Citalopram

Generic name: citalopram (citalopram hydrobromide) · Brand names: Celexa

Quick facts

Drug class
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f), Highlights; openFDA returned no pharm_class_epc for citalopram (fetched 2026-11-02)
Source text (exact source wording)
Citalopram tablets are a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of major depressive disorder (MDD) in adults (1).
Rx or otc
Rx (label is prescribing information; DailyMed lists prescription drug)
Controlled schedule
Not controlled. Label 9.1: 'Citalopram hydrobromide is not a controlled substance.'
Forms and strengths
  • Tablets: 10 mg; 20 mg; and 40 mg (label section 3). 10 mg: beige colored, film-coated, oval shaped, biconvex tablets with 'G 11' on one side and '10' on the other side
  • 20 mg: pink colored, film-coated, oval shaped, biconvex tablets with 'G' engraved on one side and '11' on the other side of bisect on one face. The other face is engraved with '20'
  • 40 mg: white to off-white colored, film-coated, oval shaped, biconvex tablets with 'G' engraved on one side and '11' on the other side of bisect on one face. The other face is engraved with '40'
Generic available
Value
yes
Source
DailyMed: Glenmark label marketing category ANDA (ANDA077654); also ANDA labels from Torrent (ANDA078216), Aurobindo (ANDA077031), Mylan (ANDA077042), Cipla (ANDA077534), Amneal (ANDA077289), Epic (ANDA077045)
Common use one line
Treatment of major depressive disorder (MDD) in adults (label section 1).

What it is used for

Citalopram is used to treat major depressive disorder (MDD) in adults.
Section
1 INDICATIONS AND USAGE
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Citalopram tablets are indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies (14)].

How it works

The label says how citalopram works is unclear. It is presumed to be related to boosting serotonin activity in the central nervous system by blocking the reuptake of serotonin (5-HT).
Section
12.1 Mechanism of Action
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The mechanism of action of citalopram is unclear, but is presumed to be related to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).

Dosage: adults

Take citalopram once daily, with or without food. The starting dosage is 20 mg once daily. It can be increased to a maximum of 40 mg once daily, no sooner than one week apart. Doses above 40 mg once daily are not recommended because of the risk of QT prolongation. When stopping, reduce the dosage gradually rather than stopping abruptly whenever possible.
Section
2.1 Recommended Dosage; 2.6 Discontinuing Treatment
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Administer citalopram tablets once daily, with or without food, at an initial dosage of 20 mg once daily, with an increase to a maximum dosage of 40 mg once daily at an interval of no less than one week.

Dosages above 40 mg once daily are not recommended due to the risk of QT prolongation [see Warnings and Precautions (5.2)].

2.6: Adverse reactions may occur upon discontinuation of citalopram tablets [see Warnings and Precautions (5.6)]. Gradually reduce the dosage rather than stopping citalopram tablets abruptly whenever possible.

Dosage: children

Citalopram is not approved for use in pediatric patients. Safety and effectiveness have not been established, and antidepressants increase the risk of suicidal thoughts and behaviors in pediatric patients.
Section
8.4 Pediatric Use
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The safety and effectiveness of citalopram have not been established in pediatric patients. Two placebo-controlled trials in 407 pediatric patients with MDD have been conducted with citalopram, and the data were not sufficient to support use in pediatric patients. Antidepressants increase the risk of suicidal thoughts and behaviors in pediatric patients. Decreased appetite and weight loss have been observed in association with the use of SSRIs in pediatric patients.

