Citalopram Dosing Guidelines

Initial Dosing and Titration

• The American Academy of Family Physicians recommends starting citalopram at 20 mg once daily, with a maximum recommended dose of 40 mg daily for most adults 1
• Citalopram can be taken in the morning or evening with no significant difference in efficacy, and dose increases should be made in increments of 10-20 mg if needed after 1-2 weeks of treatment based on clinical response 1, 2

Efficacy and Duration of Treatment

• Clinical response to citalopram may take 4-8 weeks to fully manifest, and patients with more severe depression may benefit from higher doses within the recommended range 1, 2
• The American Academy of Family Physicians recommends continuing treatment for 4-12 months after remission of a first depressive episode, and longer treatment duration may be beneficial for patients with recurrent depression 1

Discontinuation and Side Effects

• When discontinuing citalopram, it is recommended to taper gradually over 10-14 days to minimize withdrawal symptoms, and common side effects include nausea, sleep disturbances, sweating, tremors, nervousness, dizziness, and sexual dysfunction 1, 3, 4
• Citalopram is generally well-tolerated compared to other antidepressants, according to the American Academy of Family Physicians 1, 2