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SSRI Antidepressant

Citalopram

Brand names: Cipramil

Used in: Depression & Anxiety

Citalopram is a selective serotonin reuptake inhibitor (SSRI) used for depression and panic disorder.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Administer once daily with or without food ( 2 ) . Initial dosage is 20 mg once daily; after one week may increase to maximum dosage of 40 mg once daily ( 2.1 ). Patients greater than 60 years of age, patients with hepatic impairment, and CYP2C19 poor metabolizers: maximum recommended dosage is 20 mg once daily ( 2.2 ). When discontinuing citalopram tablets, reduce dosage gradually ( 2.4 , 5.6 ). 2.1 Recommended Dosage 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 …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-04-30. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It selectively inhibits serotonin reuptake, increasing synaptic serotonin over several weeks.

Prescribing in practice

  • It causes dose-related QT-interval prolongation, so maximum doses are capped — lower in older patients and in hepatic impairment (MHRA); avoid with other QT-prolonging drugs.
  • Watch for hyponatraemia and an increased bleeding risk in older patients, especially with NSAIDs or antithrombotics.
  • Risk of serotonin syndrome with other serotonergic drugs.

Monitoring

Review mood and suicidal ideation early; check sodium if features of hyponatraemia develop; consider ECG where QT risk is high.

Counselling the patient

  • It can take a few weeks to work, and anxiety may briefly increase at first.
  • Do not stop suddenly.
  • Report palpitations, and worsening mood or thoughts of self-harm.

Evidence & guidelines

A first-line SSRI for depression (NICE NG222), with MHRA maximum-dose limits because of QT prolongation.

Reference: MHRA Drug Safety Update 2011 (citalopram QT); NICE CG90 (Depression); AGS Beers Criteria 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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