Citalopram Side Effects

Medically reviewed by Drugs.com. Last updated on Sep 15, 2023.

Applies to citalopram: oral capsule, oral solution, oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (capsule; tablet)

Suicidal Thoughts and Behaviors. Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies.

Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.

Citalopram capsules and tablets are not approved for use in pediatric patients.

Oral route (solution)

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 hydrobromide 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 hydrobromide oral solution is not approved for use in pediatric patients.

Serious side effects of citalopram

Along with its needed effects, citalopram 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 while taking citalopram:

More common

• change or problem with discharge of semen

Less common

• agitation
• blurred vision
• confusion
• decreased interest in sexual intercourse
• fever
• inability to have or keep an erection
• increase in the frequency of urination or amount of urine produced
• lack of emotion
• loss in sexual ability, desire, drive, or performance
• 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
• delayed or inability to have an orgasm
• 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
• seizures
• 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

• back or leg pains
• black, tarry stools
• blistering, peeling, or loosening of the skin
• bloating
• bloody stools
• chest pain or tightness
• 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, itching
• holding false beliefs that cannot be changed by fact
• impaired consciousness, ranging from confusion to coma
• indigestion
• joint or muscle pain
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of appetite
• loss of bladder control
• loss of consciousness
• muscle cramps, spasms, tightness, twitching, or jerking
• painful or prolonged erection of the penis
• pale skin
• penile erections, frequent or continuing
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• recurrent fainting
• red skin lesions, often with a purple center
• rhythmic movement of the muscles
• seeing, hearing, or feeling things that are not there
• sores, ulcers, or white spots in the mouth or on the lips
• stomach pain
• swelling of the breasts or unusual milk production
• tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
• 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

Other side effects of citalopram

Some side effects of citalopram 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
• continuing ringing or buzzing or other unexplained noise in the ears
• gas
• headache (severe and throbbing)
• hearing loss
• heartburn
• increased sweating
• increased yawning
• loss of voice
• loss or thinning of the hair
• 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

Rare

• increased hair growth on the forehead, back, arms, and legs
• tanning or blue-gray discoloration of the skin

Incidence not known

• bruising
• decrease in smell
• inability to sit still
• large, flat, blue or purplish patches in the skin
• loss of sense of smell
• need to keep moving
• uncontrolled eye movements

For healthcare professionals

Applies to citalopram: oral capsule, oral solution, oral tablet.

General

The side effects observed with citalopram in clinical trials were generally reported as mild and transient, occurring most frequently in the first 1 to 2 weeks of therapy, and attenuating subsequently. The most commonly reported side effects were nausea, somnolence, dry mouth, increased sweating, tremor, diarrhea, and ejaculation disorder.^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 26.9%), somnolence (up to 17.9%), dizziness (up to 10.3%)
• Common (1% to 10%): Amnesia, extrapyramidal disorder, migraine, paresthesia, tremor,
• Uncommon (0.1% to 1%): Abnormal gait, ataxia, cerebrovascular accident, convulsions, dystonia, hypoesthesia, involuntary muscle contractions, neuralgia, speech disorder, syncope, hyperkinesia, hypertonia, hypokinesia, dyskinesia, vertigo, transient ischemic attack
• Rare (less than 0.1%): Abnormal coordination, dyskinesia, grand mal convulsion, hyperesthesia, stupor
• Frequency not reported: Akathisia, movement disorder, serotonin syndrome
• Postmarketing reports: Choreoathetosis, myoclonus, neuroleptic malignant syndrome, nystagmus^[Ref]

Potentially life-threatening serotonin syndrome has been reported with SSRIs and SNRIs as monotherapy, but particularly with concomitant use of other serotonergic drugs and drugs that impair the metabolism of serotonin.^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 21.4%), dry mouth (up to 20%)
• Common (1% to 10%): Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, increased saliva, taste loss/perversion, vomiting
• Uncommon (0.1% to 1%): Abnormal bleeding (predominantly of the mucous membranes), dysphagia, eructation, esophagitis, gastrointestinal bleeding, gastritis, gastroenteritis, gingivitis, hemorrhoids, stomatitis, teeth grinding
• Rare (less than 0.1%): Colitis, diverticulitis, duodenal ulcer, gastric ulcer, gastroesophageal reflux, gingival bleeding, glossitis, rectal hemorrhage
• Frequency not reported: Gastrointestinal hemorrhage
• Postmarketing reports: Pancreatitis^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (up to 18.8%)
• Common (1% to 10%): Abnormal dreams, aggravated depression, agitation, anxiety, apathy, confusion, depression, impaired concentration, nervousness, suicide attempt, sleep disorder
• Uncommon (0.1% to 1%): Aggressive reaction, delusion, depersonalization, drug dependence, emotional lability, euphoria, hallucination, mania, panic reaction, paranoid reaction, paroniria, psychosis, psychotic depression
• Rare (less than 0.1%): Catatonic reaction, melancholia, suicide-related events
• Frequency not reported: Bruxism, restlessness, panic attack, suicidal ideation/behavior
• Postmarketing reports: Delirium, withdrawal syndrome^[Ref]

Other

• Very common (10% or more): Asthenia (up to 11.5%)
• Common (1% to 10%): Fatigue, fever/pyrexia, tinnitus, asthenia
• Rare (less than 0.1%): Facial edema, malaise, rigors
• Postmarketing reports: Spontaneous abortion^[Ref]

