Citalopram is used to treat depression. It belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of a chemical called serotonin in the brain.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor, to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Citalopram may be taken with or without food. If your doctor tells you to take it at a specific time, follow your doctor's instructions.

If you are using the oral liquid, shake the bottle well before measuring each dose. Use a marked measuring spoon, oral syringe or medicine cup to measure each dose. The average household teaspoon may not hold the right amount of liquid.

You may have to take citalopram for a month or longer before you begin to feel better.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Agitation

blurred vision

confusion

fever

increase in the frequency of urination or amount of urine produced

lack of emotion

loss of memory

menstrual changes

skin rash or itching

trouble breathing

Rare

Behavior change similar to drunkenness

bleeding gums

breast tenderness or enlargement or unusual secretion of milk (in females)

chills

convulsions (seizures)

diarrhea

difficulty with concentrating

dizziness or fainting

drowsiness

increased hunger

increased thirst

irregular heartbeat

lack of energy

lethargy

nosebleed

overactive reflexes

painful urination

poor coordination

purple or red spots on the skin

rapid weight gain

red or irritated eyes

redness, tenderness, itching, burning, or peeling of the skin

shivering

slow or irregular heartbeat (less than 50 beats per minute)

sore throat

stupor

sweating

swelling of the face, ankles, or hands

talking or acting with excitement you cannot control

trembling, shaking, or twitching

trouble with holding or releasing urine

unusual or sudden body or facial movements or postures

unusual tiredness or weakness

Incidence not known

Abdominal or stomach pain

back or leg pains

black, tarry stools

bloating

bloody stools

chest pain

confusion as to time, place, or person

constipation

cough

darkened urine

difficult or fast breathing

difficulty with swallowing

drooling

fast, slow, or irregular heartbeat

general body swelling

hive-like swelling on the face, eyelids, lips, tongue, or throat

hives

holding false beliefs that cannot be changed by fact

impaired consciousness, ranging from confusion to coma

indigestion

itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

loss of appetite

loss of bladder control

loss of consciousness

muscle cramps or spasms

muscle tightness

muscle twitching or jerking

painful or prolonged erection of the penis

pale skin

penile erections, frequent or continuing

recurrent fainting

rhythmic movement of the muscles

seeing, hearing, or feeling things that are not there

swelling of the breasts or unusual milk production

tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area

tightness in the chest

total body jerking

twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled jerking or twisting movements

unusual excitement

vomiting of blood or material that looks like coffee grounds

yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Decrease in sexual desire or ability

sleepiness or unusual drowsiness

Less common

Body aches or pain

change in sense of taste

gas

headache (severe and throbbing)

heartburn

increased sweating

increased yawning

loss of voice

pain in the muscles or joints

sneezing

stuffy or runny nose

tingling, burning, or prickly feelings on the skin

tooth grinding

unusual increase or decrease in weight

watering of the mouth

Incidence not known

Bruising

inability to sit still

large, flat, blue or purplish patches in the skin

need to keep moving

uncontrolled eye movements

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for unwanted effects.

Do not take citalopram with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid (Zyvox®), methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking citalopram during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping citalopram before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

Do not take pimozide (Orap®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

Citalopram may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use citalopram with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St. John's wort, amphetamines, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with citalopram.

Citalopram may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or irregular heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation or slow heartbeat.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble in sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, such as aspirin, nonsteroidal antiinflammatory agents, also called NSAIDs (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or feel unsteady when standing.

The use of alcohol is not recommended in patients who are taking this medicine.

This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Your doctor may want to monitor your child's weight and height, because this medicine may cause decreased appetite and weight loss in children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.