Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
SSRI (Selective Serotonin Reuptake Inhibitor)

Citalopram

Brand names: Cipramil

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 the reuptake of serotonin (5-HT) at the presynaptic neuronal membrane, enhancing central serotonergic activity.

Prescribing in practice

  • Citalopram causes dose-dependent QT-interval prolongation; observe the maximum daily dose limits (reduced in older patients and in hepatic impairment) and avoid co-prescribing with other QT-prolonging drugs.
  • Risk of hyponatraemia (especially in older patients) and increased gastrointestinal bleeding (consider gastroprotection with concurrent NSAID or anticoagulant).
  • Do not stop abruptly, as discontinuation symptoms can occur; taper the dose gradually.

Monitoring

Consider an ECG where there are cardiac risk factors or concurrent QT-prolonging drugs, and correct electrolyte disturbances. Monitor mood and suicidality early in treatment, and check sodium in those at risk of hyponatraemia.

Counselling the patient

  • It may take several weeks to feel the full benefit of this medicine.
  • Do not stop taking it suddenly; your dose should be reduced gradually.
  • Tell your prescriber about all your other medicines, as some can affect your heart rhythm when taken together.

Evidence & guidelines

Guideline-recommended SSRI (NICE NG222); MHRA Drug Safety Update on dose-dependent QT prolongation.

Reference: MHRA Drug Safety Update 2011 (QT Citalopram); NICE CG90 (Depression); 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.

Calculators
Drugs
Pathways