SSRI (Selective Serotonin Reuptake Inhibitor)
Selective serotonin reuptake inhibitor (SERT), increasing serotonergic neurotransmission.
Major depressive disorder (MDD)
Generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-stroke affective lability, post-stroke depression, depression in Parkinson’s disease (PD), depression in dementia, agitation and aggression in neurodevelopmental disabilities
Oral tablets (10 mg, 20 mg, 40 mg)
10–20 mg p.o. daily, titrating to 20–40 mg/day as tolerated; maximum dose in adults >60 years is 20 mg/day due to QTc prolongation risk
20–40 mg/day (max 20 mg/day in elderly >60 years)
Half-life ~35 hours; metabolized primarily via CYP2C19 and CYP3A4; steady state in ~1 week
Nausea, dry mouth, sexual dysfunction, sedation
QTc prolongation, serotonin syndrome, hyponatremia
ECG monitoring recommended for patients with cardiac risk factors or on QT-prolonging medications; monitor electrolytes especially in elderly
Increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults with MDD and other psychiatric disorders
Citalopram is frequently used to manage behavioral symptoms of dementia, particularly agitation and impulsivity. It requires ECG monitoring in patients with cardiac risk factors, especially those with QT prolongation or taking other QTc-prolonging drugs. High doses should be avoided in elderly patients and those with electrolyte abnormalities to reduce the risk of cardiac arrhythmias.