Buy Citalopram online in the USA from a licensed pharmacy

Product Name	Citalopram (Celexa)
Dosage	10 mg, 20 mg, 40 mg
Active Ingredient	Citalopram hydrobromide
Form	Oral film-coated tablets
Description	SSRI antidepressant approved in the USA for major depressive disorder (MDD) in adults; commonly used off-label for anxiety-related conditions. Rx only.
How to Order	Complete a brief online consultation; a US-licensed clinician reviews your request and, if appropriate, issues a prescription shipped to your address.

Citalopram is a prescription selective serotonin reuptake inhibitor (SSRI) used in the United States to treat major depressive disorder (MDD) in adults. It helps restore the balance of serotonin in the brain, which can improve mood, energy, and overall sense of well-being. Tablets are available in 10 mg, 20 mg, and 40 mg strengths. In the USA, citalopram may be dispensed only with a valid prescription; many patients obtain their prescription through a secure online evaluation by a US-licensed clinician followed by home delivery from a licensed pharmacy.

As a widely used SSRI, citalopram has a long track record of effectiveness and safety when used as directed. Generic citalopram is typically more affordable than brand-name Celexa while providing the same active ingredient and therapeutic effect. Below you’ll find comprehensive USA-focused guidance on dosing, safety, side effects, important warnings (including the FDA boxed warning for suicidality and the risk of QT prolongation), drug interactions, costs, and how to start treatment through an online visit and convenient shipping options.

Citalopram at a glance

Citalopram is an SSRI antidepressant that increases serotonin levels by blocking its reabsorption into presynaptic neurons. In the USA, it is FDA-approved for treating major depressive disorder in adults. Clinicians may also use citalopram off-label for certain anxiety disorders, panic disorder, premenstrual dysphoric disorder (PMDD), and other conditions when deemed appropriate. Full antidepressant effects typically emerge within 4 to 6 weeks of consistent daily use, though some patients notice improvements in sleep, appetite, or energy earlier.

Important safety considerations include a dose-related risk of QT interval prolongation (a heart rhythm change that can be serious in susceptible individuals) and the FDA boxed warning about the increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Citalopram is not approved for pediatric patients. Adults over 60 years of age, those with hepatic impairment, or patients who are CYP2C19 poor metabolizers generally require a maximum dose of 20 mg daily due to QT prolongation risk.

What is citalopram used for?

In the United States, citalopram is FDA-approved for:

• Major depressive disorder (MDD) in adults

When clinically justified, healthcare providers may also prescribe citalopram off-label for conditions such as:

• Anxiety disorders (e.g., generalized anxiety disorder)
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Premenstrual dysphoric disorder (PMDD)
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder

Only a qualified clinician can determine if citalopram is appropriate for your condition. Always follow your prescriber’s guidance and discuss any concerns about treatment goals and timelines.

How citalopram works (mechanism of action)

Citalopram selectively inhibits the serotonin transporter (SERT), decreasing serotonin reuptake into the presynaptic neuron and increasing synaptic serotonin availability. This enhanced serotonergic signaling helps regulate mood, anxiety, sleep, and appetite. Unlike tricyclic antidepressants, citalopram has minimal effects on norepinephrine and dopamine reuptake and exhibits low affinity for histaminic, cholinergic, and adrenergic receptors, which contributes to a generally favorable side-effect profile relative to older antidepressants.

Dosing and administration (adults, USA)

The dosing of citalopram should be individualized by a clinician. Typical guidance for adults with major depressive disorder includes:

• Initial dose: 20 mg by mouth once daily.
• Titration: Based on response and tolerability, the dose may be increased to 40 mg once daily after at least 1 week.
• Maximum dose: 40 mg once daily (do not exceed due to QT prolongation risk).

Special populations and dose limits:

• Age ≥60 years: Maximum recommended dose is 20 mg once daily.
• Hepatic impairment: Maximum recommended dose is 20 mg once daily.
• CYP2C19 poor metabolizers or those taking strong CYP2C19 inhibitors (e.g., cimetidine, some PPIs such as omeprazole): Maximum 20 mg once daily.
• Renal impairment: No routine dose adjustment, but use caution in severe renal disease.

