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What is citalopram? Facts on its uses, benefits and side effects

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What is citalopram?

Citalopram (sit-ALLO-pram) is an antidepressant of the SSRI (selective serotonin reuptake inhibitor) class. It’s often used to treat depression and/or anxiety and is sometimes used for panic attacks.

Quick facts

  • Citalopram was first synthesised in 1972 by scientists at the Danish pharmaceutical company Lundbeck.
  • In 2017, over 14 million items of citalopram were prescribed in the UK (source: openprescribing.net).
  • Citalopram is not a banned substance in sport, meaning it doesn’t affect athletic performance.
  • The brand name for citalopram is Cipramil.

How does citalopram work?

As a selective serotonin reuptake inhibitor (SSRI), citalopram helps to restore the balance of serotonin in the brain. It’s thought that low serotonin levels may contribute to depression, and citalopram counters this by boosting these levels.

The effects of citalopram should be seen at least two weeks after starting treatment.

Citalopram is only available on prescription, and comes as tablets or oral drops.

Citalopram dosage information

Citalopram comes as 10mg, 20mg and 40mg tablets, and also as 40mg/ml oral drops.

The usual starting dose for an adult is 20mg a day, although you may start at a lower dose and gradually increase to the maximum dose of 40mg. If you are over 65 or have liver problems, 20mg is the maximum recommended dose.

Dosage can vary from person to person, and your GP will prescribe you with the dose that will best alleviate your symptoms or condition.

How to take citalopram

Take citalopram once a day. You can take it with or without food.

Citalopram can be taken at any time of the day. Just make sure you stick to the same time every day. If you’re having trouble sleeping, it’s best to take it in the morning.

Do not crush, break or chew the tablets - take them whole with a glass of water. If you were prescribed Citalopram oral drops, you should mix them with water, orange juice, or apple juice before taking.

If you forget to take a dose, take it as soon as possible unless it’s almost time for your next dose. Do not take two doses together. Using Echo can help you keep on top of your doses.

What are the side effects of citalopram?

As an SSRI, citalopram has fewer unwanted effects than older antidepressants. However, it’s still possible for some people to experience side effects.

Common side effects include:

  • Drowsiness and fatigue
  • Sleep problems such as insomnia
  • Mild nausea, diarrhoea, constipation or stomach upset
  • Agitation, anxiety, nervousness
  • Tremor, disturbance in attention
  • Decreased sex drive
  • Increased sweating or urination

If you have any of the following serious side effects, call your GP immediately:

  • Fast or irregular heartbeat, seizures, fainting
  • Thoughts about harming yourself or ending your life
  • Weight changes without any reasons
  • Changes in your period

Many of you might be wondering about a link between citalopram and weight gain. Currently, there’s no evidence that citalopram causes weight gain. If you’re worried about a sudden change in your weight while on citalopram, see your GP.

Citalopram interactions

If you have been prescribed citalopram, do not take:

  • MAO-inhibitor antidepressants (e.g. selegiline, moclobemide)
  • Medicines for heart rhythm problems (e.g. Class IA and III antiarrhythmics)
  • Antipsychotics (e.g. haloperidol, pimozide)
  • Certain antihistamines (e.g. astemizole, mizolastine)

A full list of interactions with citalopram can be found here.

If you have recently taken or are taking any other medication before starting your citalopram course, let your GP or pharmacist know as soon as possible.

Citalopram contraindications

There are some instances where it may not be safe to take citalopram.

Speak to your GP if you:

  • Have a heart problem. Citalopram can speed up or change your heartbeat.
  • Have diabetes. Taking citalopram can make it difficult to keep your blood sugar stable.  Insulin and/or oral tablets dosage may need to be adjusted.
  • Have had an allergic reaction to citalopram or another medicine in the past.
  • Have ever taken another antidepressant. Some older antidepressants (especially MAOIs) can interact with citalopram to trigger very high blood pressure, even if you’ve not taken them for a few weeks.
  • Are trying to become pregnant, are pregnant, or are breastfeeding. Citalopram isn’t usually recommended if you are pregnant or breastfeeding.
  • Have an eye condition called glaucoma? Citalopram can increase pressure in your eye.

Your GP will weigh up the situation and suggest treatment that best meets your situation.

Taking citalopram during pregnancy or while breastfeeding

If you’re pregnant or breastfeeding, it’s generally advised against taking citalopram.

Citalopram is passed to a baby through breastmilk, meaning it’s possible for the child to suffer side effects (including withdrawal symptoms).

If you’ve been prescribed citalopram despite being pregnant or breastfeeding, it’s because your doctor feels the benefits outweigh the risks. If you have any concerns about taking citalopram, speak to your GP, pharmacist or midwife.

Citalopram and alcohol

If you are taking citalopram, you can drink alcohol in moderation. However, you may find that alcohol can make you a bit sleepier and might cause you to lose focus, so it’s advised to stay clear of alcohol during the first few weeks of your course.

Consult with your GP or pharmacist if you intend to drink while on citalopram.

Citalopram and driving/using machines

Citalopram has minor or moderate impact on your capacity to drive and use machines, it can reduce the ability to make judgements and to react to emergencies.

Make sure you speak to your GP or pharmacist if you work or lifestyle requires you to drive or operate machines. Please see the DVLA website for more information.

Before taking citalopram, speak to your GP if your job or lifestyle requires you to drive or operate machinery.

Citalopram vs escitalopram

Despite the similar-sounding names, and despite the fact they’re both used to treat depression, citalopram and escitalopram are different medicines.

Citalopram doses are double the strength of escitalopram doses, and both medicines can cause different side effects.

What’s the easiest way to get citalopram?

Eleventh-hour dashes to the pharmacy to get collect your citalopram prescription can be a stressful experience; especially if you’ve already got a time-pressed schedule.

If your GP has authorised you to take citalopram on repeat prescription, you can cut out the hassle and manage your citalopram prescription with Echo today.

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