Dosage adjustments

Drug interaction caps
With a CYP2C19 inhibitor, the maximum recommended dosage is 20 mg once daily.
Section
2.4
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The maximum recommended dosage of citalopram tablets when used concomitantly with a CYP2C19 inhibitor is 20 mg once daily [see Warnings and Precautions (5.2), Drug Interactions (7)].
Kidney
Section
n/a
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Liver
With liver impairment, exposure is increased and the maximum recommended dosage is 20 mg once daily.
Section
8.6 Hepatic Impairment; 2.3
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Increased citalopram exposure occurs in patients with hepatic impairment. The maximum recommended dosage of citalopram is lower in patients with hepatic impairment [see Dosage and Administration (2.3), Clinical Pharmacology (12.3)]. (2.3) The maximum recommended dosage of citalopram tablets for patients who are greater than 60 years of age, patients with hepatic impairment, and for CYP2C19 poor metabolizers is 20 mg once daily.
Elderly
For patients greater than 60 years of age, the maximum recommended dosage is 20 mg once daily because exposure is higher. Older adults may be at greater risk of low sodium (hyponatremia) with SSRIs.
Section
8.5 Geriatric Use; 2.3
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Of 4422 patients in clinical studies of citalopram, 1357 were 60 and over, 1034 were 65 and over, and 457 were 75 and over. In two pharmacokinetic studies, citalopram AUC was increased by 23% and 30%, respectively, in subjects ≥ 60 years of age as compared to younger subjects, and its half-life was increased by 30% and 50%, respectively [see Clinical Pharmacology (12.3)]. Therefore, the maximum recommended dosage in patients 60 years of age and older is lower than younger patients [see Dosage and Administration (2.3), Warnings and Precautions (5.2)]. SSRIs, including citalopram, have been associated with cases of clinically significant hyponatremia in elderly patients, who may be at greater risk for this adverse reaction [see Warnings and Precautions (5.9)].

Missed dose

MedlinePlus says to take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue your regular schedule. Do not take a double dose.
Section
What should I do if I forget a dose?
Source
MedlinePlus citalopram page (Last Revised - 11/15/2025)
Medlineplus source text (exact source wording)
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Overdose

Overdose can cause seizures (which may be delayed), coma, heart rhythm problems, and serotonin syndrome. Call poison control at 1-800-222-1222. Call 911 if the person has collapsed, had a seizure, has trouble breathing, or can't be awakened. Note: the Glenmark label prints the poison center number as 1-800-221-2222, while MedlinePlus gives 1-800-222-1222; see conflicts.
Section
10 OVERDOSAGE; MedlinePlus
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The following have been reported with citalopram tablet overdosage:
• Seizures, which may be delayed, and altered mental status including coma.
• Cardiovascular toxicity, which may be delayed, including QRS and QTc interval prolongation, wide complex tachyarrhythmias, and torsade de pointes. Hypertension most commonly seen, but rarely can see hypotension alone or with co‑ingestants including alcohol.
• Serotonin syndrome (patients with a multiple drug overdosage with other proserotonergic drugs may have a higher risk).

Prolonged cardiac monitoring is recommended in citalopram overdosage ingestions due to the arrhythmia risk. Gastrointestinal decontamination with activated charcoal should be considered in patients who present early after a citalopram overdose. Consider contacting a Poison Center (1‑800‑221‑2222) or a medical toxicologist for additional overdosage management recommendations.

[MedlinePlus] In case of overdose, call the poison control helpline at 1-800-222-1222. ... If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Storage

Store at 20ºC to 25°C (68°F to 77°F), with excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from light and moisture.
Section
16 HOW SUPPLIED/STORAGE AND HANDLING (Glenmark-specific)
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Citalopram Tablets, USP should be stored at 20ºC to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Protect from light and moisture.

Boxed warning

Antidepressants increased the risk of suicidal thoughts and behaviors in children and young adults in short-term studies. All patients should be closely monitored for worsening and for new suicidal thoughts or behaviors. Citalopram is not approved for pediatric patients.
Section
BOXED WARNING
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1)]. Citalopram is not approved for use in pediatric patients [see Use in Specific Populations (8.4)].

Contraindications

Do not use with MAOIs or within 14 days of stopping an MAOI (including linezolid or intravenous methylene blue) because of an increased risk of serotonin syndrome.
Section
4 CONTRAINDICATIONS
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
taking, or within 14 days of stopping, MAOIs (including MAOIs such as linezolid or intravenous methylene blue) because of an increased risk of serotonin syndrome [see Warnings and Precautions (5.3), Drug Interactions (7)].
Do not use with pimozide because of the risk of QT prolongation.
Section
4 CONTRAINDICATIONS
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
taking pimozide because of risk of QT prolongation [see Drug Interactions (7)].
Do not use if you are allergic to citalopram or any inactive ingredient. Reactions have included angioedema and anaphylaxis.
Section
4 CONTRAINDICATIONS
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
with known hypersensitivity to citalopram or any of the inactive ingredients in citalopram tablets. Reactions have included angioedema and anaphylaxis [see Adverse Reactions (6.2)].

