Citalopram: What It Is, How to Use It & What to Expect

If you or someone you know has been prescribed citalopram, you’re probably wondering what the pill actually does. In short, citalopram is an SSRI antidepressant that helps boost mood by increasing serotonin levels in the brain. Doctors usually turn to it for depression, anxiety, and sometimes panic attacks.

When you first start a new med, the biggest worry is often the dose. Most adults begin with 20 mg once daily, taken either in the morning or evening – whatever fits your routine best. If you tolerate it well after about a week, the doctor may raise the dose to 40 mg. Going above 40 mg isn’t common and can raise the risk of heart rhythm issues, so stick to what your prescriber says.

Common Side Effects (And How to Deal With Them)

About half of people notice some side effects early on. The most frequent are mild: nausea, dry mouth, drowsiness, or a headache. These usually fade after a few days as your body adjusts. If they linger, try taking the pill with food or at bedtime to reduce morning grogginess.

Less common but still important are changes in sleep patterns, sweating, or a jittery feeling. If you notice any new or worsening depression, thoughts of self‑harm, or severe anxiety, call your doctor right away – these can be signs of a rare reaction called serotonin syndrome.

Drug Interactions & Safety Tips

Citalopram can mix poorly with certain meds. Avoid combining it with other SSRIs, MAO inhibitors, or tramadol without medical supervision because the serotonin load can get too high. Over‑the‑counter cold medicines that contain dextromethorphan also need caution.

Alcohol doesn’t kill citalopram, but it can boost drowsiness and impair judgment. If you’re driving or handling heavy machinery, keep drinking to a minimum until you know how the drug affects you.

People with heart problems should get an ECG before starting high doses – citalopram can lengthen the QT interval on an EKG, which might lead to abnormal rhythms. Also, let your doctor know about any liver or kidney disease; dosage tweaks may be needed.

Pregnancy and breastfeeding are another gray area. While some doctors feel it’s safe in later pregnancy, they’ll weigh benefits against risks. If you’re planning a family, discuss alternatives early on.

Finally, never stop citalopram abruptly. Stopping suddenly can cause withdrawal‑like symptoms such as dizziness, “brain zaps,” or mood swings. Taper the dose gradually under medical guidance.

Bottom line: citalopram works well for many, but it’s not a one‑size‑fits‑all. Keep an open line with your healthcare provider, report any odd symptoms, and give the medication a few weeks to settle before judging its effectiveness.