About citalopram
Citalopram can improve mood and energy is an antidepressant from the selective serotonin reuptake inhibitor class, widely prescribed for depression and sometimes for anxiety-related conditions. It is the active molecule in brand names such as Celexa, though in the United Kingdom generic citalopram and other trade names like Cipramil are commonly used.
- Primary use: treatment of major depressive disorder; may also be used for certain anxiety disorders after clinical assessment.
- Common UK tablet strengths: 10 mg and 20 mg; a 40 mg option exists but is subject to specific limits for some patients.
- Typical adult dose ceiling: 40 mg per day. For older adults or people at risk of cardiac rhythm problems a 20 mg maximum is often advised.
For practical information on taking citalopram see Daily guidance on dosing. If you need help about missed tablets jump to Instructions for the dose was misseds. Safety verifications and worrying signs are covered under Guidance for monitoring in real time and safety and Aftereffects with urgent cautions.
Daily safe dosing recommendations
Citalopram helps balance serotonin levels in the brain is normally taken once a day, at roughly the same time each day, with or without food. Swallow whole with water and follow the instructions on your prescription label. Do not alter the dose or stop suddenly without speaking to your prescriber; a gradual reduction is commonly needed to reduce withdrawal symptoms.
Therapeutic benefit usually develops gradually. Many people notice some improvement in two to four weeks, with further progress over subsequent weeks. In the event of suspected take an overdose seek urgent help: contact NHS 111 for advice, go to A&E, or call 999 if there is collapse, fainting or a dangerously irregular heartbeat.
Some patients choose morning dosing to avoid sleep disturbance, while others prefer night dosing if the drug causes drowsiness. Keep the chosen schedule consistent. Use in children and adolescents should be overseen by specialist services; if under 18 consult child and adolescent mental health teams.
Assess tracking two-way communication in actions helps measure engagement. at Interaction patterns with medicines and substances. For instructions about late or missed tablets see What to do after missing your dose.
Guidance for a missed a dose
If you forget to take your medicine dose, take it as soon as you remember unless your next dose is due within about four hours. If the next scheduled dose is near, omit the missed tablet and resume the normal routine. Do not double up to make up for i skipped a dose todays.
If forgetting tablets happens often talk to your pharmacist or prescriber about practical reminders such as phone alarms, pill organisers, or pairing the tablet with a daily habit.
Engagements and exchanges with medicines and substances
The medication Citalopram interacts with a wide range of prescription drugs, over-the-counter products, herbal supplements and recreational substances. Give a full list of everything you take so your healthcare team can assess risks.
Drugs that are generally contraindicated
- Monoamine oxidase inhibitors (MAOIs) such as phenelzine, tranylcypromine or selegiline. Allow the recommended washout period when changing drug classes.
- Pimozide therapy, a psychiatric medication.
- Cisapride is a prokinetic medication influencing gut motility. and thioridazine because of potential cardiac risk.
- St John’s wort and tryptophan supplements due to increased risk of serotonin excess.
- Co-prescribing another SSRI (for example escitalopram) leading to duplication of therapy.
- Nefazodone clinical option and older appetite suppressants like sibutramine.
Drugs requiring caution or observation and tracking
- Linezolid antibiotic or intravenous methylene blue as therapy. (MAOI-like effects) — seek specialist advice.
- Other antidepressants, many antipsychotics and agents known to prolong the QT interval such as some antiarrhythmics, certain antibiotics and some antihistamines.
- Triptans for migraine (for example sumatriptan) — monitor for serotonin-related effects.
- Anticoagulants and antiplatelet medicines including warfarin and DOACs, plus non-steroidal anti-inflammatory drugs — bleeding risk may be increased.
- CYP2C19 inhibitors (for example cimetidine, omeprazole) can raise citalopram levels and may require dose limits.
- Enzyme inducers like carbamazepine can lower levels; beta-blockers may have altered effects when combined.