Warnings and precautions

Patients should be watched for worsening and new suicidal thoughts, especially in the first few months and when the dosage changes. Family members or caregivers should watch for behavior changes and tell the provider.
Heading
Suicidal Thoughts and Behavior in Adolescents and Young Adults
Section
5.1
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors, especially during the initial few months of drug therapy and at times of dosage changes. Counsel family members or caregivers of patients to monitor for changes in behavior and to alert the healthcare provider. Consider changing the therapeutic regimen, including possibly discontinuing citalopram tablets, in patients whose depression is persistently worse, or who are experiencing emergent suicidal thoughts or behaviors.
Citalopram can lengthen the QTc interval in a dose-dependent way, which has been linked to dangerous heart rhythms and sudden death. Doses above 40 mg once daily are not recommended. It should be avoided in people with congenital long QT syndrome, a slow heartbeat, low potassium or magnesium, a recent heart attack, or uncompensated heart failure unless benefits outweigh risks. The maximum is 20 mg once daily for CYP2C19 poor metabolizers, people taking cimetidine or another CYP2C19 inhibitor, people with liver impairment, and people greater than 60 years of age. Stop it if QTc is persistently >500 ms. Dizziness, palpitations, or fainting need further evaluation. (Ellipses mark omitted text.)
Heading
QT-Prolongation and Torsade de Pointes
Section
5.2
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Citalopram causes dose-dependent QTc prolongation an ECG abnormality that has been associated with Torsade de Pointes (TdP), ventricular tachycardia, and sudden death, all of which have been observed in postmarketing reports for citalopram. Because of the risk of QTc prolongation at higher citalopram doses, it is recommended that citalopram tablets not be given at doses above 40 mg once daily. Citalopram should be avoided in patients with congenital long QT syndrome, bradycardia, hypokalemia or hypomagnesemia, recent acute myocardial infarction, or uncompensated heart failure unless the benefits outweigh the risks for a particular patient. ... The maximum dose should be limited to 20 mg once daily in patients who are CYP2C19 poor metabolizers or those patients receiving concomitant cimetidine or another CYP2C19 inhibitor ... The maximum dose should also be limited to 20 mg once daily in patients with hepatic impairment and in patients who are greater than 60 years of age because of expected higher exposures. ... Discontinue citalopram tablets in patients who are found to have persistent QTc measurements >500 ms. If patients taking citalopram experience symptoms that could indicate the occurrence of cardiac arrhythmias, e.g., dizziness, palpitations, or syncope, the prescriber should initiate further evaluation, including cardiac monitoring.
Citalopram can cause serotonin syndrome, which can be life-threatening. The risk is higher with other serotonergic drugs and MAOIs. Signs include agitation, hallucinations, delirium, coma, fast heartbeat, unstable blood pressure, dizziness, sweating, flushing, high body temperature, tremor, rigidity, muscle twitching, overactive reflexes, poor coordination, seizures, nausea, vomiting, and diarrhea.
Heading
Serotonin Syndrome
Section
5.3
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
SSRIs, including citalopram, can precipitate serotonin syndrome, a potentially life-threatening condition. The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs. ... Serotonin syndrome signs and symptoms may include mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, and gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
Citalopram increases the risk of bleeding. Aspirin, NSAIDs, other antiplatelet drugs, warfarin, and other anticoagulants may add to this risk. Bleeding events have ranged from bruising, hematoma, nosebleeds, and petechiae to life-threatening hemorrhages.
Heading
Increased Risk of Bleeding
Section
5.4
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Drugs that interfere with serotonin reuptake inhibition, including citalopram, increase the risk of bleeding events. Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), other antiplatelet drugs, warfarin, and other anticoagulants may add to this risk. ... Bleeding events related to drugs that interfere with serotonin reuptake have ranged from ecchymosis, hematoma, epistaxis, and petechiae to life-threatening hemorrhages.
In people with bipolar disorder, citalopram may trigger a mixed or manic episode. Patients should be screened for personal or family history of bipolar disorder, mania, or hypomania before starting.
Heading
Activation of Mania or Hypomania
Section
5.5
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
In patients with bipolar disorder, treating a depressive episode with citalopram or another antidepressant may precipitate a mixed/manic episode. ... Prior to initiating treatment with citalopram tablets, screen patients for any personal or family history of bipolar disorder, mania, or hypomania
Stopping abruptly can cause nausea, sweating, mood changes, irritability, agitation, dizziness, electric-shock sensations, tremor, anxiety, confusion, headache, lethargy, insomnia, tinnitus, and seizures. A gradual reduction is recommended.
Heading
Discontinuation Syndrome
Section
5.6
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Adverse reactions after discontinuation of serotonergic antidepressants, particularly after abrupt discontinuation, include: nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible
Use with caution in people with a seizure disorder. In clinical trials, seizures occurred in 0.3% of citalopram patients and 0.5% of placebo patients.
Heading
Seizures
Section
5.7
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
In clinical trials of citalopram, seizures occurred in 0.3% of patients treated with citalopram (a rate of one patient per 98 years of exposure) and 0.5% of patients treated with placebo (a rate of one patient per 50 years of exposure). Citalopram tablets should be prescribed with caution in patients with a seizure disorder.
Citalopram may trigger an angle-closure glaucoma attack in people with anatomically narrow angles. Avoid in patients with untreated anatomically narrow angles.
Heading
Angle-closure Glaucoma
Section
5.8
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The pupillary dilation that occurs following use of many antidepressant drugs, including citalopram, may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Avoid use of antidepressants, including citalopram, in patients with untreated anatomically narrow angles.
Low blood sodium can occur. Signs include headache, trouble concentrating, memory problems, confusion, weakness, and unsteadiness that may lead to falls. Older adults, people taking diuretics, and people who are volume-depleted may be at greater risk.
Heading
Hyponatremia
Section
5.9
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Hyponatremia may occur as a result of treatment with SSRIs, including citalopram. Cases of serum sodium lower than 110 mmol/L have been reported. Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. ... Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs
SSRIs may cause sexual problems. Men may have delayed or failed ejaculation, lower sex drive, and erectile dysfunction. Women may have lower sex drive and delayed or absent orgasm.
Heading
Sexual Dysfunction
Section
5.10
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Use of SSRIs, including citalopram, may cause symptoms of sexual dysfunction [see Adverse Reactions (6.1)]. In male patients, SSRI use may result in ejaculatory delay or failure, decreased libido, and erectile dysfunction. In female patients, SSRI use may result in decreased libido and delayed or absent orgasm.

