Citalopram (brand name Celexa) is a prescription medication doctors prescribe to treat depressive disorders and other mental health conditions.
It belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medications work by boosting serotonin levels in the brain, helping to regulate mood.
Imagine your brain as a super-efficient vacuum cleaner, regularly sucking up the feel-good neurotransmitter serotonin. Antidepressant medications like citalopram help interrupt this process, preventing your brain from reabsorbing serotonin. This sets off a cascade of chemical reactions in the brain cells that react to serotonin.
Over the course of a few weeks, these changes bring relief from depression, but scientists are still unsure of how that happens.
Here’s the thing: Patience is key. SSRIs like citalopram work their magic over time. It might take several weeks of consistent use for you to start feeling the full effects.
But once you do, the results can be major, with many clinical trials highlighting significant improvements in depression symptoms.
The U.S. Food and Drug Administration (FDA) has approved citalopram to treat major depressive disorder in adults.
Other off-label citalopram uses include treatment of the following:
Like many other SSRIs, citalopram can also help with premature ejaculation (PE).
Because different people respond differently to citalopram, it’s available in multiple dosages.
In tablet form, dosages include:
Citalopram also comes in an oral solution.
In most cases, you’ll start off with a 20 mg dose once daily, increasing up to a maximum of 40 mg. But everyone’s different, and you may not need to increase the dose to get the full effects of the medication.
Antidepressant dosing typically requires a bit of trial and error.
A word of caution: Never take more citalopram than you’re supposed to. Doubling your dose can lead to severe side effects and even heart problems. If citalopram is combined with other medications that target the serotonin system, it can lead to serotonin syndrome, a very serious condition.
The symptoms of serotonin syndrome include:
Confusion
Rapid heart rate
High blood pressure
Twitching muscles
Vomiting and diarrhea
If you think you’re experiencing serotonin syndrome, go to the emergency room immediately.
Some people experience side effects on citalopram.
“Side effects can be worrisome, too, but not everyone gets them,” Lieberman says. “For many people, they are quite mild.”
Common side effects may include:
In many cases, these side effects are dose-dependent, meaning a larger dose can increase the risk of adverse reactions.
More serious side effects may include:
Abnormal bleeding
Allergic reactions
Heart issues
Suicidal thoughts
If you think you’re experiencing any of these side effects, it’s important to contact your healthcare provider immediately.
Additionally, let your prescribing physician know if you have any of the following health conditions:
A family or personal history of long QT syndrome (also known as QT prolongation) or Torsade de Pointes, a rare heart rhythm issue
Bipolar disorder
Heart issues, including a history of heart attacks, heart failure, or an irregular heartbeat
Magnesium or potassium deficiency
Bleeding problems
A seizure condition
Kidney or liver disease
In some cases, citalopram can worsen these health issues.
But don’t stop taking the medication without talking to a healthcare provider, even if you’re experiencing adverse effects. Stopping suddenly may cause withdrawal symptoms.
If you’re breastfeeding, read our guide on Celexa and breastfeeding for more information.
Citalopram can interact with certain medications, increasing the risk of side effects.
Tell your healthcare provider if you take any of the following medications or supplements:
Antiarrhythmics, like pimozide
Blood thinners, including warfarin
Methylene blue
St. John’s wort, a herbal supplement
Monoamine oxidase inhibitors (MAOIs)
Other SSRIs, like fluoxetine and escitalopram
Serotonin-norepinephrine reuptake inhibitors (SNRIs), including venlafaxine and duloxetine
Triptans (used to treat migraines)
Pain medications, including NSAIDs like ibuprofen
Mood stabilizers, like lithium
Tricyclic antidepressants, like amitriptyline
Linezolid
In some cases, you can still use citalopram if you’re taking one of these medications. If you’re unsure whether it’s safe to take citalopram with certain medications, it’s a good idea to speak with your healthcare provider.
Starting a new antidepressant can be tough, especially in the first few weeks when side effects are most prominent.
Research shows citalopram can take up to two weeks to start working, with full effects appearing in four to eight weeks. So if you’re still feeling down after a month, try not to stress too much.
“Finding the right treatment for a psychiatric condition can be challenging because identifying the best medication is often a process of trial and error,” Lieberman explains. “What makes it even worse is that each trial can last a month or more.”
Lieberman adds that it’s important to be patient during this process, as frustrating as it can be. He reminds his patients that these side effects aren’t permanent. “If the medication doesn't feel right, we'll stop it and try something else,” he explains. “But if we don't give it a chance, we'll never know what it can do.”
If citalopram still isn’t working for you, your healthcare provider might suggest trying other antidepressants, such as:
Need extra support during this time? Talking to a therapist can be incredibly helpful. They can teach you coping skills, help you understand your feelings, and provide a safe space to express yourself.
Our guides on finding a therapist and learning about how to start therapy can help you navigate mental health treatment.
Depression doesn’t look the same for everyone — and neither does depression treatment.
While some people can manage their mental health with therapy and lifestyle changes alone, others may benefit from using antidepressants like citalopram.
Let’s recap what we know about citalopram:
It’s a type of antidepressant called an SSRI. Healthcare professionals prescribe citalopram for anxiety, depression, and other mental health conditions.
Side effects are possible, especially in the beginning. Many side effects wane after a few weeks, which is when citalopram’s effect will start kicking in.
Stick to your dosage. Don’t increase or decrease your dosage without a healthcare professional’s go-ahead.
If you’re taking citalopram for your mental health, it could be helpful to chat with a therapist, too. They can offer you extra support and guidance.
Looking for a provider? Hers can connect you with a mental health professional who can prescribe citalopram or another antidepressant, if appropriate. Get started with our online mental health assessment.
- About citalopram. (2022). https://www.nhs.uk/medicines/citalopram/about-citalopram/
- Depression — Treatment and management. (2020). https://adaa.org/understanding-anxiety/depression/treatment-management
- Drugs and lactation database (LactMed) [Internet]. (2024). https://www.ncbi.nlm.nih.gov/books/NBK501185/
- How and when to take citalopram. (2022). https://www.nhs.uk/medicines/citalopram/how-and-when-to-take-citalopram/
- Sharbaf Shoar N, et al. (2023). Citalopram. https://www.ncbi.nlm.nih.gov/books/NBK482222/
- Simon LV, et al. (2024). Serotonin Syndrome. https://www.ncbi.nlm.nih.gov/books/NBK482377/
- Citalopram: Medlineplus drug information. (2022). https://medlineplus.gov/druginfo/meds/a699001.html
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