Try to take citalopram at the same time each day.
It may take up to four weeks after starting this treatment before you feel the full benefit. Do not stop taking it, feeling it is not helping.
Tell your doctor if you feel that you are not getting any better, or if you experience any troublesome side-effects.
|Type of medicine||A selective serotonin reuptake inhibitor (SSRI) antidepressant|
|Used for||Depression, and panic disorders in adults|
|Also called||Cipramil®; Paxoran®|
|Available as||Tablets and oral drops|
Depression and panic disorders can develop for no apparent reason, or they may be triggered by a life event such as a relationship problem, a bereavement, or an illness.
Brain cells, called neurons, release a number of chemicals which go on to stimulate other neurons. This leads to electrical impulses which result in many functions controlled by the brain. Serotonin is one such chemical in the brain. Once released, it stimulates other neurons and is then taken back up into the neuron cells and recycled. Selective serotonin reuptake inhibitors (SSRIs) like citalopram increase the amount of circulating serotonin available in your brain. This may help the symptoms of depression or panic disorder in some people.
Before taking citalopram
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking citalopram it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any liver or kidney disorders.
- If you have a heart condition or have been told you have an irregular heartbeat.
- If you have epilepsy.
- If you have diabetes mellitus (sugar diabetes).
- If you have an eye problem called glaucoma.
- If you have ever had a bleeding disorder.
- If you have ever had abnormally 'high' moods, called mania.
- If you are being treated with electroconvulsive therapy (ECT).
- If you have ever had an allergic reaction to a medicine.
- If you have taken an antidepressant known as a monoamine-oxidase inhibitor (MAOI) within the previous two weeks.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take citalopram
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about citalopram and will provide you with a full list of the side-effects which you may experience from taking it.
- Take citalopram exactly as your doctor tells you to. It is prescribed as a once-daily dose. You can generally take it at a time to suit you, but try to take your doses at the same time of day, each day. There are several strengths of tablet available, so your doctor will tell you which strength is right for you. This information will also be on the label of the pack you have been supplied with.
- If you are being treated for a panic disorder, your doctor may prescribe a low dose for you to begin with. This is because some people develop anxiety during the first two weeks, and slowly increasing the dose helps to reduce this.
- If you have been given Cipramil® oral drops, your doctor will tell you how many drops to take each day. Count the correct number of drops into a drink of water, orange juice or apple juice. Stir it briefly, and then drink it straightaway.
- You can take citalopram before or after food.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- You may feel that citalopram is not working for you straightaway. It can take a week or two after starting this treatment before the effect begins to build up, and 4-6 weeks before you feel the full benefit. Do not stop taking it after a week or two, feeling it is not helping.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend that you do not drink alcohol while you are on citalopram, as it increases the risk of side-effects, such as feeling sleepy.
- If you have diabetes, you may need to check your blood glucose more frequently, as citalopram may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
- If you buy any medicines, check with a pharmacist that they are safe to take with citalopram. This is because several medicines which are available from general retail outlets can interfere with this treatment. In particular, do not take the herbal remedy St John's wort, and ask for advice before buying any anti-inflammatory painkillers.
- There are several types of antidepressants and they differ in their possible side-effects. If you find that citalopram does not suit you then let your doctor know, as another may be found that will.
- While you are taking citalopram, you may have thoughts about harming yourself or ending your life. These thoughts may also be associated with your condition. It is very important that you tell your doctor about this if it happens.
- You should expect that a course of treatment will last for several months. This is normal and helps to prevent your symptoms from recurring.
- Do not stop taking citalopram unless your doctor tells you to do so. Stopping treatment suddenly can cause problems and your doctor will probably want you to reduce your dose gradually when this becomes necessary.
- A few people taking citalopram find that their skin is more sensitive to sunlight than normal. Until you know how your skin reacts, use a sun cream with a high sun protection factor (SPF) in strong sunlight.
Can citalopram cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with citalopram. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common citalopram side-effects||What can I do if I experience this?|
|Feeling or being sick, indigestion, constipation or diarrhoea||Stick to simple foods and drink plenty of water|
|Feeling sleepy, weak or tired||If this happens, do not drive or use tools or machines|
|Dry mouth||Try chewing sugar-free gum or sugar-free sweets|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Mood changes such as feeling anxious, nervous, agitated or forgetful. Feeling restless or shaky||This may happen when you first start taking citalopram but usually settles within a few days. If it becomes troublesome or severe, speak with your doctor|
|Increased sweating, difficulty sleeping, lack of appetite, loss of weight, aches and pains, tingling feelings, reduced sexual drive or ability, ringing in your ears, yawning, palpitations, runny nose, itching||If any of these become troublesome, speak with your doctor|
Important: a few people taking citalopram have developed an allergic-type reaction. Although this is quite rare, you should contact your doctor straightaway if you develop any swelling around your face, any difficulties breathing, or a severe rash.
If you experience any other symptoms that you think may be due to this medicine, speak with your doctor or pharmacist for further advice.
How to store citalopram
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- You can use citalopram drops for 16 weeks after first opening the bottle. Do not use the drops after this time.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Cipramil® Tablets; Lundbeck Limited, The electronic Medicines Compendium. Dated April 2014.
- Manufacturer's PIL, Cipramil® Drops; Lundbeck Limited, The electronic Medicines Compendium. Dated April 2014.
- British National Formulary; 67th Edition (March 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox