condition that may cause irregular heartbeat, fainting, or sudden death) within your family or personal use of street drugs or excessive prescription medication. Inform your doctor if you are over 60 years old and have experienced a slow or irregular heartbeat, high blood pressure, bleeding disorders, stroke, low levels of magnesium or potassium in your blood, a heart attack, heart failure, or other heart issues. Mention any history of seizures, kidney or liver disease, or severe vomiting, diarrhea, or sweating, or if you develop these symptoms during treatment.
• Notify your doctor if you are pregnant, especially during the last months of pregnancy, or if you plan to become pregnant or are breastfeeding. Citalopram taken in the final months of pregnancy may cause problems in newborns.
• Be aware that citalopram may cause drowsiness. Avoid operating vehicles or heavy machinery until you have a clear understanding of how this medication impacts your capabilities.
• Discuss the safe use of alcoholic beverages during your citalopram treatment with your doctor, as alcohol can exacerbate citalopram's side effects.
• Understand that citalopram may lead to angle-closure glaucoma, a condition in which fluid is suddenly blocked in the eye, causing rapid and severe increases in eye pressure that may result in vision loss. Consult your doctor about undergoing an eye examination before starting citalopram. If you experience symptoms such as nausea, eye pain, vision changes (e.g., seeing colored rings around lights), and swelling or redness in or around the eye, contact your doctor or seek emergency medical attention immediately.
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| Important Warnings: |
A limited number of children, teenagers, and young adults, up to the age of 24, who participated in clinical studies involving antidepressants like citalopram, experienced thoughts of self-harm or suicide (including planning or attempting suicide). Those in this age group using antidepressants for depression or other mental health conditions may have a higher likelihood of developing suicidal tendencies compared to those not using antidepressants for these conditions. However, experts remain uncertain about the extent of this risk and how it should be weighed when considering antidepressant use in children and teenagers. Typically, individuals under the age of 18 should avoid taking citalopram, though, in certain situations, a doctor may determine that it is the most appropriate treatment for a child's specific condition.
It is important to understand that your mental well-being can undergo unexpected changes while taking citalopram or other antidepressants, even if you are an adult over 24 years of age. Suicidal thoughts may emerge, particularly at the start of treatment or whenever your dosage is adjusted, either increased or decreased. If you, your family, or your caregiver notice any of the following symptoms, contact your doctor immediately: worsening depression, new thoughts of self-harm or suicide, including plans or attempts; heightened anxiety; agitation; panic attacks; sleep difficulties (trouble falling asleep or staying asleep); increased aggression; irritability; impulsive actions; severe restlessness; and extreme, frenzied excitement. Make sure that your family or caregiver is aware of which symptoms should be treated as serious so they can contact your doctor if you are unable to seek help on your own.
While taking citalopram, it is essential to maintain regular doctor's appointments, especially at the beginning of your treatment. Be sure to attend all scheduled office visits. Regardless of your age, before beginning antidepressant treatment, discuss with your doctor the advantages and disadvantages of using an antidepressant to address your condition versus alternative treatments. It's also important to evaluate the potential benefits and risks of not treating your condition. Keep in mind that having depression or another mental health disorder significantly raises the risk of suicidal thoughts. This risk is further increased if you or any family member has a history of bipolar disorder (mood swings from depression to abnormally high excitement) or mania (intense, abnormally high mood) or has contemplated or attempted suicide. Engage in an open dialogue with your doctor about your condition, symptoms, and your personal and family medical history. Together, you and your doctor can determine the most suitable course of treatment for you.
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