Citalopram: Price, Dosage & Where to Buy

Citalopram is an antidepressant called a selective serotonin reuptake inhibitor (SSRI), used to treat major depressive disorder in adults. It acts on serotonin, a chemical involved in communication between nerve cells in the brain. Citalopram requires a prescription in the United Kingdom and is available as tablets, capsules and an oral solution.

Citalopram tablets are indicated for treating major depressive disorder in adults. This is the condition named in the label, which describes citalopram as an antidepressant. Treatment needs monitoring for worsening depression and changes in behaviour, including new suicidal thoughts.

The label also describes evidence that antidepressant treatment can delay the return of depression in adults. Citalopram is not approved for use in children.

Citalopram belongs to a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. Serotonin is a chemical messenger that helps nerve cells communicate in the brain. Nerve cells normally absorb serotonin again after releasing it.

SSRIs slow this reabsorption, allowing serotonin to remain available between nerve cells for longer. This changes serotonin signalling in brain pathways involved in mood. The effect is not simply an immediate change in mood.

The label lists oral capsules of 30 mg, oral solution of 10 mg/5 mL, and tablets and film-coated tablets of 10 mg, 20 mg and 40 mg. The usual starting dose is 20 mg once daily, with or without food. The label lists an increase to a maximum of 40 mg once daily after an interval of no less than one week.

The label lists a maximum recommended dosage of 20 mg once daily for patients greater than 60 years of age, those with liver impairment and those who break down citalopram slowly through the CYP2C19 enzyme. The label lists the same maximum of 20 mg once daily when used with a CYP2C19 inhibitor. The label lists dosages above 40 mg once daily as not recommended because of heart rhythm risks.

When treatment ends, the label recommends gradual dose reduction rather than abrupt stopping. These are label facts, not a personal dosing plan.

A missed dose interrupts the regular treatment schedule. General pharmacy advice is to resume the normal schedule if the next dose is nearly due, rather than doubling a dose to make up for it.

A pharmacist can advise if there is uncertainty. Repeated missed doses or abrupt stopping may lead to discontinuation symptoms.

Available studies have not established an increased risk of major birth defects or miscarriage with citalopram. Use near delivery may increase bleeding after childbirth. Exposure late in pregnancy can be associated with breathing problems and poor adaptation in newborn babies, including feeding difficulties, tremor and irritability.

Untreated depression also carries risks, and stopping antidepressants during pregnancy can increase the chance of depression returning. Citalopram is present in human breast milk. Discuss pregnancy or breastfeeding with a doctor or pharmacist before changing treatment.

The label specifies storage at 20° to 25°C, with excursions permitted to 15° to 30°C. Keep the medicine out of the sight and reach of children and follow the packaging instructions to maintain quality.