How Long Can You Stay on Citalopram?

If you’ve been diagnosed with major depressive disorder (MDD), your healthcare provider might prescribe an antidepressant to help you control your depression symptoms. 

One common antidepressant is citalopram (sold as Celexa®). Used on its own or in combination with therapy, citalopram can help to reduce the severity of depression and help you as you work on recovering.

If you’ve been prescribed citalopram, you might wonder how long you can take your medication before stopping. In general, your mental health provider will recommend using citalopram for as long as required to bring your symptoms under control.

Depending on the severity of your depression and your response to treatment, this could mean using citalopram or similar medication for several months, or even several years.

Below, we’ve explained what citalopram is, as well as how it and similar antidepressants work to treat depressive symptoms.

We’ve also discussed how long you can stay on citalopram, potential citalopram side effects and other things you should be aware of before using this medication. 

Citalopram is an antidepressant. It belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs. SSRIs like citalopram work by increasing levels of serotonin — a neurotransmitter that’s involved in managing certain aspects of your moods and behavior.

Serotonin plays a key role in regulating your moods, happiness, levels of anxiety and a variety of internal bodily functions. Low serotonin levels are associated with a range of mental health issues, including depression, anxiety and suicidal behavior.

By increasing serotonin levels, citalopram and similar SSRIs reduce the severity of depression symptoms and assist in recovery from clinical depression.

Although citalopram is approved by the FDA as a treatment for depression, it’s commonly used as an off-label medication for other mental health issues. Off-label uses of citalopram include:

• Generalized anxiety disorder (GAD)

• Obsessive-compulsive disorder (OCD)

• Premenstrual dysphoric disorder (PMDD)

• Social anxiety disorder (SAD)

• Post-traumatic stress disorder (PTSD)

• Separation anxiety disorder

• Panic disorder

• Binge eating disorder

Citalopram and other SSRIs are also occasionally prescribed off-label to treat sexual issues in men, such as premature ejaculation (PE).

Citalopram is an oral medication that’s available as a tablet and as a solution. Your healthcare provider will generally prescribe citalopram for use once per day. Most people take citalopram on a consistent schedule in the morning or evening, either with or without food.

It’s common to start citalopram at a dosage of 20mg per day. Your mental health provider may slowly increase your dosage of citalopram up to a maximum dosage of 40mg per day based on the severity of your symptoms and your response to the medication.

If you’re prescribed citalopram, make sure to closely follow the instructions given by your mental health provider.

Citalopram is generally effective at treating depression. In fact, a review involving more than 10 years of data published in the Journal of Clinical Psychiatry in 2000 found that it showed similar efficacy to other SSRIs and tricyclic antidepressants.

Antidepressants like citalopram need time to start working. You may need to take citalopram for four weeks or longer before you notice any improvements in your moods, energy levels or other symptoms of depression.

If you don’t notice any improvements after using citalopram for several weeks, it’s important that you tell your mental health provider. It’s common and very normal to try several antidepressants before finding one that works well for you.

It’s normal to use antidepressants like citalopram for at least a few months. This long-term use is important for controlling your symptoms and preventing your depression from coming back — an issue that’s referred to as a depression relapse. 

At the start of treatment with citalopram or similar medication, your mental health provider and you will work together to bring your depressive symptoms under control.

Once your depression symptoms are under control, you’ll usually need to continue using citalopram or a similar type of antidepressant for at least four to nine months to stop your depressive symptoms from returning.

It’s common to use citalopram over the long term. In fact, many people with depression continue to use antidepressants for several years. In one study, people with depression used citalopram for a period of 28 months without any significant issues.

If you’re prescribed citalopram for a long time period, your mental health provider might ask you to check in with them on a regular basis. During these appointments, you can keep your mental health provider informed about your progress and any side effects you’re experiencing.

Your mental health provider may gradually adjust your dosage of citalopram over time based on the severity of your symptoms and your response to treatment.

When used as directed, citalopram is a safe and effective medication for most people. However, like other antidepressants, it can potentially cause side effects, including some that may have a negative effect on your wellbeing and quality of life.

Common side effects of citalopram include:

• Drowsiness

• Dizziness

• Headaches

• Insomnia and/or sleep disturbances

• Diaphoresis (excessive, abnormal sweating)

• Nausea and vomiting

• Xerostomia (dry mouth)

• Constipation

• Diarrhea

Citalopram and other SSRIs can also cause sexual side effects, such as difficulty ejaculating in a normal amount of time during sex.

Citalopram may also cause other side effects, including some that can have a serious effect on your health and wellbeing. Less common adverse effects of citalopram include:

• Changes in heart rhythm

• Symptoms of mania

• Suicidal ideation and behavior

• Myocardial infarction (heart attack)

• Cerebrovascular accident (stroke)

It’s important to contact your healthcare provider or seek immediate medical help if you develop any severe or concerning side effects while using citalopram. 

Our guide to citalopram side effects provides more information about potential side effects and interactions to be aware of while using this medication. 

Citalopram Drug Interactions

Citalopram can interact with other medications, including other antidepressants and medications that increase serotonin levels. When used together, these medications may cause a dangerous, potentially life-threatening group of symptoms called serotonin syndrome.

Serotonin syndrome is a particular risk with monoamine oxidase inhibitors (MAOIs), an old class of antidepressants that can remain active in the body for several weeks after use.

Other medications, including drugs used to treat cardiovascular health issues, pain, anxiety and other mental health issues, may potentially interact with citalopram.

To reduce your risk of experiencing side effects and/or drug interactions, it’s important to inform your mental health provider about all medications and dietary supplements you currently use or have used in the last 14 days before using citalopram.

If you’re prescribed citalopram, your mental health provider will generally suggest that you keep using it even after your symptoms improve. This is referred to as continuation therapy, and it’s a key part of preventing depression symptoms from returning.

Most of the time, antidepressants like citalopram are continued for four to nine months after your depression symptoms improve.

Your mental health provider will let you know when it’s time to stop using citalopram. In order to prevent antidepressant withdrawal symptoms, they’ll typically adjust your dosage gradually over the course of several weeks.

You may notice some side effects as you stop taking citalopram, such as nausea, restlessness and sleep issues. It’s important to keep your healthcare provider informed if these issues are persistent and don’t improve on their own. 

So, how long can you stay on citalopram? Since depression can vary in severity, there’s no set length of time for which antidepressants like citalopram are prescribed. However, it’s normal to use citalopram for several months, or even several years, in order to treat depression.

If you’re prescribed citalopram, follow your mental health provider’s instructions and take your medication exactly as prescribed. They’ll let you know when it’s time to adjust your dosage or stop using citalopram.

If you think you could have depression, drugs like citalopram may help you to gain control over your symptoms. We offer generic citalopram and other evidence-based medications for mental health, following an online psychiatry consultation with a licensed provider. 

You can also learn more about treating depression with our guide to depression treatments and free online mental health resources and content.