Citalopram

Depression, panic attacks and who citalopram is for

Citalopram is often the tablet chosen when low mood has hung around for weeks and begun to affect work, sleep or appetite. It eases the current episode and, kept up, makes a relapse less likely. It is just as established for panic disorder, where attacks of intense fear arrive without warning, and it is used for some other anxiety-related conditions too. As an SSRI (selective serotonin reuptake inhibitor), it sits among the standard antidepressants.

What the first weeks are like

Serotonin is one of the brain's chemical messengers, helping keep mood, sleep and appetite steady. After a nerve cell releases it, the same cell normally draws most of it back; citalopram slows that re-uptake, so more of it stays in the gap between cells and the signal carries further. Nothing changes on day one. Improvement often starts within a week or two, while mood can take several weeks to come round properly, which is why a dose goes up in steps rather than all at once.

The routine is one tablet a day, with or without food, at roughly the same hour. Adults commonly start at 20mg; 10mg is the lower starting point. Some people take theirs in the morning because it keeps them awake, others at night because it makes them drowsy.

Side effects and interactions

Nausea, dry mouth, sweating, headache and either drowsiness or trouble sleeping are the usual early complaints, and most settle as the body adjusts. Sexual effects — a lower sex drive, delayed orgasm — are common too and can last. Citalopram makes bleeding more likely, especially alongside aspirin or anti-inflammatory painkillers such as ibuprofen, and it can affect the rhythm of the heart. Serotonin syndrome is the serious one: fever, shivering, stiff or twitching muscles, agitation, confusion and a racing heartbeat need urgent treatment. Citalopram is not combined with an MAOI antidepressant (phenelzine, tranylcypromine, selegiline), and St John's wort or tryptophan supplements push serotonin up in the same way. In people under 25, thoughts of self-harm become more likely in the first weeks and after a dose increase.

Coming off the tablets

Stopping suddenly can bring dizziness, nausea, irritability, disturbed sleep and short electric-shock-like feelings in the hands and feet, so the dose is stepped down over weeks. Treatment is usually kept going for several months after mood has returned to normal.

Celexa and Citalopram tablets

Two citalopram products are sold here, both tablets in 10mg and 20mg. Celexa is the brand-name version; Citalopram carries the ingredient's own name, and the tablets contain citalopram hydrobromide as the salt form. Same medicine, same strengths, so the choice comes down to the name and pack you prefer. Other medicines for low mood sit in the antidepressants category.