Citalopram
Return to Citalopram overviewI honestly wouldn’t know what to do with myself if I wasn’t taking meds but hopefully one day I won’t need to take them because I’ll be recovered from my condition.
Citalopram can be used to treat the following conditions
Headmeds fills the medicines information gaps for young people - things you might want to know about meds like will it affect my sex life? Can I still study? Can I drink?
Headmeds does not give medical advice so this is just general information.
Each medicine has a balance of good and bad effects, and each person gets their own individual effects.
You might want to know just one thing about your medicine, but on each page we have given you the ‘safety headlines’. Please read them as they are important.
We have included lots of information about each medicine - but if you want all the details, please look at the patient information leaflet - which is inside every pack. These leaflets are also at www.medicines.org.uk - where there will be the most up-to-date information.
Safety headlines
- If you have taken more citalopram than it said on the label, you must see a doctor quickly – even if you do not feel any different.
- Citalopram can make some people think about hurting themselves or committing suicide. It can happen in the first two weeks of taking it. You must go straight to hospital with your tablets if you have any of these thoughts.
- Citalopram can sometimes also cause other serious side-effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital if you get any of these symptoms, with your medicine.
- Do not take citalopram if you have taken a monoamine oxidase inhibitor antidepressant (MAOI) like moclobemide, phenelzine, isocarboxazid or tranylcypromine in the last 14 days.
- Stopping citalopram suddenly can cause serious side-effects – go to your doctor if you are thinking of stopping or want to stop, talk to your doctor.
- If you take citalopram while you are pregnant, it may affect the developing baby’s heart. Use good contraception while you are taking citalopram. It can also cause symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.
Basic details
Citalopram is a Selective Serotonin Re-uptake Inhibitor
A Selective Serotonin Re-uptake Inhibitor (SSRI) helps make more serotonin available in your brain.
Citalopram can be used to help with low mood or anxiety.
You can take citalopram in tablets or drops
- Tablets (10mg, 20mg and 40mg strengths)
- Oral drops (40mg per ml - each drop contains 2mg. 4 drops are like one 10mg tablet)
The dose of citalopram in mg given as drops is a bit lower than that of tablets. This is because your body more easily absorbs the drops than the tablets, so you don't need as many mg to have the same effect.
The tablets contain lactose
- The tablets may not be suitable for you if you have problems eating some sugars or dairy (milk-based) foods, as they contain lactose.
- The drops contain a small amount of alcohol, but it would not affect your blood-alcohol level.
Use and Action
Citalopram can be used for a number of conditions
- Low mood (depression)
- Anxiety
- Eating disorders such as bulimia nervosa and binge eating disorder
- Panic Disorder
- Generalised Anxiety Disorder
- Obsessive Compulsive Disorder
- Body Dysmorphic Disorder
- Post-traumatic stress disorder
- Social anxiety
- Phobias
Citalopram can help to adjust the chemicals your brain needs
For low mood (depression):
The brain is usually good at making sure we have enough of the chemicals we need to function properly.
- Experiments suggest that depression or low mood is more likely to happen when the brain doesn’t have enough of a chemical called serotonin (also called ‘5HT’). Serotonin is a natural chemical in the brain that helps messages get around.
- Medicines like citalopram are called selective serotonin reuptake inhibitors (SSRIs) because they stop the brain reabsorbing serotonin in the brain, keeping levels higher for longer.
- This means that the amount of serotonin becomes hihger and the depression and low mood improves.
You should take citalopram once a day
- To get the best effect from citalopram, take it every day.
- Make sure that you know your dose. If it is not written on the label, check it with your pharmacist or doctor.
- You should start by taking it in the morning, this will lower the chance of it affecting your sleep.
- Try to get into a routine, like taking it when you have breakfast or brush your teeth.
- If you find that it makes you sleepy, you can take it at night-time instead.
- You can take it before or after food, it doesn't matter.
- Swallow the tablet with a drink of water or liquid - if you chew it, it tastes bitter.
If you forget to take a dose then just take it as soon as possible
What to do if you miss a dose:
- If you remember later during the day, take it as soon as possible.
- If you forget to take it by bedtime, just start again on the next day.
- Do not take a double dose.
What might happen?
- If you forget to take it for a few days, you may start getting withdrawal symptoms, such as flu-like symptoms. If you do, see your doctor as soon as possible.
- If you want to stop your tablets please speak to your doctor first as it is better if they are stopped slowly over a few weeks rather than stopping suddenly.
You must go to A&E if you take too much
What to do if you take too much:
- If you have taken more citalopram than it said on the label, you must get help quickly – even if you do not feel any different.
- Go to A&E. Take your medicine with you, to show to the doctors. Tell them how much you have taken.
- Get a friend or family member to go with you, if you can, just in case you feel ill on the way.
You might get any of the following signs:
- changes in your heartbeat, going fast or unevenly
- feeling sick (nausea) or being sick
- having a fit (seizure)
- sweating
- feeling sleepy
- passing out
- feeling shaky (tremor) or dizzy
- changing blood pressure, where you feel dizzy if you stand up
- feeling agitated
- your eye pupils getting bigger (dilating)
- your skin going a bit blue
- your fingers and toes may feel very cold
- quick breathing
You are also at risk of getting ‘Serotonin syndrome’. This is when you can get a high fever, agitation, confusion, trembling, or weird movements of your muscles. This is rare, but you should watch out for it. Go straight to A&E if you experience these side effects.
It can take a few weeks to have its full affect but should start to help within the first 1-2 weeks for depression
For anxiety it can take up to 4 weeks for the benefits to be noticed
It takes up to 4 weeks for citalopram to show its full effect but you should notice some benefits within the first 1-2 weeks.
- Scientists think that at first the higher level of serotonin feeds back to the brain that it should make less of it (this means you do not feel any better).
- But after some days of regular treatment, the feedback receptors send fewer messages and the brain gradually releases more serotonin.
Your doctor will probably start you on a low dose (10-20mg) and then increase it slowly over 2-4 weeks to a dose that works for you (usually between 20mg-40mg a day). This is because at first citalopram may make you feel anxious or sick, but starting with a low dose makes this less likely to happen.
If you're taking citalopram for anxiety it can take longer to feel any benfit and may initially make you feel a bit more anxious - this will improve.
Most people take citalopram for about 6 months
You and your doctor should talk about how long you need to take citalopram.
- You will not get the full effect for a few weeks.
- You should probably take it for at least 6-9 months for depression - otherwise your symptoms can come back. If you're taking it for anxiety you may need to take it for longer.
- People who have had low mood or depression more than once may take these for over 6-9 months. This is to stop themselves experiencing depression or low mood again.
- Never stop the tablets suddenly because this may make you more at risk of experiencing low mood. Ask your doctor or your pharmacist for advice on how to stop medicines safely.
It can take a month before you will see good effects. Let your doctor know if you do not feel better after a month.
- For the first 2-3 weeks you may not feel any different. In fact, you may feel a bit more anxious at the start of treatment.
- But by the end of the first month on treatment you should feel your mood lifting, have more interest in things, and start to enjoy things you used to.
- If you do not feel any different after a month, you may need something different or need the dose increased. Carry on taking the medicine and go back to see your doctor as soon as possible.
Reference sources
- Cipramil (R) SPC last updated 11/06/14
http://www.medicines.org.uk/emc/medicine/1070
Accessed 16/11/14 - Cipramil (R) Patient Information Leaflet last updated 09/06/14
https://www.medicines.org.uk/emc/PIL.5197.latest.pdf
Accessed 16/11/14 - Strattera SPC last updated 19/12/13
http://www.medicines.org.uk/emc/medicine/14482/SPC/Strattera+10mg%2c+18mg%2c+25mg%2c+40mg%2c+60mg%2c+80mg+or+100mg+hard+capsules./
Accessed 28/2/14 - Strattera PIL last updated 24/2/14
http://www.medicines.org.uk/emc/medicine/14549/PIL/Strattera++10mg%2c+18mg%2c+25mg%2c+40mg%2c+60mgm%2c+80mg+or+100mg+hard+capsules./
Accessed 28/2/14 - Medscape article about atomoxetine action.
http://www.medscape.com/viewarticle/489321_2
Accessed 31/1/14 - NICE Clinical Guidance 72: Attention Deficit Hyperactivity Disorder ADHD, March 2013. Available at http://www.nice.org.uk/nicemedia/live/12061/42060/42060.pdf
Accessed 31/1/14 - British Association for Psychopharmacology- Consensus Statement- ADHD, 2014. Available at http://www.bap.org.uk/pdfs/ADHD_Guidelines.pdf
Accessed 31/1/14 - Toxbase - Atomoxetine:
http://www.toxbase.org/upload/Pregnancy%20pdfs/Atomoxetine%202013.pdf
Accessed 3/2/14 - Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation, 9th edition. Lippincott Williams & Wilkins,2011.
- Taylor D, Paton C, Kapur S. Maudsley Prescribing Guidelines in Psychiatry, 11th edition. Oxford: John Wiley & Sons, 2012
- British National Formulary (BNF) 66th edition. London: BMJ Group / Pharmaceutical Press, 2013
- British National Formulary for Children (BNFc) 2013-2014. London: BMJ Group / Pharmaceutical Press, 2013
- WADA Prohibited List 2014. Available at http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/2014/WADA-prohibited-list-2014-EN.pdf
- Neal MC. Medical Pharmacology at a Glance (7th Edition). Oxford: John Wiley & Sons, 2012
- Royal Pharmaceutical Society of Great Britain. Medicines Ethics and Practice (37th edition). London: RPS, 2013