Citalopram Discontinuation Guidelines

General Principles

The American Academy of Family Physicians recommends a gradual reduction in dose over 10 to 14 days to limit withdrawal symptoms when weaning off citalopram 1
The standard tapering period for antidepressants is 10-14 days, which helps limit withdrawal symptoms while ensuring safe discontinuation 1, 2

For patients on standard doses, a dose reduction of approximately 10-20% every 2-4 days is recommended 1, 2
Patients who have been on citalopram for longer periods may require a more extended tapering schedule than the standard 10-14 days 1, 2

Monitor for withdrawal symptoms, including dizziness, nausea, headache, paresthesia, irritability, anxiety, and sleep disturbances 3
Patients with a history of severe depression may need closer monitoring during the tapering process to watch for signs of relapse 4
Those with a history of antidepressant discontinuation syndrome may benefit from an even more gradual taper 3
For patients with comorbid anxiety disorders, a slower taper may be necessary to prevent exacerbation of anxiety symptoms 4

Common withdrawal symptoms include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal 3
These symptoms typically begin within 1-3 days of dose reduction and may last 1-2 weeks 3
Distinguishing between withdrawal symptoms and depression recurrence is important, as withdrawal symptoms typically emerge quickly after dose reduction and diminish over time, while recurrence develops more gradually and persists 3

If signs of depression recurrence emerge, prompt medical evaluation is needed 4
Suicidal thoughts or severe mood disturbances during tapering warrant immediate medical attention 3