Pregnancy and breastfeeding

Studies have not established an increased risk of major birth defects or miscarriage. SSRIs late in pregnancy carry a risk of persistent pulmonary hypertension of the newborn and poor neonatal adaptation, and newborns have developed complications needing prolonged hospitalization, respiratory support, and tube feeding. Use in the month before delivery may be linked to postpartum hemorrhage. Untreated depression in pregnancy also has risks. Citalopram is present in human milk; breastfed infants have had irritability, restlessness, excessive sleepiness, decreased feeding, and weight loss and should be monitored. There is a pregnancy registry; the label gives 1-844-405-6185.
Section
8.1 Pregnancy; 8.2 Lactation (ellipses mark omitted text)
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Available data from published epidemiologic studies and postmarketing reports with citalopram use in pregnancy have not established an increased risk of major birth defects or miscarriage. ... There are risks of persistent pulmonary hypertension of the newborn (PPHN) (see Data) and/or poor neonatal adaptation with exposure to selective serotonin reuptake inhibitors (SSRIs), including citalopram, during pregnancy. There also are risks associated with untreated depression in pregnancy ... Neonates exposed to citalopram and other SSRIs late in third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. ... Use of citalopram in the month before delivery may be associated with an increased risk of postpartum hemorrhage. (8.2 Lactation) Data from the published literature report the presence of citalopram in human milk ... There are reports of breastfed infants exposed to citalopram experiencing irritability, restlessness, excessive somnolence, decreased feeding, and weight loss ... Monitor breastfeeding infants for adverse reactions, such as irritability, restlessness, excessive somnolence, decreased feeding, and weight loss. (8.1 Pregnancy Exposure Registry) Healthcare providers are encouraged to advise patients to register by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185

