Wellbutrin XL
Celexa (Citalopram)
Zoloft (Sertraline)
Effexor XR (Venlafaxine)

Celexa (Citalopram)

  • Generic name: Citalopram hydrobromide
  • Trade name: Celexa
  • Functional class: Antidepressant
  • Chemical class: Selective serotonin reuptake inhibitor
  • FDA approved: July 17, 1998
  • Manufacturer: Forest Pharmaceuticals, Inc.
  • Habit forming? No
  • Pregnancy risk factor: C

Medical uses

Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors. It is indicated for the treatment of depression. Citalopramis is also effective in the treatment of certain eating disorders (e.g., anorexia nervosa, bulimia), anxiety, and panic disorders. It has the potential to effectively treat substance use disorders.

Citalopram is generally sedating antidepressant, and it is considerably less activating than fluoxetine and sertraline. Citalopram represents a good balance of tolerability, efficacy, and cost.

Citalopram is effective in the treatment of moderate-to-severe major depression, especially symptoms of depressed mood and melancholia, with particularly robust effects at doses of 40 and 60 mg/day 1.

Pharmacological characteristics

  • Steady state: reached in about 1 week.
  • Metabolism: Citalopram is metabolized in the liver by the cytochrome P450 enzyme system to demethylcitalopram, didemethylcitalopram, citalopram N-oxide and a deaninated propionic acid derivative. These metabolites are not thought to contribute to the therapeutic action since both metabolites are less potent serotonin reuptake inhibitors than the parent compound, are present in lower concentrations and enter the brain less readily.
  • Bioavailability: approximately 80%.
  • Elimination half-life: 37 hours (range 30-42 hours). The half-life of demethylcitalopram being 2 days and 4 days for didemethylcitalopram.
  • Excretion: eliminated primarily via the liver (85%) and the remainder via the kidneys. Approximately 12% of the daily dose is excreted in urine as unchanged citalopram.


  • Lower risk of drug interactions than with some other antidepressants 3. Citalopram does not significantly affect the metabolism of other drugs. Also, its metabolism is not affected by digoxin, lithium, warfarin, or carbamazepine.
  • Probably safe for use on a long-term basis
  • Causes less withdrawal symptoms than other SSRIs
  • Absorption is not affected by food
  • Low incidence of activating side effects
  • Less likely than other antidepressants to cause sexual dysfunction 4
  • Anxiolytic effects 15
  • Suitable alternative for fluoxetine intolerant individuals
  • Elicit relaxation of intestinal smooth muscle 16


  • Risk of QT prolongation. Citalopram is not appropriate for people with risk factors for QT-prolongation, such as structural heart disease, bradycardia, hypokalaemia, hypomagnesaemia or hypocalcaemia.
  • Weight gain and craving for carbohydrate 6.
  • Sexual side effects.
  • Citalopram should be used with caution in persons who are at risk of taking an overdose, especially those with cardiovascular disease.

Unlabeled uses

  • social anxiety disorder 11
  • premature ejaculation 5
  • premenstrual dysphoric disorder (PMDD) 12
  • alcohol dependence 9
  • binge-eating disorder 14
  • anorexia nervosa 7
  • diabetic neuropathy 8
  • panic disorder 10
  • irritable bowel syndrome 13

Mechanism of action

Citalopram represents a racemic mixture of two enantiomers - molecules that have the same atomic framework but different spatial arrangements.

Citalopram is an antidepressant that selectively inhibits serotonin reuptake thereby potentiating serotonin neurotransmission. It is the most selective serotonin reuptake inhibitor currently available 2. It has only minimal effects on norepinephrine and dopamine neurotransmission with 3,400 times more serotonin (5-HT) activity than norepinephrine.

Citalopram also has mild antagonist actions at H1 histamine receptors.