Administration tips:

• Take citalopram at the same time each day, with or without food.
• If you experience drowsiness, consider taking it in the evening; if insomnia occurs, morning dosing may be preferable.
• Do not abruptly stop citalopram; taper gradually under clinician supervision to reduce discontinuation symptoms (e.g., irritability, dizziness, sensory disturbances).

What to expect: onset, timeline, and treatment goals

Antidepressants work gradually. Some patients report subtle improvements in sleep or appetite within 1–2 weeks. Meaningful mood improvement and reduced depressive symptoms often require 4–6 weeks of consistent use, and the full effect can take 8–12 weeks in some cases. Your clinician may adjust the dose after the first week if early response and side-effect profile suggest a change is appropriate.

For a first episode of depression, many US guidelines recommend continuing the effective dose for at least 6–12 months after symptom remission to reduce relapse risk. Patients with recurrent depression or chronic symptoms may require longer maintenance therapy. Do not modify your dose or discontinue without medical guidance.

Who should not take citalopram (contraindications and cautions)

Contraindications and key cautions in the USA include:

• Do not take with or within 14 days of monoamine oxidase inhibitors (MAOIs) due to risk of serotonin syndrome. Avoid within 14 days after stopping citalopram before starting an MAOI.
• Concomitant use with pimozide is contraindicated (risk of significant QT prolongation).
• Known hypersensitivity to citalopram or formulation components.
• Congenital long QT syndrome or a history of QT prolongation, torsades de pointes, or serious ventricular arrhythmias.
• Uncorrected hypokalemia or hypomagnesemia increases QT risk; correct electrolytes prior to initiation and monitor as indicated.
• Use caution in patients with bradycardia, recent myocardial infarction, uncompensated heart failure, or those on other QT-prolonging medications.

If you have a personal or family history of bipolar disorder, mania/hypomania, angle-closure glaucoma, seizure disorder, bleeding risk, or low sodium (hyponatremia), discuss risks and monitoring with your clinician before starting citalopram.

Common side effects

Many side effects are mild and often lessen as your body adapts. Commonly reported effects may include:

• Nausea, dry mouth, decreased appetite
• Drowsiness or insomnia, fatigue
• Increased sweating
• Tremor, restlessness
• Diarrhea or constipation
• Sexual side effects (decreased libido, delayed ejaculation, difficulty achieving orgasm)
• Headache, dizziness

Contact a clinician if side effects are persistent, bothersome, or worsening. Never change your dose without medical advice.

Serious risks and FDA boxed warning

Serious but less common risks require prompt attention:

• Suicidality: Antidepressants increased the risk of suicidal thoughts and behaviors in children, adolescents, and young adults in short-term studies. Monitor closely for clinical worsening, suicidality, or unusual behavior changes, especially early in treatment or after dose changes. Citalopram is not approved for pediatric use.
• QT prolongation and torsades de pointes: Risk increases with higher doses and in predisposed patients (e.g., electrolyte disturbances, concurrent QT-prolonging drugs). Seek immediate help for palpitations, fainting, or unexplained dizziness.
• Serotonin syndrome: Potentially life-threatening; symptoms include agitation, hallucinations, rapid heart rate, fever, muscle stiffness, loss of coordination, sweating, nausea, vomiting, or diarrhea. Risk increases with other serotonergic agents (triptans, tramadol, MAOIs, linezolid, methylene blue, St. John’s wort).
• Hyponatremia/SIADH: More common in older adults or those on diuretics. Report headache, confusion, weakness, or seizures.
• Abnormal bleeding: Increased bleeding risk, especially with NSAIDs, aspirin, warfarin, or other anticoagulants/antiplatelets.
• Mania/hypomania: Can be unmasked in individuals with bipolar disorder.
• Angle-closure glaucoma: SSRIs can precipitate angle closure in susceptible individuals; consider eye evaluation for those with narrow angles.
• Seizures: Use caution in patients with seizure disorders.

