Celexa Tapering Guide
citalopram
Boxed Warning
Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.
Overview
Citalopram is a racemic SSRI approved for major depressive disorder. It is the racemic form of escitalopram and one of the most selective SSRIs for the serotonin transporter. The FDA limits maximum dose to 40mg due to dose-dependent QT prolongation.
10mg, 20mg, 40mg
Tablets: 10mg, 20mg, 40mg; Oral solution: 10mg/5mL
Category C (risk cannot be ruled out)
Mechanism of Action
Selective serotonin reuptake inhibitor (SSRI) that blocks the serotonin transporter (SERT) with high selectivity. The S-enantiomer is responsible for most of the therapeutic activity.
Taper Notes
Liquid formulation available. Hyperbolic taper recommended for final reductions.
Hyperbolic Tapering Guidance
Oral solution (10mg/5mL) available for precise dose reductions. Follow hyperbolic tapering schedule.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- MAOIs — contraindicated (serotonin syndrome risk)
- Pimozide — contraindicated (QT prolongation)
- QT-prolonging drugs should be used cautiously
Food Interactions
- No significant food effect on absorption
- Avoid alcohol during treatment
Contraindications
- MAOIs within 14 days
- Pimozide
- Congenital long QT syndrome
Toxicity
Dose-dependent QT prolongation (maximum recommended dose 40mg/day, 20mg/day in patients >60 years). Serotonin syndrome with serotonergic combinations.
Pharmacokinetics
ADME Profile
Rapidly and well absorbed after oral administration. Bioavailability ~80%. Tmax ~4 hours. Food does not significantly affect absorption.
~12 L/kg
Hepatic via CYP3A4 and CYP2C19 (primary) to demethylcitalopram (DCT) and didemethylcitalopram (DDCT), both with weak pharmacological activity.
Renal (~10% unchanged) and hepatic metabolism. Fecal excretion minor.
~80%
~330 mL/min (oral clearance)
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Other Drug Profiles
Sources & References
Celexa (citalopram) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Peer-reviewed research
Primary literature cited in this taper guide.
- Horowitz MA, Taylor D 2019 — Tapering of SSRI treatment to mitigate withdrawal symptoms (hyperbolic taper) (The Lancet Psychiatry)
- Davies J, Read J 2019 — A systematic review into the incidence, severity and duration of antidepressant withdrawal effects (Addictive Behaviors)
- Framer A 2021 — The patient voice: an exploration of the experience of withdrawal from antidepressants (Therapeutic Advances in Psychopharmacology)
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Deprescribing.org — Evidence-based deprescribing algorithms from the Bruyère Research Institute
- Royal College of Psychiatrists — Stopping antidepressants — UK clinical guidance on safely discontinuing antidepressants
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Surviving Antidepressants — tapering forum — Long-running community archive of antidepressant taper experiences
- Inner Compass Initiative — Withdrawal Project — Peer-led resources for psychiatric drug withdrawal
- Mad in America — antidepressant withdrawal archive — Journalism and personal narratives on SSRI/SNRI discontinuation
- RxISK — adverse drug reaction reporting — Independent database of patient-reported adverse effects
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.