Quick answer
What is citalopram used for?
Citalopram is an SSRI antidepressant used to treat depression and anxiety disorders. The usual maximum dose is 40mg a day, reduced to 20mg in people over 65 or those on certain interacting medicines, because of a small risk of QT prolongation (an abnormal heart rhythm). It takes weeks to work and should be tapered off gradually, not stopped suddenly.
What citalopram is used for
Citalopram is prescribed for depression and anxiety disorders. It is occasionally used off-label for chronic pain, although this is not its main licensed use.
How citalopram is dosed
Treatment usually starts at 20mg a day and may be increased to 40mg if needed. In older adults, and in people taking certain other medicines that interact with citalopram through the CYP2C19 liver enzyme, the maximum dose is kept lower to reduce risk.
Side effects of citalopram
Common side effects include gastrointestinal upset, changes to sleep, and sexual dysfunction, similar to other SSRIs. QT prolongation is a rare but serious side effect, so you should seek help promptly if you notice palpitations or fainting (syncope).
Stopping citalopram safely
Citalopram should be tapered gradually over several weeks rather than stopped abruptly, as sudden withdrawal can cause uncomfortable symptoms. Always agree a stopping plan with your GP rather than discontinuing it on your own.
Common questions about citalopram
- Is citalopram better than sertraline?
- Citalopram and sertraline are both SSRIs with broadly similar effectiveness for depression and anxiety. The choice between them usually comes down to individual side effects, other medicines you take, and your past response to treatment.
- Why is the citalopram dose limited in older people?
- Older adults tend to reach higher blood levels of citalopram, which increases the risk of QT prolongation, an abnormal heart rhythm. Because of this, the maximum recommended dose is usually 20mg a day in people over 65.
- Does citalopram need heart monitoring?
- An ECG may be recommended if you are on a higher dose, have existing heart disease, or take other medicines that can also prolong the QT interval. Your GP will advise whether monitoring is needed in your case.
- What happens if I stop citalopram suddenly?
- Stopping citalopram abruptly can cause withdrawal symptoms, including unusual sensations sometimes described as electric shocks. Citalopram should instead be reduced gradually under GP guidance.