Reviews, Discussions & Forums


  • 1. Feighner JP, Over K. Multicenter study of citalopram in moderate-to-severe depression. J Clin Psychiatry. 1999 Dec;60(12):824-30. PubMed
  • 2. 1. Milne RJ, Goa KL. Citalopram: its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness. Drugs. Mar 1991;41(3):450-477.
  • 3. Lane RM. Pharmacokinetic drug interaction potential of SSRIs. Int Clin Psychopharmacol. 1996 Dec;11 Suppl 5:31-61.
  • 4. Arias F, Padi'n JJ, Rivas MT, Sa'nchez A. Sexual dysfunctions induced by serotonin reuptake inhibitors. Aten Primaria. 2000 Oct 15;26(6):389-94.
  • 5. Safarinejad MR, Hosseini SY. Safety and efficacy of citalopram in the treatment of premature ejaculation: a double-blind placebo-controlled, randomized study. Int J Impot Res. 2006 Mar-Apr;18(2):164-9.
  • 6. Bouwer CD, Harvey BH. Phasic craving for carbohydrate observed with citalopram. Int Clin Psychopharmacol. 1996 Dec;11(4):273-8.
  • 7. Fassino S, Leombruni P, Daga G, Brustolin A, Migliaretti G, Cavallo F, Rovera G. Efficacy of citalopram in anorexia nervosa: a pilot study. Eur Neuropsychopharmacol. 2002 Oct;12(5):453-9. PubMed
  • 8. Sindrup SH, Bjerre U, Dejgaard A, Brsen K, Aaes-Jrgensen T, Gram LF. Citalopram relieves the symptoms of diabetic neuropathy. Clin Pharmacol Ther. 1992 Nov;52(5):547-52.
  • 9. C A Naranjo, D M Knoke, and K E Bremner. Variations in response to citalopram in men and women with alcohol dependence. J Psychiatry Neurosci. 2000 May; 25(3): 269275. PubMed
  • 10. Leinonen E, Lepola U, Koponen H, Turtonen J, Wade A, Lehto H. Citalopram controls phobic symptoms in patients with panic disorder. J Psychiatry Neurosci. 2000 Jan;25(1):24-32. PubMed
  • 11. Simon NM, Korbly NB, Worthington JJ, Kinrys G, Pollack MH. Citalopram for social anxiety disorder: an open-label pilot study in refractory and nonrefractory patients. CNS Spectr. 2002 Sep;7(9):655-7.
  • 12. Pearlstein T. Selective serotonin reuptake inhibitors for premenstrual dysphoric disorder: the emerging gold standard? Drugs. 2002;62(13):1869-85.
  • 13. Tack J, Broekaert D, Fischler B, Oudenhove LV, Gevers AM, Janssens J. A controlled crossover study of the citalopram in irritable bowel syndrome. Gut. 2006 Aug;55(8):1095-103.
  • 14. McElroy SL, Hudson JI, Malhotra S, Welge JA, Nelson EB, Keck PE. Citalopram in the treatment of binge-eating disorder. J Clin Psychiatry. 2003 Jul;64(7):807-13. PubMed
  • 15. Izumi T, Inoue T, Kitaichi Y, Nakagawa S, Koyama T. Target brain sites of the anxiolytic effect of citalopram. Eur J Pharmacol. 2006 Mar 18;534(1-3):129-32.
  • 16. Tack J, Broekaert D, Corsetti M, Fischler B, Janssens J. Influence of acute serotonin reuptake inhibition on colonic sensorimotor function in man. Aliment Pharmacol Ther. 2006 Jan 15;23(2):265-74. PubMed

Written by, October 2009.
Last updated: July, 2015

Interesting facts



  • Citalopram was developed by the Danish pharmaceutical firm H. Lundbeck A/S and is marketed in the U.S. by Forest Laboratories under trade name Celexa.
  • Citalopram is a highly selective inhibitor of serotonin reuptake with a negligible affinity for other neurotransmitter receptors.
  • Celexa appears to be safe to use on a long-term basis and may cause less withdrawal than other antidepressants when use is stopped.
  • Of all of the SSRIs Citalopram has the most favorable drug interactions profile because it has the least effect on the cytochrome P450 enzymes.

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