From the Guidelines
The starting dose of citalopram is 20 mg daily. This recommendation is based on the most recent and highest quality study available, which evaluated the efficacy of SSRIs in IBS patients 1. According to this study, citalopram was used at a starting dose of 20 mg that was increased to 40 mg daily after 2,3, or 4 weeks.
Key Considerations
- The study found that SSRIs showed possible improvement in symptom relief, although the certainty in evidence was rated as low due to serious inconsistency and imprecision 1.
- Citalopram works by increasing serotonin levels in the brain, which helps regulate mood, and requires consistent daily dosing to maintain stable blood levels for optimal effectiveness.
- Common initial side effects include nausea, dry mouth, increased sweating, and sleep disturbances, which often improve with continued use.
Important Details
- The medication can be taken with or without food.
- After starting citalopram, it's essential to continue at the initial dose for at least 1-2 weeks before considering any dose adjustments, as this allows time to assess tolerability.
- If needed, the dose may be increased gradually to a maximum of 40 mg daily.
- Patients should be aware that the full therapeutic effect may take 2-4 weeks to develop.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Citalopram tablets (citalopram HBr) should be administered once daily, in the morning or evening, with or without food. Initial Treatment Citalopram tablets should be administered at an initial dose of 20 mg once daily, with an increase to a maximum dose of 40 mg/day at an interval of no less than one week
- The initial dose of citalopram is 20 mg once daily 2.
- This dose can be increased to a maximum dose of 40 mg/day at an interval of no less than one week.
- Doses above 40 mg/day are not recommended due to the risk of QT prolongation.
From the Research
Citalopram Start Dose
- The start dose of citalopram is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, study 3 mentions that eligible participants are those who are currently taking citalopram 20 mg, suggesting that 20 mg is a common dose for maintenance treatment.
- Study 4 provides guidance on the selection of individual SSRIs, including citalopram, but does not specify a start dose.
- Studies 5, 6, and 7 compare the efficacy and tolerability of various antidepressants, including citalopram, but do not provide information on start doses.
Key Points
- Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression 4.
- The efficacy and tolerability of citalopram compared to other SSRIs have been studied in various trials 4, 5, 6, 7.
- While the start dose of citalopram is not explicitly stated in the provided studies, 20 mg is a common dose for maintenance treatment 3.