Active ingredient: Citalopram (selective serotonin reuptake inhibitor, SSRI).
Therapeutic class: Antidepressant.
Common strengths available in the U.S.: 10 mg, 20 mg tablets. A 40 mg tablet exists in the market, but dosing above 40 mg per day is generally avoided due to QT prolongation risk.
Overview and Indications
Celexa (citalopram) is an SSRI antidepressant most often prescribed for major depressive disorder in adults. It helps increase serotonin in the brain. It is not approved for use in pediatric patients for depression in the U.S. Decisions about use in younger people are individualized by a clinician.
For information on safety monitoring and the FDA boxed warning about suicidality, see What to watch for, and for the legal framework around prescribing in the U.S., see Legal status.
Before you start: tell your health care provider
Share your history and current conditions so dosing and monitoring can be tailored. Be sure to mention if any of the following apply:
- Heart disease, history of QT prolongation, or family history of sudden cardiac death
- Seizure disorder
- Kidney or liver disease
- Past or current suicidal thoughts, attempts, or worsening depression
- Bipolar disorder personally or in the family
- Diabetes
- Pregnant, trying to conceive, or breastfeeding
- Allergies to citalopram, escitalopram, or any medication ingredients, foods, dyes, or preservatives
- Receiving electroconvulsive therapy (ECT)
How to take Celexa
Take by mouth once daily at the same time each day, with or without food. Swallow with water. Your prescriber may start at a lower dose and adjust gradually.
Do not change your dose or stop abruptly unless your prescriber directs you to taper. Stopping suddenly can cause symptoms such as sleep problems, irritability, and flu-like feelings. For safety guidance, see What to watch for.
Pediatric use: discuss risks and benefits with a pediatric specialist if use is being considered in a minor.
Overdose or urgent concerns: call Poison Help at 1-800-222-1222 in the U.S. or seek emergency care immediately.
If you miss a dose
Take it as soon as you remember unless it is close to the time for your next scheduled dose. If it is less than about 4 hours before the next dose, skip the missed dose and resume your regular schedule. Do not double up.
Important interactions
Never combine citalopram with the following, due to risk of serious reactions (including serotonin syndrome or heart rhythm problems):
- MAO inhibitors such as Nardil (phenelzine), Marplan (isocarboxazid), Parnate (tranylcypromine), Eldepryl/Carbex (selegiline)
- Pimozide
- Thioridazine or other phenothiazines such as chlorpromazine, mesoridazine, prochlorperazine
- Escitalopram
- Venlafaxine
- Cisapride
- Procarbazine
- St. John's wort herbal products
- Tryptophan supplements
- Appetite suppressants like phentermine, dexfenfluramine, fenfluramine, or sibutramine
- Nefazodone
Other medicines can interact and may require monitoring, dose changes, or alternatives. Tell your clinician if you use:
- NSAIDs for pain or inflammation such as ibuprofen or naproxen
- Linezolid
- Cimetidine
- Medicines affecting blood clotting such as warfarin, enoxaparin, or dalteparin
- Antimigraine triptans such as sumatriptan, rizatriptan, almotriptan, eletriptan, naratriptan, frovatriptan, or zolmitriptan
- Medicines for depression, anxiety, or psychotic disorders
- Medicines for HIV or AIDS
- Metoprolol
- Amphetamine or dextroamphetamine
- Aspirin or aspirin-like products
- Carbamazepine
This list does not include every possible interaction. Always provide a complete list of prescription and over-the-counter drugs, vitamins, and herbal products to your prescriber and pharmacist. Alcohol can increase side effects such as drowsiness and impaired judgment.
What to watch for while taking Celexa
Expect several weeks before full benefit appears. Keep follow-up visits as scheduled.
Boxed warning: antidepressants can increase suicidal thoughts and behaviors in children, adolescents, and young adults, especially when starting or changing dose. Watch for sudden mood or behavior changes such as anxiety, agitation, panic, irritability, hostility, aggression, impulsivity, restlessness, insomnia, or mania. If concerning changes occur, contact your clinician urgently.
