Citalopram is approved to treat the symptoms of major depression.[1]
- Adult dosing
- Discontinue with gradual dose reduction and monitoring for withdrawal symptoms.
- Doses above 40 mg/day are not recommended because of the risk for QT prolongation.
- Depression
- Initial, 20 mg/day orally as a single dose in the morning or evening;
- Dose increases should usually occur in increments of 20 mg at intervals of no less than one week;max., 40 mg/day
A test of the GRIK4 gene can be made in order to know if a depressed patient will respond to the citalopram.[2]
There is controversy over selective publishing of SSRI clinical trials by pharmaceutical companies.[3] Ameta-analysis analyzing published as well as unpublished trials found the benefits of SSRIs over placebosto be insignificant in all but the most severe cases of depression (benefits over placebo were substantial in very severe cases).[4][5]
Off-label[edit]
Citalopram is frequently used off-label to treat anxiety, panic disorder, PMDD, body dysmorphic disorderand OCD.[6]
Citalopram has been found to greatly reduce the symptoms of diabetic neuropathy[7] and premature ejaculation.[8] There is also evidence that citalopram may be effective in the treatment of post-stroke pathological crying.[9]
While on its own citalopram is less effective than amitriptyline in the prevention of migraines, in refractory cases combination therapy may be more effective.[10]
Citalopram and other SSRIs can be used to treat hot flashes.[11]:107
A 2009 multisite randomized controlled study found no benefit and some adverse effects in autistic children from citalopram, raising doubts whether SSRIs are effective for treating repetitive behavior in children with autism.[12]
Some research suggests that citalopram interacts with cannabinoid protein-couplings in the rat brain, and this is put forward as a potential cause of some of the drug's antidepressant effect.[13]