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Citalopram is a prescription medicine used to treat depression. Citalopram is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medications change the levels of chemicals in the brain that affect mood.
CYP2D6 and CYP2C19 are proteins in your body that are involved in the elimination of citalopram and other drugs from your body. Some patients have less of this protein in their bodies, affecting how much of the drug gets eliminated. Levels of CYP2D6 and CYP2C19 can vary greatly between individuals, and those having less of this protein are known as “poor metabolizers.” 
CYP2D6 and CYP2C19 testing is done to determine whether you are a poor metabolizer. 
If you are a poor metabolizer, the levels of citalopram in your blood can become too high. As a result you may be at an increased risk of having more side effects from citalopram. 
Your doctor may adjust your dose of citalopram if you are a poor metabolizer.
Citalopram is a prescription medicine used to treat depression.
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Citalopram may be found in some form under the following brand names:
Citalopram is part of the drug class:
Other side effects in children and adolescents include:
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of citalopram. For more information, ask your healthcare provider or pharmacist.
Serious side effects have been reported with citalopram.  See “Citalopram Precautions” section.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA­-1088. 
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you are taking certain drugs such as:
This is not a complete list of citalopram drug interactions. Ask your healthcare provider or pharmacist for more information.
Citalopram and other antidepressant medicines may cause serious side effects, including:
Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:
Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. Citalopram may be associated with these serious side effects:
2.  Changes in the electrical activity of your heart (QT prolongation and Torsade de Pointes).This condition can be life threatening. Symptoms may include:
3.  Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. This condition can be life-threatening. Symptoms may include:
5.  Abnormal bleeding.  Citalopram and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen ), or aspirin.
8.  Changes in appetite or weight.  Children and adolescents should have height and weight monitored during treatment.
9.  Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:
Do not stop citalopram without first talking to your healthcare provider. Stopping citalopram too quickly may cause serious symptoms including:
People who take citalopram close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:
Citalopram can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how citalopram affects you. Do not drink alcohol while using citalopram.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of citalopram there are no specific foods that you must exclude from your diet when receiving citalopram.
Before starting citalopram, tell your healthcare provider if you:
Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Citalopram and some medicines may interact with each other, may not work as well, or may cause serious side effects. See “Drug Interactions”.
Your healthcare provider or pharmacist can tell you if it is safe to take citalopram with your other medicines. Do not start or stop any medicine while taking citalopram without talking to your healthcare provider first.
Tell your healthcare provider if you are pregnant or plan to become pregnant.It is not known if citalopram will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy.
Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Some citalopram may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking citalopram.
Citalopram can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how citalopram affects you. Do not drink alcohol while using citalopram.
If you take too much citalopram call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.
If citalopram is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.
Suicidality and Antidepressant Drugs
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Citalopram is not approved for use in pediatric patients.

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