Safety tips:
- Avoid driving or operating machinery until you know how the medicine affects you.
- Rise slowly from sitting or lying positions to reduce dizziness or fainting.
- Limit or avoid alcohol.
- Check with your clinician before using OTC products for cough, cold, or allergies; some ingredients raise the risk of side effects or serotonin syndrome. See interactions.
- Dry mouth can be improved by sugarless gum or candy and adequate water intake.
- If you have been on therapy for a while, do not stop suddenly; a gradual taper is usually needed.
Possible side effects
Seek medical help promptly for any of the following:
- Seizures
- Allergic reactions such as rash, hives, itching, or swelling of the face, lips, or tongue
- Hallucinations or loss of contact with reality
- Confusion
- Unusual bleeding or bruising
- Fast talking with extreme excitement or uncontrolled actions
- Dizziness or feeling lightheaded
Common effects that often improve with time; tell your clinician if persistent or bothersome:
- Nausea
- Headache
- Blurred vision
- Changes in appetite
- Increased sweating
- Insomnia or sleep disturbance
- Changes in sexual desire or performance
Storage and handling
- Keep out of reach of children and pets.
- Store at room temperature, 15 to 30 C (59 to 86 F).
- Dispose of unused or expired tablets properly. Many communities offer take-back programs. See also Legal status for disposal guidance.
Alternatives and price comparison in USD
Similar medicines may be considered if Celexa is not a fit. Never switch or combine antidepressants without medical guidance due to interaction and withdrawal risks. See interactions.
SSRIs with similar indications:
- Sertraline (Zoloft) - SSRI often used for depression and anxiety disorders
- Escitalopram (Lexapro) - closely related to citalopram; may be used as an alternative, not together
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
Other classes sometimes considered:
- Duloxetine (Cymbalta) - SNRI
- Venlafaxine ER (Effexor XR) - SNRI
- Bupropion SR/XL (Wellbutrin) - NDRI, often chosen if sexual side effects are a concern
- Mirtazapine (Remeron) - may help with insomnia and appetite
Rough U.S. retail pricing snapshots for 2026 without insurance (may vary widely by pharmacy, location, and discounts):
- Citalopram generic 20 mg tablets: about $5 to $20 for 30 tablets with common pharmacy discount programs; $15 to $50 retail without coupons. Ninety tablets often range $10 to $40 with discounts.
- Brand Celexa 20 mg: less commonly stocked; can be around $250 to $350 for 30 tablets.
- Comparable generics:
- Sertraline 50 mg: roughly $6 to $25 for 30 tablets with discounts.
- Fluoxetine 20 mg: roughly $4 to $15 for 30 capsules with discounts.
- Escitalopram 10 mg: about $7 to $30 for 30 tablets with discounts.
- Venlafaxine ER 75 mg: about $10 to $40 for 30 capsules with discounts.
Note: Prices fluctuate. Check local pharmacies, verified online pharmacies, or savings programs. Clinical fit, side-effect profile, and interactions should drive drug choice, not price alone.
Legal status and U.S. purchasing rules
- Prescription-only: Celexa (citalopram) requires a valid prescription from a U.S.-licensed prescriber. It is not a controlled substance but is still Rx-only.
- FDA guidance: A Medication Guide is provided with each dispense. There is an FDA boxed warning about suicidality in younger patients.
- Telehealth: Many states permit telemedicine prescribing for SSRIs; clinicians must follow state licensure and standard-of-care rules.
- Online pharmacies: Use state-licensed and NABP-accredited sites (look for the .pharmacy domain or NABP seal). Avoid websites offering citalopram without a prescription.
- Importation: Personal importation of prescription drugs from outside the U.S. is generally restricted and may be refused by customs.
- Refills: Number and timing of refills are determined by the prescriber and state law; pharmacies may require periodic follow-up.
- Use and safety: Do not share prescription medications. Report serious side effects to FDA MedWatch.
- Disposal: Prefer community drug take-back programs. If unavailable, follow FDA guidance on household disposal per label instructions.
For help choosing an alternative or navigating pricing under U.S. rules, see Alternatives and prices.