Side effects

Common
Using the label's own definition (incidence of 5% or greater and at least twice placebo), the only most common reaction is ejaculation disorder, mostly delayed ejaculation, in male patients (6% vs 1% placebo).
Threshold
The most common adverse reaction that occurred in citalopram-treated patients with an incidence of 5% or greater and at least twice the incidence in placebo patients was ejaculation disorder (primarily ejaculatory delay) in male patients (see Table 3).
Section
6.1 Clinical Trials Experience; Highlights
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
The most common adverse reaction that occurred in citalopram-treated patients with an incidence of 5% or greater and at least twice the incidence in placebo patients was ejaculation disorder (primarily ejaculatory delay) in male patients (see Table 3). Table 3: Ejaculation Disorder (primarily ejaculatory delay) 6 (citalopram, N=1,063, males N=425) vs 1 (placebo, N=446, males N=194).
Less common
Other reactions reported by at least 2% of citalopram patients and more than placebo include nausea (21% vs 14% placebo), dry mouth (20% vs 14%), somnolence (18% vs 10%), insomnia (15% vs 14%), sweating increased (11% vs 9%), diarrhea (8% vs 5%), tremor (8% vs 6%), dyspepsia (5% vs 4%), fatigue (5% vs 3%), and others in Table 3. These do not meet the label's 'most common' definition.
Section
6.1 Table 3
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Table 3: Adverse Reactions (≥2% and Greater than Placebo) Among Citalopram-Treated Patients (citalopram N=1,063 %, placebo N=446 %): Nausea 21 vs 14; Diarrhea 8 vs 5; Dyspepsia 5 vs 4; Vomiting 4 vs 3; Abdominal Pain 3 vs 2; Dry Mouth 20 vs 14; Sweating Increased 11 vs 9; Somnolence 18 vs 10; Insomnia 15 vs 14; Anxiety 4 vs 3; Anorexia 4 vs 2; Agitation 3 vs 1; Dysmenorrhea (females only) 3 vs 2; Libido Decreased 2 vs <1; Yawning 2 vs <1; Tremor 8 vs 6; Impotence (males only) 3 vs <1; Upper Respiratory Tract Infection 5 vs 4; Rhinitis 5 vs 3; Sinusitis 3 vs <1; Fatigue 5 vs 3; Fever 2 vs <1; Arthralgia 2 vs 1; Myalgia 2 vs 1; Ejaculation Disorder (primarily ejaculatory delay, males only) 6 vs 1. (Table 3 footnote: adverse reactions with incidence on placebo ≥ citalopram, such as headache, dizziness, constipation, were excluded from the table.) Nausea 21 vs 14, dry mouth 20 vs 14 and somnolence 18 vs 10 are the highest-percentage entries but do not meet the label's 'most common' definition (at least twice placebo).
Serious
Label
Serious problems named in the label include dangerous heart rhythm changes (torsade de pointes), serotonin syndrome, bleeding, low sodium, seizures, angle-closure glaucoma, liver necrosis, severe skin reactions, and anaphylaxis.
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Postmarketing (6.2): Cardiac Disorders: torsade de pointes, ventricular arrhythmia, QT prolonged; Eye Disorders: angle-closure glaucoma; Gastrointestinal Disorders: gastrointestinal hemorrhage, pancreatitis; Hepatobiliary Disorders: hepatic necrosis; Immune System Disorders: anaphylaxis, allergic reaction; Musculoskeletal and Connective Tissue Disorders: rhabdomyolysis; Nervous System Disorders: grand mal convulsion(s), myoclonus, choreoathetosis, dyskinesia, akathisia, nystagmus; Renal and Urinary Disorders: acute renal failure; Skin and Subcutaneous Tissue Disorders: Stevens Johnson Syndrome, epidermal necrolysis, angioedema, erythema multiforme, ecchymosis. Also Warnings and Precautions: serotonin syndrome (5.3), increased risk of bleeding (5.4), hyponatremia (5.9), seizures (5.7), discontinuation syndrome (5.6).
Medlineplus
MedlinePlus says to call your doctor immediately or get emergency care for chest pain, shortness of breath, fainting, signs of serotonin syndrome, coma, rash or swelling, unusual bleeding or bruising, severe headache or thinking problems, or seizures.
Source
MedlinePlus citalopram page (Last Revised - 11/15/2025)
Source text (exact source wording)
Some side effects can be serious. If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment: chest pain, shortness of breath, dizziness, fainting; fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhea; coma (loss of consciousness); rash; itching; hives or blisters; hoarseness; difficulty breathing or swallowing; swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs; unusual bleeding or bruising; headache; unsteadiness; problems with thinking, concentration, or memory; seizures
Led to discontinuation
In placebo-controlled trials of up to 6 weeks, 16% of citalopram patients stopped because of an adverse reaction, compared with 8% on placebo. Reasons included nausea (4% vs 0), insomnia (3% vs 1), dizziness (2% vs <1), somnolence (2% vs 1), asthenia, dry mouth, vomiting, and agitation (1% each).
Section
6.1 Table 2
Source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f)
Source text (exact source wording)
Among 1,063 patients with MDD who received citalopram at doses ranging from 10 mg to 80 mg once daily in placebo- controlled trials of up to 6 weeks duration, 16% discontinued treatment due to an adverse reaction, as compared to 8% of 446 patients receiving placebo. The adverse reactions associated with discontinuation (i.e., associated with discontinuation in at least 1% of citalopram-treated patients at a rate at least twice that of placebo) are shown in Table 2. Table 2 (citalopram N=1,063 % vs placebo N=446 %): Asthenia 1 vs <1; Nausea 4 vs 0; Dry Mouth 1 vs <1; Vomiting 1 vs 0; Dizziness 2 vs <1; Insomnia 3 vs 1; Somnolence 2 vs 1; Agitation 1 vs <1.

