Citalopram

What citalopram is for

Citalopram is used to treat:

• depression
• panic disorder

Citalopram is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).

It's thought to work by increasing the level of serotonin (a chemical in the brain linked to mood). When serotonin levels are normal, this may reduce stress levels and negative thoughts.

How to take citalopram

Citalopram comes as tablets and a liquid that you swallow (oral drops). How much you need to take depends on your age and why you're taking it.

Your doctor may prescribe a low dose to start with and increase it after a few weeks. This reduces the chances of side effects.

You may need to take citalopram for a few weeks before you notice an improvement in your symptoms.

When taking citalopram:

• take it with or without food
• take the tablets once a day, either in the morning or evening – swallow the tablets whole with a glass of water (do not chew them)
• take the oral drops once a day – add the number of drops prescribed for you into a glass of water, orange juice or apple juice

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

How long you need to take citalopram for depends on why you're taking it. You'll usually need to take it for at least 6 months. Keep taking it for as long as your doctor recommends.

If you miss a dose of citalopram

If you forget to take a dose of citalopram, take it as soon as you remember, unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose the next day as usual.

Do not take 2 doses to make up for a missed dose.

If you take too much citalopram

Taking an extra dose of citalopram can be dangerous.

How to stop taking citalopram

Your doctor may suggest that you stop taking citalopram if you've been feeling better for some time.

Do not suddenly stop taking it because it may cause withdrawal symptoms.

Your doctor will gradually reduce your dose over a few weeks. Always follow your doctor's advice.

Side effects of citalopram

Like all medicines, citalopram can cause side effects, although not everyone gets them.

Most side effects should ease after a couple of weeks as your body gets used to the medicine, but some can last longer.

Common side effects

Common side effects of citalopram include:

• headaches
• feeling sick (nausea) and being sick (vomiting)
• sweating
• dry mouth
• diarrhoea or constipation
• problems sleeping
• a fast heartbeat (palpitations)
• sexual problems, such as low sex drive (loss of libido)

If you feel dizzy or drowsy after taking citalopram, do not drive, ride a bike or use machinery until you no longer have these symptoms.

Serious side effects

Citalopram can sometimes cause more serious side effects, although most of them are rare.

Possible serious side effects of citalopram include:

• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• serotonin syndrome – a rare but serious condition that causes a fast heartbeat, sweating, shaking, twitching muscles and feeling confused or agitated
• internal bleeding, which you may notice if you have bruises, or blood in your pee, poo or vomit
• a rare, life-threatening condition that causes a fast, irregular heartbeat, light-headedness and fainting (torsades de pointes)
• feeling very low and having suicidal thoughts

Who can and cannot take citalopram

Most adults can take citalopram. It's not usually recommended for children and young people under the age of 18.

Citalopram is not suitable for everyone. For example, it may not be suitable if:

• you've had an allergic reaction or serious side effect from citalopram or another selective serotonin reuptake inhibitor (SSRI)
• you have a heart condition, such as a previous heart attack, a heart rhythm problem, or a fast or irregular heartbeat
• you have a condition such as diabetes, epilepsy, liver or kidney disease, or glaucoma (an eye condition)
• you have a condition that affects how your blood clots (a bleeding disorder), particularly if it causes bleeding in the digestive system

Before taking citalopram, tell your doctor if you have any other medical conditions.

Breastfeeding and citalopram

Tell your doctor if you're breastfeeding.

Citalopram can be used while breastfeeding, but it's best to check because the medicine can pass into your breast milk in small amounts.

You'll usually be advised to continue taking it if the benefits to you outweigh any possible risks to your baby.

It's rare for breastfed babies to get any side effects of medicines you're using, but speak to a healthcare professional if you have any concerns about your baby.

Pregnancy and citalopram

Tell your doctor if you're pregnant or you get pregnant while taking citalopram.

Citalopram can be used during pregnancy if needed. Your doctor will talk to you about the risks and benefits of taking it while you're pregnant.

If you need to take citalopram while you're pregnant, your doctor will prescribe the lowest possible effective dose.

You may also be advised to give birth in hospital so you and your baby can be closely monitored after you've given birth.

Find out more about taking citalopram during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking citalopram with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with citalopram.

These include:

• sumatriptan, which is used to treat migraine
• strong painkillers, such as tramadol and buprenorphine
• non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and diclofenac
• medicines used to reduce stomach acid, such as omeprazole and esomeprazole
• anticoagulants, such as aspirin and warfarin
• antidepressants called monoamine oxidase inhibitors (MAOIs), such as moclobemide

Do not use the herbal supplement St John's wort when taking citalopram.

Before taking citalopram, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with citalopram

You can eat as normal while taking citalopram.

It's best not to drink alcohol while taking citalopram because it can increase your risk of getting side effects.