Citalopram

💊 What is Citalopram used for?

• •The label says citalopram is used to treat major depressive disorder (MDD), a type of depression, in adults. The label also says it is not approved for use in children.

How it works

The label describes citalopram as a selective serotonin reuptake inhibitor (SSRI). It does not explain in detail how the medicine works in the body.

How it is usually taken

• •The label says citalopram is taken once a day, with or without food. Your prescriber sets the starting dose and any later changes. The label says that when treatment is stopped, the dose is usually reduced gradually rather than stopped all at once when possible. Follow the instructions from your prescriber or pharmacist.

Comes as

• •40 mg white, capsule-shaped, film-coated, scored tablets (debossed with 'A' on one side and a score line between '0' and '7' on the other)

⚠️ Citalopram side effects

🛑 Who should not take Citalopram, and who should be careful

The label says not to take it if

• 🚨You take a monoamine oxidase inhibitor (MAOI). The label says citalopram should not be used with an MAOI or within 14 days of stopping one.
• 🚨You are being treated with the antibiotic linezolid or intravenous methylene blue.
• 🚨You take pimozide.
• 🚨You are allergic to citalopram or any of its inactive ingredients.

Tell your doctor before taking it if

• •Tell your provider if you have or have a family history of suicide, depression, bipolar disorder, mania, or hypomania. The label says your provider should screen for bipolar disorder before starting.
• •Tell your provider if you have an abnormal heart rhythm called QT prolongation, or heart problems such as a heart attack, heart failure, abnormal heart rhythm, or long QT syndrome.
• •Tell your provider if you have low potassium, magnesium, or sodium levels in your blood.
• •Tell your provider if you have or had bleeding problems.
• •Tell your provider if you have or had seizures (convulsions).
• •Tell your provider if you have glaucoma (high pressure in the eye).
• •Tell your provider if you have or had kidney or liver problems.
• •Tell your provider if you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed.

🔀 Citalopram with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Monoamine oxidase inhibitors (MAOIs), including linezolid and intravenous methylene blue. These are not allowed with citalopram.
• •Pimozide. Citalopram is not allowed with this medicine.
• •Medicines that prolong the QT interval. The label says to avoid these where possible, and it lists CYP2C19 inhibitors as needing a lower maximum dose.
• •Other serotonin-affecting medicines, such as other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids (including tramadol, fentanyl, meperidine, and methadone), lithium, buspirone, amphetamines, tryptophan, and St. John's Wort. These can raise the risk of serotonin syndrome.
• •Medicines that affect blood clotting, such as aspirin, NSAIDs, other antiplatelet drugs, and warfarin or other anticoagulants. These may increase the risk of bleeding.
• •Diuretics, gatifloxacin or moxifloxacin, and antiarrhythmic medicines are also listed in the label as medicines to discuss with your provider.
• •Tell your provider about all prescription and over-the-counter medicines, vitamins, and herbal supplements you take.

Alcohol and food

The label says citalopram can be taken with or without food. The label does not give specific alcohol instructions in the sections provided, but it notes that overdose risks are higher when alcohol is also involved.

🤰 Citalopram in pregnancy and breastfeeding

Pregnancy

The label says citalopram may harm an unborn baby. Taking it late in pregnancy may lead to an increased risk of certain problems in the newborn, including persistent pulmonary hypertension of the newborn (PPHN) and poor neonatal adaptation. The label also says untreated depression during pregnancy carries its own risks, so the benefits and risks should be discussed with your provider. The label mentions a National Pregnancy Registry for Antidepressants, which can be reached at 1-844-405-6185 or https://womensmentalhealth.org/research/pregnancyregistry/antidepressants.

Breastfeeding

The label says it is not known whether citalopram passes into breast milk. Talk with your provider about the best way to feed your baby. The label says to call your provider right away if a breastfed baby becomes sleepy or fussy, or is not feeding or gaining weight well.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 to 25 degrees C (68 to 77 degrees F). Short temperature changes between 15 and 30 degrees C (59 and 86 degrees F) are permitted.

If a dose is missed

The label does not say.

If too much is taken

The label says overdose has been reported to cause seizures, which may be delayed, and altered mental status including coma. It can also cause heart problems such as QRS and QTc interval prolongation, wide complex tachyarrhythmias, and torsade de pointes. High blood pressure is most common, though low blood pressure can occur, sometimes with alcohol or other substances. Serotonin syndrome may occur, with a higher risk when other serotonin-affecting drugs are involved. The label recommends prolonged cardiac monitoring after overdose and says activated charcoal may be considered if treatment is started early. Seek emergency medical help right away if an overdose is suspected.

🗒️ Questions to ask about Citalopram

• Is citalopram the right antidepressant for my depression, and how long should I expect to take it?
• What starting dose and maximum dose has my prescriber chosen for me, and how should changes be made?
• What warning signs should I watch for in my mood or behavior, and who should I call if they appear?
• Do any of my current medicines, supplements, or over-the-counter products interact with citalopram?
• Do I have any heart rhythm, electrolyte, bleeding, seizure, or eye conditions that I should tell you about?
• How should I stop citalopram safely if I need to, and what symptoms should I watch for afterward?
• What should I do if I am pregnant, planning a pregnancy, or breastfeeding while taking citalopram?

❓ Citalopram: frequently asked questions