From the Guidelines
The starting dose of citalopram for adults should be 20 mg once daily. This recommendation is based on the evidence from the American Family Physician study 1, which provides a dosage range for citalopram of 20 to 40 mg per day for outpatients.
Key Considerations
- The dose may need to be adjusted for patients with renal or hepatic disease, as indicated by the study 1, which suggests considering a decrease in dose for these patients.
- It is essential to continue the initial dose for at least 1-2 weeks before considering any adjustments, allowing for the full therapeutic effect to develop.
- The maximum daily dose should not exceed 40 mg, as specified in the study 1.
- Patients should be aware of potential initial side effects, such as nausea or headache, which typically improve within the first few weeks of treatment.
- Discontinuation of citalopram should be done gradually under medical supervision to avoid withdrawal symptoms.
Important Details
- The study 1 also notes that citalopram is a preferred agent due to its favorable adverse effect profile, making it a suitable choice for many patients.
- However, it is crucial to consider individual patient factors, such as age and liver function, when determining the starting dose and potential adjustments.
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 starting dose of citalopram is 20 mg once daily 2.
- The dose can be increased to a maximum 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 Starting Dose
- The provided studies do not directly mention the starting dose of citalopram.
- However, one study 3 mentions that eligible participants were those who were currently taking citalopram 20 mg, among other medications.
- Another study 4 compares the efficacy and tolerability of citalopram with other antidepressants, but does not specify the starting dose.
- The other studies 5, 6, 7 do not provide information on the starting dose of citalopram.
Available Information on Citalopram
- Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder (MDD) 4.
- It has been compared to other antidepressants in terms of efficacy, tolerability, and acceptability 4.
- Citalopram has been shown to be effective in treating MDD, but its prophylactic efficacy in preventing recurrence is limited 7.
- The use of citalopram and other antidepressants in preventing relapse in primary care patients is being investigated in a randomized controlled trial 3.