Interactions

Drugs
Using an MAOI (including linezolid or IV methylene blue) with citalopram raises the risk of serotonin syndrome and is contraindicated.
Name
Monoamine Oxidase Inhibitors (MAOIs)
Section
7 Table 5
Source text (exact source wording)
Concomitant use of SSRIs, including citalopram, and MAOIs increases the risk of serotonin syndrome. Citalopram is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue.
Pimozide raises QT and heart rhythm risk with citalopram and is contraindicated.
Name
Pimozide
Section
7 Table 5
Source text (exact source wording)
Concomitant use of citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of citalopram alone. Citalopram is contraindicated in patients taking pimozide.
Avoid taking citalopram with other drugs that prolong the QT interval, such as certain antiarrhythmics, antipsychotics, and antibiotics.
Name
Drugs that Prolong the QTc Interval
Section
7 Table 5; 5.2
Source text (exact source wording)
Concomitant use of citalopram with drugs that prolong QT can cause additional QT prolongation compared to the use of citalopram alone. Avoid concomitant use of citalopram with drugs that prolong the QT interval (citalopram is contraindicated in patients taking pimozide). [5.2: Such drugs include Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval (e.g., pentamidine, levomethadyl acetate, methadone).]
With a CYP2C19 inhibitor, the maximum recommended dosage is 20 mg daily.
Name
CYP2C19 Inhibitors
Section
7 Table 5
Source text (exact source wording)
Concomitant use of citalopram with CYP2C19 inhibitors increases the risk of QT prolongation and/or ventricular arrhythmias compared to the use of citalopram alone. The maximum recommended dosage of citalopram is 20 mg daily when used concomitantly with a CYP2C19 inhibitor.
Other serotonergic drugs raise the risk of serotonin syndrome; patients should be monitored.
Name
Other Serotonergic Drugs
Section
7 Table 5
Source text (exact source wording)
Concomitant use of citalopram and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome. Monitor patients for signs and symptoms of serotonin syndrome, particularly during citalopram initiation and dosage increases.
Antiplatelets and anticoagulants may raise bleeding risk. For patients taking warfarin, the INR is monitored carefully.
Name
Drugs That Interfere With Hemostasis (antiplatelet agents and anticoagulants)
Section
7 Table 5
Source text (exact source wording)
Concomitant use of citalopram and an antiplatelet or anticoagulant may potentiate the risk of bleeding. Inform patients of the increased risk of bleeding associated with the concomitant use of citalopram and antiplatelet agents and anticoagulants. For patients taking warfarin, carefully monitor the international normalized ratio
Food and alcohol
Talk to your doctor about safe use of alcohol. Alcohol can make the side effects worse. The Glenmark label's interaction section does not address alcohol.
Name
Alcohol (MedlinePlus)
Section
MedlinePlus: What special precautions should I follow?
Source text (exact source wording)
talk to your doctor about the safe use of alcoholic beverages during your treatment with citalopram. Alcohol can make the side effects of citalopram worse.
Name
Food (MedlinePlus)
Section
MedlinePlus
Source text (exact source wording)
Take once a day, with or without food. ... Unless your doctor tells you otherwise, continue your normal diet.
Other
St. John's wort, tryptophan, cimetidine, aspirin, and NSAIDs such as ibuprofen and naproxen may interact with citalopram.
Name
Nonprescription and herbal products (MedlinePlus)
Section
MedlinePlus
Source text (exact source wording)
the following nonprescription or herbal products may interact with citalopram: St. John's wort; tryptophan; cimetidine; aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen.