- Medications that increase serotonin activity (tramadol, dextromethorphan, some stimulants) — risk of serotonin syndrome.
- Drugs that affect sodium balance (certain diuretics) — added risk of hyponatraemia.
This collection is not exhaustive. Always inform prescribers and pharmacists about prescription medicines, over-the-counter items, herbal remedies and recreational drug use.
Possible deleterious effects and time sensitive risk alerts
Serious acute side effects needing immediate medical attention
- Allergic reaction signs such as widespread rash, swelling of the face, lips, tongue or throat, severe itching or breathing difficulties.
- High fever, severe agitation, tremor, muscle stiffness or very rapid heartbeat — possible serotonin syndrome.
- Seizure spells or loss of consciousness.
- Severe dizziness, fainting, or pronounced irregular pulse.
- New psychotic symptoms including hallucinations or marked detachment from reality.
- Unexplained bleeding or bruising.
- Emergence or worsening of suicidal thoughts or self-harm ideas.
Common, usually less severe reactions
- Nausea, reduced or changed appetite, or stomach upset.
- I am having a head pain sensation.
- Sleep fragmentation such as insomnia or vivid dreams.
- Sweat production has risen.
- My sight is hazy.
- Sexual drug side effects such as reduced libido or difficulty with sexual function.
- Mild drowsiness or lightheadedness.
If you suspect an adverse event consider reporting it to the MHRA Yellow Card scheme. For routine safety checks see Advice for safety integrity through continuous oversight and for entry that is legally permissible information consult Legal framework in the United Kingdom and access.
Security monitoring for safety guidance
- Arrange early follow-up with the prescriber, especially within the first few weeks and after changing dose. Contact services urgently if mood worsens or suicidal thoughts appear.
- Do not stop suddenly without clinical advice; withdrawal effects are common after abrupt cessation and a taper is usually advised.
- Citalopram is a prescription antidepressant may impair concentration or cause drowsiness. Avoid driving or using heavy machinery if you are affected; driving while impaired may be illegal in the UK.
- Limit alcohol while taking this medication because it can increase sedation and worsen mood symptoms.
- Ask a pharmacist before using OTC cold, flu or cough remedies as some contain interacting substances.
- If you have risk factors for QT prolongation your clinician may request an ECG and electrolyte checks such as potassium and magnesium.
- Good oral hydration helps reduce dry mouth; sugar-free gum or sweets can be useful.
What to convey to your clinician before starting
Pre-treatment period begins, tell your prescriber or pharmacist if you have any of the following conditions or histories:
- A personal or family history of bipolar disorder or prior episodes of mania or hypomania.
- Known heart disease, previous diagnosis of QT prolongation, or current therapy with other drugs that affect heart rhythm.
- Previous history of seizures or epilepsy.
- Hepatic or renal dysfunction.
- Type 1 diabetes or other major long-term health conditions.
- Current suicidal thoughts or a history of self-harm.
- Allergy to citalopram, escitalopram, or any tablet excipients.
- Pregnancy, intent to conceive, or lactation.
- Latest or upcoming electroconvulsive therapy.
- History of narrow-angle glaucoma or raised intraocular pressure.
See UK price handbook and more options for other medication options, and State of UK the law and how citizens access it control for purchasing rules.
Archive access to storage space determines how quickly items can be retrieved., handling and disposal
- Store medicines in a locked cabinet to prevent access by children.
- Store at typical room temperature; a common recommended range is 15 to 30 degrees C (59 to 86 degrees F).
- Do not use after the expiry date on the packaging. Take back any unused or expired medications to a pharmacy for safe disposal.
- Retain tablets in original packaging where possible to protect from moisture and to preserve batch and expiry information at hand.
UK based multiple options paired with a rate card guide
If citalopram is not an appropriate choice, prescribers select choice variations based on diagnosis, past treatment response, side-effect considerations, cardiac risk and growth potential communication in actions among teammates fuel progress.. Typical choice variations include:
- Other SSRIs, including sertraline, fluoxetine, escitalopram, and paroxetine, are available.
