Key points
- The only FDA-approved use of citalopram is major depressive disorder in adults.
- Anxiety conditions such as panic disorder and social anxiety disorder are off-label uses, according to MedlinePlus.
- The label warns about dose-dependent heart rhythm changes, called QT prolongation, and names conditions and medicines that raise that risk.
- The boxed warning covers suicidal thoughts and behaviors in young people, and citalopram is not approved for pediatric patients.
- Stopping suddenly can cause withdrawal symptoms, so talk with your prescriber before any change.
What citalopram is
Citalopram is an antidepressant in the group called selective serotonin reuptake inhibitors, or SSRIs. Celexa is its brand name, and generic citalopram is also sold. MedlinePlus says it comes as a tablet, a capsule and a liquid.
It is closely related to escitalopram, which the escitalopram label describes as one form of the citalopram molecule. This page is general information from the FDA label and MedlinePlus, and it does not replace the Medication Guide that comes with a prescription.
What citalopram is approved for, and off-label uses
The Celexa label lists one approved use: major depressive disorder in adults.
Off-label means a use not on the FDA label. MedlinePlus says citalopram may also be used for the conditions below. Each is off-label, and MedlinePlus asks people to talk with their doctor about the possible risks of using it this way.
- Panic disorder.
- Social anxiety disorder.
- Obsessive-compulsive disorder.
- Premenstrual dysphoric disorder.
- Posttraumatic stress disorder (PTSD).
What the evidence and the age limits say
For PTSD, the VA's National Center for PTSD says the 2023 VA/DoD guideline found insufficient evidence to recommend citalopram for or against. It also notes that only sertraline and paroxetine are FDA-approved for PTSD.
The Celexa label says citalopram is not approved for pediatric patients, and that two trials in young people with depression did not give enough data to support use in them.
How citalopram is thought to work
The label says the way citalopram works is unclear, and is presumed to be related to raising serotonin activity by blocking nerve cells from taking serotonin back up. Serotonin is a natural chemical messenger in the brain. Animal studies described in the label suggest minimal effects on norepinephrine and dopamine, two other messengers.
What taking citalopram can be like
MedlinePlus says it may take several weeks to notice the full benefit. The label asks for close watching on mood and behavior, especially early on and at dose changes.
Because of the heart rhythm warning, some people may need tests that a video visit cannot do. The label recommends blood tests for potassium and magnesium in people at risk of imbalances, and heart tracing (ECG) monitoring in certain people. If this applies to you, your prescriber can explain how those would be arranged.
Do not stop citalopram suddenly. MedlinePlus lists withdrawal symptoms such as mood changes, irritability, agitation, dizziness, electric-shock sensations, anxiety, confusion, headache, tiredness, nausea, sweating, shaking and trouble sleeping. Talk with your prescriber first.
Side effects and warnings for citalopram
Boxed warning: antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Anyone taking citalopram should be watched closely for worsening or new suicidal thoughts. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Our crisis resources list more options.
Heart rhythm: the label says citalopram causes dose-dependent QT prolongation, a change on a heart tracing linked with a dangerous rhythm called torsade de pointes and with sudden death. It says to avoid citalopram in people with congenital long QT syndrome, slow heart rate, low potassium or magnesium, a recent heart attack or uncompensated heart failure, unless the benefits outweigh the risks, and in people taking other medicines that prolong QT. Chest pain, shortness of breath, dizziness or fainting need urgent attention, according to MedlinePlus.
The label's most common side effect is ejaculation disorder, mainly delay. MedlinePlus also lists nausea, drowsiness and other sexual problems. Other dangers named on the label:
- MAOIs: contraindicated with citalopram, or within 14 days of stopping one, because of serotonin syndrome. This includes linezolid and intravenous methylene blue.
- Pimozide: contraindicated, because of QT prolongation. A known allergy to citalopram or its ingredients is another contraindication.
- Serotonin syndrome: a potentially life-threatening reaction, with raised risk alongside other serotonin-affecting medicines.
- Bleeding risk with aspirin, NSAIDs or blood thinners, mania or hypomania, seizures, angle-closure glaucoma and low sodium.
Can citalopram be managed online in Pennsylvania and New York
The Celexa label says citalopram is not a controlled substance. A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine, treats anxiety and depression by secure video for people physically located in Pennsylvania or New York during each visit. See online psychiatry in Pennsylvania or in New York.
Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, using our contact form. Fees, insurance and the ages he sees are also things to ask us. Our therapists do not prescribe. They see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York, so people in New York can get psychiatry here but not therapy here.
Common questions
Is citalopram approved for anxiety?
No anxiety condition is on the Celexa label. Its one approved use is major depressive disorder in adults. MedlinePlus says citalopram may be used off-label for panic disorder and social anxiety disorder, and asks people to discuss the possible risks with their doctor. Your prescriber can explain how that applies to you.
Why does citalopram have a heart warning?
The label says citalopram can lengthen the QT interval on a heart tracing, more so at higher doses, and that this has been linked with dangerous rhythms and sudden death. Tell your prescriber about any heart condition, low potassium or magnesium, or other medicines you take. Call 911 for chest pain or fainting.
What should I tell my prescriber before taking citalopram?
Share every medicine and supplement you take, especially MAOIs, pimozide, heart rhythm medicines, antipsychotics and blood thinners. Mention any personal or family history of bipolar disorder, plus seizures, glaucoma or heart problems. If you are pregnant, may become pregnant or are breastfeeding, tell your prescriber.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.