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Citalopram

Sounds like 'sit-al-oh-pram'

Key points about citalopram

Citalopram is used to treat moderate to severe depression, where psychological therapy and lifestyle changes have not been enough for the depression to go away.
Citalopram is also called Celapram.
Find out how to take it safely and possible side effects.

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Citalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). Citalopram is used to treat depression, usually for people with moderate to severe depression, where psychological therapy and lifestyle changes have not been enough for the depression to go away.

For most people the effectiveness of antidepressants can be improved when they are used together with psychological therapies, like CBT (cognitive behavioural therapy), and lifestyle changes. Read more about depression.

We don't know for certain, but researchers think that SSRIs could work by increasing the activity of serotonin which is thought to improve mood, emotion and sleep. Read more about SSRIs.

If you need help or want to talk to somebody about your mental health, you can get support from any of the following:

Free call or text 1737 any time for support from a trained counsellor
Lifeline 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
Healthline 0800 611 116
Samaritans 0800 726 666.

In Aotearoa New Zealand citalopram is available as tablets (20 mg).

The dose of citalopram will be different for different people.
Your doctor will usually start you on a low dose and if needed, will increase your dose slowly. This allows your body to get used to the medicine and reduces the chance of side effects.
Always take your citalopram exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much citalopram to take, how often to take it, and any special instructions.

Take citalopram once a day, in the morning OR the evening. Take your dose at the same time each day. 
You can take citalopram with or without food but if you think it is upsetting your stomach, try taking it with food.
Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take it at the right time. Do not take double the dose.
Keep taking citalopram every day. It may take 4 to 6 weeks before you notice the full benefits of citalopram and you should start to feel better after 1 to 2 weeks. Some people notice side effects in the first few weeks before they start to feel better. Citalopram is usually needed for at least a few months. Your doctor will discuss with you how long to take it for; this depends on what you are taking it for, and how well it is working.
If you think citalopram isn't working for you. Don't stop taking it suddenly; talk to your doctor or nurse before stopping. It is usually best to stop taking citalopram very slowly to avoid side effects.

Here are some things to know when you're taking citalopram. Other things may be important as well, so ask your healthcare provider what you should know about.

Limit alcohol intake while you are taking citalopram. Alcohol can increase your chance of side effects such as drowsiness and reduced concentration.
Avoid driving and doing other tasks where you need to be alert until you know how this medicine affects you.
Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
Citalopram can interact with some other medicines (including anticoagulants and anti-inflammatories such as ibuprofen), herbal supplements (eg, St John's Wort), and recreational drugs, so check with your doctor or pharmacist before starting citalopram and before starting any new products.
If you have diabetes, you may need to check your blood glucose more often because citalopram can affect the levels of glucose in your blood.

Like all medicines, citalopram can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Nausea (feeling sick) Vomiting (being sick) Headache Dry mouth Increased sweating Diarrhoea (runny poos)	This is quite common when you first start citalopram. If you have nausea, try taking your dose with food. Tell your doctor if they bother you.
Difficulty falling asleep	This is quite common. Try taking your dose in the morning.
Feeling sleepy, drowsy, dizzy or tired Difficulty concentrating	These are quite common.  Try taking your dose in the evening. Be careful when driving or using tools until you know how this medicine affects you. Avoid drinking alcohol. Read more about how alcohol affects medicines.
Feeling less or more hungry than usual Changes in weight (increase or decrease)	Tell your doctor if they cause you problems.
Loss of sex drive or libido Changes in periods (menstruation)	Tell your doctor if you are concerned. Read more about medicines and sexual problems.
Signs of low sodium such as dizziness, confusion, agitation, cramps, unsteadiness, feeling faint or tired.	This is most common in older people, women, people who are also taking diuretics (water tablets) or omeprazole and people with low body weight. Let your doctor know if you get these symptoms.
Suicidal feelings or behaviour such as self-harm, worsening of low mood, agitation, aggression.	These are rare but serious side effects. They are most likely to happen during the start of treatment or when doses are changed. Contact your doctor immediately. For urgent help contact Healthline 0800 611 116 or Lifeline 0800 543 354 (available 24/7).
Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heartbeat, headache, diarrhoea and rigid or twitching muscles.	These are rare but serious side effects. You are at increased risk of serotonin syndrome if you just started taking the SSRI or increased the dose or started other medicines that can cause serotonin syndrome. Tell your doctor immediately or ring Healthline 0800 611 116
Read more about medicines and side effects and reporting a reaction you think might be a side effect.