Patient tips

Label
Read the Medication Guide. Watch for suicidal thoughts, especially early on and when the dose changes, and report them. Contact your provider right away if you feel faint, lose consciousness, or have heart palpitations.
Source text (exact source wording)
Advise the patient to read the FDA-approved patient labeling (Medication Guide). Suicidal Thoughts and Behaviors: Advise patients and caregivers to look for the emergence of suicidality, especially early during treatment and when the dosage is adjusted up or down, and instruct them to report such symptoms to the healthcare provider. QT Prolongation and Torsade de Pointes: Advise patients to consult their health care provider immediately if they feel faint, lose consciousness, or have heart palpitations.
Medlineplus
Take it exactly as directed. It may take several weeks to feel the full benefit. Do not stop without talking to your doctor, who will probably lower the dose gradually. It may make you drowsy, so do not drive or operate machinery until you know how it affects you.
Source
MedlinePlus citalopram page (Last Revised - 11/15/2025)
Source text (exact source wording)
Take citalopram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. ... It may take several weeks before you notice the full benefit of citalopram. Do not stop taking citalopram without talking to your doctor. Your doctor will probably decrease your dose gradually. ... you should know that citalopram may make you drowsy and may affect your judgment, thinking, and movements. Do not drive a car or operate machinery until you know how this medication affects you.

Alternatives

Class
selective serotonin reuptake inhibitor (SSRI)
Class source
Glenmark label (set ID 18330b41-27ad-461b-a0a9-aac94e8ee87f) Indications and Usage; openFDA returned no pharm_class_epc
Indication source
Glenmark label: major depressive disorder in adults
Note
No recommendation made.

