Citalopram (Celexa^®): Dosage, Usage, Side Effects, and More

Citalopram, or Celexa^®, is a popular antidepressant that helps many people manage their mental health. 

If you’re experiencing symptoms of depression or other mental health issues, an antidepressant might help you feel better.

“There can be anxiety when it comes to trying a mental health medication for the first time,” says Daniel Z. Lieberman, a board-certified psychiatrist. “People worry that it may change their personality or other aspects of who they are. The goal is to get back to how you felt before the illness began. It's the depression that changes who you are; the medication restores your healthy self.” 

Want to feel like your best self again? You’ve got options, and citalopram could be one of them. While healthcare professionals typically prescribe it for clinical depression, it may also help with anxiety disorders or other mental health conditions. 

Our guide below covers everything you need to know about citalopram, including its uses, dosage, and side effects.

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: 

• Generalized anxiety disorder (GAD)

• Obsessive-compulsive disorder (OCD) 

• Panic disorder

• Posttraumatic stress disorder (PTSD) 

• Premenstrual dysphoric disorder (PMDD)

• Poststroke depression

• Separation anxiety disorder

• Social anxiety disorder (SAD) 

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:

• 10 mg 

• 20 mg

• 40 mg 

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:

• Drowsiness

• Dry mouth

• Insomnia

• Dizziness

• Nausea

• Vomiting

• Constipation

• Diarrhea

• Headaches

• Trouble sleeping

• Weight loss

• Reduced sexual function (specifically, lower libido and difficulty reaching climax.)

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: 

• Escitalopram (Lexapro^®)

• Fluoxetine (Prozac^®)

• Sertraline (Zoloft^®)

• Venlafaxine (Effexor^®) 

• Duloxetine (Cymbalta^®) 

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.