Citalopram (Celexa®) Dosage Guide

Citalopram, sold under the brand name Celexa®, is an antidepressant medication that belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs.

Currently, citalopram is FDA-approved as a treatment for depression. It’s also used off-label to treat other psychiatric disorders and anxiety disorders, including obsessive-compulsive disorder (OCD), and body dysmorphic disorder (BDD).

Like many other antidepressant drugs, citalopram comes in tablet form and is available in a range of different dosages.

Read on to learn all about citalopram and how it works as an antidepressant. 

You’ll also find information on the typical dosage of citalopram for major depressive disorder, along with any side effects and potential drug interactions you should be aware of before using the medication.

Citalopram is an antidepressant. It belongs to a class of antidepressant drugs referred to as selective serotonin reuptake inhibitors (SSRIs) and is currently approved by the FDA as a medication for treating major depressive disorder (MDD, or major depression).

Some healthcare professionals may also prescribe citalopram off-label to treat anxiety, premenstrual dysphoric disorder, obsessive-compulsive disorder, panic disorder, body dysmorphic disorder and persistent depressive disorder (dysthymia, or PDD).

Citalopram is also used off-label to treat alcohol use disorder, coronary arteriosclerosis (plaque buildup in the coronary arteries) and postmenopausal flushing.

As an SSRI, citalopram works by increasing the amount of serotonin in your brain. Serotonin is a neurotransmitter that’s responsible for regulating your mood, happiness, sleep and wake cycle and anxiety level.

Low levels of serotonin are linked to depression. Experts believe that SSRIs such as citalopram treat depression by increasing serotonin levels in the brain and body.

You can learn more about SSRIs in this guide to how citalopram and other treatments work for depression, anxiety and other mental health conditions. 

Citalopram comes in tablet form in daily doses of 10mg, 20mg and 40mg. It’s also available as an oral solution.

The initial dose of citalopram to treat depression is typically 20mg per day, taken once daily with or without food in either the morning or evening.

If you’re prescribed citalopram for depression, your healthcare provider will typically adjust your dosage to a maximum of 40mg per day after approximately one week of treatment, but it may take several weeks of treatment before you see desired results.

In patients older than 60 years of age, or in patients with poor CYP2C19 metabolism, citalopram is prescribed at a maximum recommended dosage of 20mg per day.

Because citalopram is currently only approved by the FDA as a treatment for depression, there are no standardized dosages available from the FDA for conditions such as anxiety. 

However, research shows that citalopram is effective at a range of different dosages for anxiety and other conditions. 

For example, the American Psychological Association has previously recommended that, in clinical practice, citalopram be prescribed at a dosage of 20mg to 60mg per day for obsessive-compulsive disorder, with a suggested maximum dose of 80mg to 120mg per day. 

If you’re prescribed citalopram for any off-label use, make sure to closely follow the instructions from your healthcare provider and use your medication only as directed.  Read our blog for more information on citalopram for anxiety.

Citalopram is a safe, effective medication for most people for short-term and long-term treatment, and offers a smaller side effect profile than other medications like tricyclic antidepressants (TCAs). How long you stay on citalopram varies depending on your symptoms.

However, like other antidepressant drugs, it can cause adverse effects. 

Common side effects of citalopram include:

• Nausea

• Diarrhea

• Vomiting

• Abdominal pain

• Constipation

• Weight loss

• Reduced appetite

• Yawning and/or tiredness

• Frequent urination

• Dry mouth

• Tremor

• Blurred vision

• Physical weakness

• Sexual side effects, such as changes in sex drive and ejaculation disorder

These undesirable effects may improve over time. Research suggests that up to 10 percent of people who use citalopram experience side effects or adverse events during treatment.

Although rare, citalopram may cause more severe side effects including chest pain, shortness of breath, dizziness, fainting, seizure and abnormal electrical activity of the heart.

If you experience severe side effects after using citalopram, contact your healthcare provider or seek emergency medical assistance immediately.

Like other SSRIs, citalopram carries a black box warning from the FDA notifying of an increase in the potential risk of suicidal thoughts and behavior in adults up to 24 years of age.

It’s also important to note that citalopram can interact with other medications, including monoamine oxidase inhibitors (MAOIs) and other medications that increase serotonin levels. 

If taken with or shortly after the use of MAOIs, your risk of serotonin syndrome increases. There’s also a risk of serotonin syndrome occurring if you suddenly stop the medication without the help or guidance of your healthcare provider. 

Serotonin syndrome is a potentially life-threatening condition that occurs when serotonin levels in the body are too high.

To prevent interactions, make sure to inform your healthcare provider about all medications you currently use or have recently used before starting treatment with citalopram. 

It’s also not unheard of to experience an allergic reaction while taking citalopram. If you experience any of the telltale signs of an allergic reaction, such as hives, rash, swelling or changes in your heart rate, seek medical help immediately. 

Citalopram comes in tablet or liquid form, making it an easy medication to use. To get the best results from your citalopram dosage, make sure to:

• Take your medication as prescribed. Be sure to use citalopram at the dosage prescribed by your healthcare provider. If you miss a dose, take it as soon as possible. 
  Take only a single dose of citalopram at once, however. Do not double up.

• Use citalopram at approximately the same time every day. This helps ensure citalopram maintains a steady state in your body. It’s okay to take citalopram with or without food.

• If you experience side effects, inform your healthcare provider. Common side effects from citalopram often improve on their own. However, your healthcare provider may adjust your citalopram dosage if you have persistent or severe side effects.

• Continue using citalopram, even if you don’t notice improvements. It may take up to four weeks of treatment for your citalopram dosage to produce a noticeable change in your mood. Make sure to continue using citalopram daily, even if its effects aren’t obvious at first.

• Store citalopram properly. Citalopram should be stored at room temperature in a safe place away from excess heat and moisture. Do not store citalopram inside a bathroom.
  

• Don’t stop using citalopram without talking to your healthcare provider. Like other SSRIs, citalopram can cause withdrawal symptoms when stopped suddenly. Make sure to consult your healthcare provider before you consider discontinuing treatment. 

As a treatment of depression, the citalopram daily dosage is typically 20mg to 40mg, taken once daily. Your healthcare provider can help you find the right dose, and adjust it over time. 

It may take a few weeks of treatment before you start feeling the true effects of this medication, so keep in close contact with your healthcare provider to monitor any changes you may experience.

If you’re prescribed generic citalopram or Celexa, make sure to closely follow your healthcare provider’s instructions and use your medication only as directed. 

For more details, check out this complete guide to SSRIs to learn how citalopram and similar medications work for depression, anxiety and other mental health conditions.