- SNRIs: venlafaxine and duloxetine.
- The antidepressant Mirtazapine (a NaSSA) which may be preferred when sedation or appetite increase is desirable.
- Amitriptyline and nortriptyline are examples within the tricyclic antidepressant category., used with caution and sometimes at lower doses for pain or sleep.
- Specialist or newer agents: vortioxetine, agomelatine, and moclobemide (a reversible MAOI requiring specialist oversight).
Estimated private medication costs for a 28 to 30 day supply (medication only; excludes consultation and dispensing fees). Figures are approximate and will vary by dose, formulation and brand:
- Generic citalopram 20 mg: about GBP 2 to 10.
- Escitalopram used for depression and anxiety (generic): roughly GBP 3 to 15 depending on strength.
- Sertraline prescription or fluoxetine (generic): commonly GBP 2 to 12.
- Mirtazapine brand name Remeron (generic): typically GBP 3 to 12.
- Venlafaxine (generic): around GBP 4 to 18; extended-release versions may cost more.
Actual outlay depends on the dose, whether a brand is prescribed, as well as the supplier. NHS prescription charges apply in England for most adults (check the current rate); prescriptions are normally free for most people in Scotland, Wales and Northern Ireland. Online pharmacies and private clinics may charge additional fees; always confirm the total cost before ordering.
See The UK legal framework and access policy for safe purchasing advice and distance-selling guidance and support.
Status under British access to legal rights and also the law
- Classification: citalopram is a Prescription Only Medicine (POM) in the UK. It is not a controlled drug, so a valid prescription from an authorised prescriber is required for lawful supply.
- Buying online: use pharmacies registered with UK regulators. Verify MHRA information and GPhC registration, and look for the approved distance-selling pharmacy logo when purchasing remotely.
- Prescription charges: in England most adults pay a per-item NHS prescription charge; check the current fee. Prescriptions are usually free for most people in Scotland, Wales and Northern Ireland. Concessions and prepayment certificates may reduce costs.
- Prescription validity: NHS and private POM prescriptions are typically valid for six months from the issue date unless the prescriber states otherwise. Repeat dispensing may be arranged when appropriate.
- Driving: do not drive if the medication or underlying condition affects your ability to drive safely. Follow DVLA guidance and discuss concerns in the presence of your clinician.
- Pregnancy and lactation: citalopram should be used only after weighing benefits and risks with your prescriber; do not stop treatment without medical advice.
- Emergency supplies: pharmacists can sometimes provide emergency supplies under defined conditions; proof of prior prescription and clinical assessment are usually required.
- Travel: carry medicines in original packaging together with a copy of the prescription. Although citalopram is not a controlled substance, customs officials may ask for proof of legitimacy.
- Off target effects reporting: report suspected adverse reactions to the MHRA Yellow Card scheme.
- Disposal: return unused or expired medicines to a pharmacy rather than disposing of them in household waste or down the drain.
Frequently posed questions
- How rapidly will I feel better? Some people notice benefit in two to four weeks; full effect can take longer. If there is no meaningful improvement by around six weeks speak to your prescriber.
- Will alcohol cause problems while I am taking citalopram? Alcohol by volume can increase drowsiness and may worsen mood. It is sensible to avoid or limit alcohol, especially when starting or adjusting the dose. See Safety guidance and health monitoring practices.
- What if I miss two doses? Follow the instructions in Guidance on missed dosing. If you miss several doses contact your pharmacist or prescriber for tailored advice rather than doubling up.
- Can I switch to another antidepressant? Switching depends on the specific medicines and clinical circumstances. Your clinician will advise on washout periods, cross-tapering and status monitoring. See Price guide and a backup route selections (UK).
- Will I need tests or an ECG? Not everyone will need tests. Blood tests or an ECG may be advised for people with heart disease, electrolyte abnormalities, or those taking other QT-prolonging drugs. See Safety tips and practical watchful oversight advice.
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