Citalopram
Antidepressant — SSRI
Indications
DepressionPanic disorder
Adult dose
Start 20 mg OD; max 40 mg OD (max 20 mg in >65 yrs, hepatic impairment, CYP2C19 poor metabolisers, or on omeprazole/cimetidine).
Common side effects
NauseaDry mouthDrowsinessSweatingSexual dysfunction
Serious side effects
Dose-dependent QT prolongationHyponatraemiaSerotonin syndromeSuicidality (<25 yrs early)
Contraindications
Congenital long QTMAOI within 14 daysCo-administration with QT-prolonging drugs
Monitoring
- ECG if cardiac risk or other QT-prolonging drugs
- Sodium if elderly
Notable interactions
- QT prolongers (methadone, antipsychotics, macrolides)
- MAOIs
- Omeprazole (raises citalopram levels)
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.