Dermatologic

• Very common (10% or more): Increased sweating (up to 11.3%)
• Common (1% to 10%): Rash, pruritus
• Uncommon (0.1% to 1%): Abnormal bleeding of the skin, acne, alopecia, dermatitis, dry skin, eczema, flushing, photosensitivity reaction, psoriasis, purpura, skin discoloration, urticaria
• Rare (less than 0.1%): Decreased sweating, cellulitis, hypertrichosis, keratitis, melanosis, pruritus ani
• Frequency not reported: Angioedema, ecchymosis
• Postmarketing reports: Epidermal necrolysis, erythema multiforme^[Ref]

Genitourinary

• Common (1% to 10%): Abnormal orgasm/anorgasmia (female), amenorrhea, decreased libido, dysmenorrhea, ejaculation disorders/ejaculation delay, impotence, menstrual disorders, polyuria, ejaculation failure, micturition disorders
• Uncommon (0.1% to 1%): Breast enlargement, breast pain, dysuria, galactorrhea, increased libido, menorrhagia, micturition frequency, nonpuerperal lactation, vaginal bleeding, vaginal hemorrhage, urinary incontinence, urinary retention
• Rare (less than 0.1%): Hematuria, oliguria
• Frequency not reported: Metrorrhagia, priapism^[Ref]

Urinary retention and galactorrhea have been reported with other SSRIs.

The estimates of the incidence of untoward sexual experience and performance may underestimate their actual incidence, partly because patients and physicians may be reluctant to discuss this issue. In placebo-controlled clinical trials, ejaculation disorder (primarily ejaculation delay) was reported as a treatment-emergent side effect at an incidence of 6% and at least twice the incidence in placebo-treated male patients.^[Ref]

Respiratory

• Common (1% to 10%): Coughing, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, yawning
• Uncommon (0.1% to 1%): Bronchitis, dyspnea, epistaxis, pneumonia
• Rare (less than 0.1%): Asthma, bronchospasm, hiccups, increased sputum, laryngitis, pneumonitis, pulmonary embolism^[Ref]

Cardiovascular

• Common (1% to 10%): Chest pain, hypotension, palpitations, postural hypotension, tachycardia
• Uncommon (0.1% to 1%): Angina pectoris, atrial fibrillation, bradycardia, cardiac failure, edema (extremities), extrasystoles, hematomas, hot flushes, hypertension, myocardial infarction, myocardial ischemia
• Rare (less than 0.1%): Bundle branch block, cardiac arrest, phlebitis, QT prolongation, torsades de pointes
• Frequency not reported: Ventricular arrhythmia, orthostatic hypotension
• Postmarketing reports: Thrombosis^[Ref]

This drug has been associated with a dose-related QT-interval prolongation; there have been reports of QT-interval prolongation and ventricular arrhythmia, including torsade de pointes, particularly in females, patients with hypokalemia, or with pre-existing QT-interval prolongation, or other cardiac disease.^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, back pain, myalgia
• Uncommon (0.1% to 1%): Arthritis, leg cramps, muscle weakness, skeletal pain
• Rare (less than 0.1%): Bursitis, osteoporosis
• Postmarketing reports: Rhabdomyolysis^[Ref]

Epidemiological studies, primarily in patients aged 50 years or older, have shown an increased risk of bone fractures in patients receiving SSRIs or TCAs.^[Ref]

Metabolic

• Common (1% to 10%): Anorexia, decreased/increased weight, decreased/increased appetite
• Uncommon (0.1% to 1%): Abnormal glucose tolerance, thirst
• Rare (less than 0.1%): Alcohol intolerance, dehydration, hypokalemia, hyponatremia, hypoglycemia, obesity^[Ref]

Ocular

• Common (1% to 10%): Abnormal accommodation
• Uncommon (0.1% to 1%): Abnormal vision, conjunctivitis, dry eyes, eye pain, mydriasis
• Rare (less than 0.1%): Abnormal lacrimation, cataract, diplopia, photophobia, ptosis
• Frequency not reported: Visual disturbance, acute narrow angle glaucoma
• Postmarketing reports: Angle-closure glaucoma^[Ref]

Hepatic

• Common (1% to 10%): Increased alkaline phosphatase
• Uncommon (0.1% to 1%): Increased ALT, GGT, and AST
• Rare (less than 0.1%): Bilirubinemia, cholelithiasis, cholecystitis, hepatitis, jaundice
• Frequency not reported: Abnormal liver function test
• Postmarketing reports: Cholestatic hepatitis, hepatic necrosis^[Ref]

Immunologic

• Common (1% to 10%): Influenza-like symptoms
• Rare (less than 0.1%): Hay fever^[Ref]

Hematologic

• Uncommon (0.1% to 1%): Anemia, leukopenia, leukocytosis, lymphadenopathy
• Rare (less than 0.1%): Coagulation disorder, granulocytopenia, hemorrhage, hypochromic anemia, lymphocytosis, lymphopenia
• Frequency not reported: Thrombocytopenia
• Postmarketing reports: Decreased prothrombin, hemolytic anemia^[Ref]

Endocrine

• Rare (less than 0.1%): Goiter, hypothyroidism
• Frequency not reported: Inappropriate ADH secretion
• Postmarketing reports: Prolactinemia^[Ref]

Renal

• Rare (less than 0.1%): Pyelonephritis, renal calculus, renal pain
• Postmarketing reports: Acute renal failure^[Ref]

Hypersensitivity

• Frequency not reported: Anaphylactic reaction, hypersensitivity not otherwise specified
• Postmarketing reports: Allergic reaction^[Ref]

Frequently asked questions

• SSRIs vs SNRIs - What's the difference between them?
• What is the difference between Celexa and Lexapro?
• What are some common side effects of antidepressants?

Further information

Citalopram side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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