Citalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).
Citalopram is available on prescription. It comes as tablets and liquid drops that you put in water and drink.
Who can take citalopram
Most adults and children aged 12 years and over can take citalopram.
If you have diabetes, citalopram can make it more difficult to keep your blood sugar stable. You’ll need to monitor your blood sugar more often in the first few weeks of taking it and adjust your diabetes treatment if necessary. Discuss this with your doctor when you start taking citalopram.
Citalopram is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:
- have ever had an allergic reaction to citalopram or any other medicine
- have a heart problem – citalopram can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
- are trying to become pregnant, are already pregnant or breastfeeding
- have an eye condition called glaucoma – citalopram can increase the pressure in your eye
- have epilepsy or are having electroconvulsive treatment – citalopram may increase your risk of having a seizure
- have ever had a bleeding disorder such as haemophilia
- have ever had a stomach ulcer
Dosage and strength
Citalopram comes in 10mg, 20mg and 40mg tablets.
The usual dose of citalopram is 20mg a day for adults. But you might start at a lower dose and increase to a maximum dose of 40mg a day.
If you are taking citalopram to prevent panic attacks, your starting dose will usually be 10mg once a day. If you're over 65 years old, or have liver problems, the maximum recommended dose is 20mg a day.
The usual dose of citalopram for children is 10mg a day, but this may be increased to 40mg a day.
With liquid drops of citalopram, taking 4 drops is the same as a 10mg tablet.
You’ll usually take citalopram once a day. You can take it at any time of day, but it’s best to stick to the same time every day.
You can take it with or without food.
If you have trouble sleeping, it's best to take it in the morning.
If you are taking citalopram liquid drops, mix them with water and drink it straight away.
It’s best not to take the drops without water.
How long to take it
Once you’re feeling better it’s likely that you’ll continue taking citalopram for several more months.
Most doctors recommend that you take antidepressants for 6 months to a year. Stopping before that time can make depression come back.
The decision to stop your treatment or carry on will depend on what symptoms you have and how serious they are. It will also depend on how well citalopram works for you, and whether you have had any bad side effects.
If you forget to take it for
If you occasionally forget to take a dose, skip the missed dose and take your next dose the next day at the usual time. Never take 2 doses at the same time to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
The amount of citalopram that can lead to an overdose varies from person to person.
Taking too much can cause symptoms such as:
- being sick (vomiting)
- feeling sleepy
- fast heart rate
- fits or seizures
- you take more than your prescribed dose of citalopram
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the citalopram packet, or the leaflet inside it, plus any remaining medicine with you.
If you have been feeling better for 6 months or more, your doctor may suggest coming off citalopram. They will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking citalopram for a long time.
This helps to stop any withdrawal symptoms you might get as a reaction to coming off the medicine.
These can include:
- feeling dizzy
- feeling sick
- numbness or tingling in the hands or feet
- trouble sleeping
- feeling agitated or anxious
Do not stop taking citalopram suddenly or without talking to your doctor first.
Common side effects
These common side effects of citalopram happen in more than 1 in 100 people. There are things you can do to help cope with them:
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects are rare and happen in less than 1 in 1,000 people.
Book an appointment with your doctor if:
- you have changes in your periods, such as heavy bleeding, spotting or bleeding between periods
- you gain or lose weight without trying
Call a doctor or contact 111 straight away if you:
- start bleeding from the gums or get bruises that appear without a reason or that get bigger
- have strong feelings of happiness, enthusiasm or excitement, or feeling restless and you cannot sit or stand still
- start coughing up blood or have blood in your pee
- have black or red poo, or blood in your vomit – these can be signs of bleeding from the gut
- you have chest pain or pressure or shortness of breath
- you have a fit or seizure for the first time, or the seizures you have had in the past become more frequent
- you feel very dizzy, or pass out
- you have painful erections that last longer than 2 hours – this may happen even when you're not having sex
- you get bleeding from any cuts or nosebleeds that is very heavy or does not stop within 10 minutes
- you have thoughts about harming yourself or ending your life
- you get headaches, have trouble focusing, have memory problems, cannot think clearly, have weakness, have a seizure or fit, or lose your balance – these can be signs of low sodium levels
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to citalopram.
The good effects of citalopram may, after a while, improve your sex life as your mood lifts and you start to feel like yourself again.
Some of the possible sexual side effects include:
- painful erections and problems getting an erection and ejaculating
- some vaginal bleeding
- not reaching orgasm the same way as before
- a lower sex drive
Sexual side effects usually stop after the first couple of weeks. Sometimes, however, they can be long lasting and may not get better even after you stop taking the medicine. If this happens and it’s a problem for you, go back to your doctor to see if there's another treatment you can try.
Other side effects
These are not all the side effects of citalopram. For a full list see the leaflet inside your medicines packet.
Citalopram and pregnancy
Citalopram can be used in pregnancy. Some studies have suggested that citalopram might occasionally affect the development of a baby’s heart. However, if there is any risk, it is small, and most babies born to women taking citalopram have a normal heart.
When citalopram is taken in the weeks before delivery it can sometimes cause short-term withdrawal symptoms and, very rarely, breathing problems in the baby. Your baby will be checked after birth and given extra care if needed.
Taking citalopram in the last month of pregnancy may slightly increase your risk of bleeding after delivery. However, because this side-effect is rare and treatable, it is not a reason to stop taking citalopram for most pregnant women.
It is important that mental health problems are well treated since these can affect both you and your baby’s wellbeing. Depression and anxiety can sometimes get worse during pregnancy, and after the baby’s born.
Speak to your doctor if you get pregnant. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.
If your doctor or health visitor says your baby is healthy, you can take citalopram while breastfeeding.
Citalopram passes into breast milk in fairly small amounts. It has often been used during breastfeeding without any problems but has been linked with side effects, including poor feeding, colic, and being unusually sleepy, irritable or restless, in a very small number of breastfed babies.
If you notice that your baby has any of these side effects, or you have any other concerns about them, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.
Although other medicines that pass into breast milk in smaller amounts might be preferred while you are breastfeeding, it is important you take the medicine that works for you. If you are breastfeeding, or planning to breastfeed, talk to your doctor or pharmacist to help you decide what is best for you.
It's important to continue taking citalopram to keep you well. Breastfeeding will also benefit both you and your baby.
Citalopram and fertility
Citalopram may possibly reduce sperm quality, but it's not known whether this reduces male fertility or not. Speak to your doctor if you're having difficulty conceiving a baby.
For women, there's no evidence to suggest that taking citalopram will reduce your fertility. Speak to a pharmacist or your doctor if you're trying to get pregnant as they may want to review your treatment.
Cautions with other medicines
Some medicines can be affected by citalopram, and other medicines can affect the way citalopram works. Using citalopram with other medicines can increase the chances of you having side effects.
Before you start taking citalopram, tell your doctor if you're taking:
- any medicines that affect your heartbeat – citalopram can make your heart beat faster or cause an irregular heartbeat
- any other medicines for depression – some rarely used antidepressants can affect citalopram and cause very high blood pressure even if you have not taken them for a few weeks
Do not take St John's wort, the herbal remedy for depression, while you're being treated with citalopram because it increases your risk of side effects.
It's not possible to say that other herbal remedies or supplements are safe to take with citalopram. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.
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