Frequently asked questions

Question
What is citalopram used for?
Answer
Citalopram tablets are indicated for the treatment of major depressive disorder (MDD) in adults. MedlinePlus says it is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs).
Source section
1 INDICATIONS AND USAGE; MedlinePlus
Source
Glenmark label; MedlinePlus
Question
Can I take citalopram with food?
Answer
Yes. The label says to administer it once daily, with or without food.
Source section
2.1
Source
Glenmark label
Question
What should I do if I miss a dose?
Answer
MedlinePlus says to take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue your regular schedule. Do not take a double dose.
Source section
What should I do if I forget a dose?
Source
MedlinePlus
Question
Can I drink alcohol with citalopram?
Answer
MedlinePlus says to talk to your doctor about the safe use of alcoholic beverages during treatment, because alcohol can make the side effects of citalopram worse.
Source section
What special precautions should I follow?
Source
MedlinePlus
Question
What are the most common side effects?
Answer
By the label's definition (incidence of 5% or greater and at least twice placebo), the most common reaction is ejaculation disorder, mostly delayed ejaculation, in male patients (6% vs 1% placebo). Other reactions seen at 2% or more and more than placebo include nausea (21% vs 14%), dry mouth (20% vs 14%), and somnolence (18% vs 10%).
Source section
6.1 Clinical Trials Experience; Table 3
Source
Glenmark label
Question
Is citalopram safe during pregnancy or breastfeeding?
Answer
SSRI use late in pregnancy carries risks of persistent pulmonary hypertension of the newborn and poor neonatal adaptation, and use in the month before delivery may be linked to postpartum hemorrhage. Citalopram is present in human milk and breastfed infants should be monitored. Talk to your doctor if you are pregnant or breastfeeding.
Source section
8.1; 8.2
Source
Glenmark label
Question
What should I not combine with citalopram?
Answer
MAOIs (including linezolid and intravenous methylene blue) and pimozide are contraindicated. Other serotonergic drugs, drugs that prolong the QT interval, CYP2C19 inhibitors, aspirin, NSAIDs, other antiplatelet drugs, warfarin, and other anticoagulants also have important interactions.
Source section
4; 7 Table 5
Source
Glenmark label
Question
Should I stop citalopram when I feel better?
Answer
MedlinePlus says not to stop taking citalopram without talking to your doctor, who will probably decrease your dose gradually. The label says to gradually reduce the dosage rather than stopping abruptly whenever possible.
Source section
2.6; MedlinePlus
Source
Glenmark label; MedlinePlus

Sources

  • DailyMed Glenmark Therapeutics citalopram tablets (PRIMARY)
    Set id: 18330b41-27ad-461b-a0a9-aac94e8ee87f · Label effective or revised date: Revised: 9/2026 (Highlights and end of label; 'May 2024' also appears once in the label body) · Dailymed version date: 2024-06-05 (DailyMed list publish date, earlier than the label's revised date: unexplained, see notes) · Fetched at: 2026-11-02 · Sections used: Highlights, 1-12 (partial 12), 16, 17 (first part)
  • DailyMed alternate: Torrent citalopram tablets
    Set id: 04766f1d-7a69-49ed-8fd3-1a6305505d47 · Label effective or revised date: Revised: 2/2026 (Highlights text also shows December 2025) · Dailymed version date: 2026-02-06 · Fetched at: 2026-11-02 · Sections used: revised date, marketing category
  • DailyMed alternate: Epic Pharma citalopram tablets
    Set id: 08b6d5da-5919-4760-9e16-3b478a14d6d7 · Label effective or revised date: Revised: 9/2024 · Dailymed version date: 2024-12-23 · Fetched at: 2026-11-02 · Sections used: revised date only
  • DailyMed other opened labels (not chosen)
    Fetched at: 2026-11-02 · Sections used: Amneal 6a402640-1c9d-4fca-8b5b-e1ac1dd4ca5a Revised 9/2024; Cipla 0580559a-783a-4a0a-8d81-ee30a29077c5 Revised 8/2024; Mylan 825c0c49-5fbf-6d8b-cb8c-94ebf0eda043 Revised 6/2024; Aurobindo 2632b547-2e13-447f-ac85-c774e437d6a8 Revised 5/2024
  • DailyMed Celexa brand label (Allergan)
    Set id: 4259d9b1-de34-43a4-85a8-41dd214e9177 · Label effective or revised date: Revised: 10/2023 · Dailymed version date: 2026-08-20 · Fetched at: 2026-11-02 · Sections used: revised date, marketing category only
  • MedlinePlus Citalopram
    Label effective or revised date: Last Revised - 11/15/2025 · Fetched at: 2026-11-02 · Sections used: all
  • openFDA
    Fetched at: 2026-11-02 · Sections used: query returned no openfda.pharm_class_epc: NOT FOUND
  • Drugs@FDA
    Sections used: NOT FOUND (not searched)
  • Liverpool HIV/HEP checkers
    Sections used: not applicable: the label's interaction table lists no antiviral drugs

Information is taken from the cited sources and is for general reference only. It is not medical advice. Report side effects to FDA MedWatch at 1-800-FDA-1088. For a poison emergency call 1-800-222-1222. See prices for this drug