Drug interactions (USA)

Always inform your clinician and pharmacist about all prescription and over-the-counter medicines, vitamins, and herbal supplements. Notable interactions include:

• MAOIs (e.g., phenelzine, tranylcypromine), linezolid, IV methylene blue: Contraindicated or require extreme caution due to serotonin syndrome risk.
• Other serotonergic drugs: Triptans, tramadol, fentanyl, lithium, tryptophan, St. John’s wort, dextromethorphan; monitor for serotonin syndrome.
• QT-prolonging agents: Amiodarone, sotalol, certain macrolides (e.g., erythromycin), fluoroquinolones (e.g., moxifloxacin), antipsychotics (e.g., ziprasidone, haloperidol), methadone—coadministration may elevate risk; consider alternatives or monitoring (e.g., ECG).
• CYP2C19 inhibitors: Cimetidine, omeprazole, esomeprazole, fluconazole—may increase citalopram levels; maximum recommended dose typically 20 mg/day when combined or in poor metabolizers.
• Anticoagulants and antiplatelets: Warfarin, aspirin, clopidogrel; and NSAIDs—heightened bleeding risk; monitor closely.
• Alcohol: Can exacerbate sedation or impair judgment; avoid or limit use.

This list is not exhaustive. Your clinician may adjust doses, recommend monitoring, or choose alternatives based on your health profile.

Citalopram cost and savings in the USA

Generic citalopram is typically cost-effective in the United States. Pricing varies by pharmacy, dosage strength, and insurance coverage. As of recent US market trends, a 30-day supply of citalopram 20 mg may range from low-cost generic tiers (often under $15 with common discount programs) to higher amounts at certain retail pharmacies without a coupon. Mail-order and 90-day supplies can further lower per-tablet costs. Brand-name Celexa usually costs more than generic citalopram.

Ways to save in the USA:

• Use pharmacy discount programs or coupons.
• Opt for 90-day fills when clinically appropriate.
• Compare prices between local pharmacies and reputable mail-order services.
• Discuss generic alternatives and dose adjustments that maintain efficacy while controlling costs.

Our online process helps you compare options and arrange convenient home delivery. Final cost depends on the selected pharmacy, your location, and insurance status.

How to order online in the USA

While citalopram is prescription-only in the United States, getting started online is straightforward:

1. Select your preferred tablet strength and quantity.
2. Complete a secure health questionnaire about your symptoms, history, and current medications.
3. A US-licensed clinician reviews your request, may contact you with questions, and, if appropriate, issues a prescription.
4. Your order is dispensed by a licensed US pharmacy and delivered to your address discreetly, with tracking and customer support.

Refills can be managed through your account. For any new symptoms or side effects, message your clinician or pharmacist for guidance.

Missed dose, overdose, and discontinuation

Missed dose: If you miss a dose, take it as soon as you remember unless it’s close to the next dose. Do not double up. Resume your regular schedule the next day.

Overdose: Seek emergency medical help or contact poison control (in the USA, 1-800-222-1222) if an overdose is suspected. Symptoms may include nausea, vomiting, sweating, tremor, sleepiness, rapid heartbeat, dizziness, seizures, or arrhythmias.

Discontinuation: Stopping citalopram suddenly can cause withdrawal-like symptoms (e.g., irritability, agitation, dizziness, electric-shock sensations, headaches). Work with your clinician on a gradual taper plan.

Pregnancy, breastfeeding, and fertility

Pregnancy: Data from observational studies suggest SSRIs, including citalopram, are not major teratogens, but risks cannot be excluded. Third-trimester exposure has been associated with neonatal adaptation issues (e.g., respiratory distress, jitteriness) and, rarely, persistent pulmonary hypertension of the newborn (PPHN). Decisions should balance maternal mental health benefits against potential fetal risks. Discuss all options with your clinician if you are pregnant or planning a pregnancy.

Breastfeeding: Citalopram is excreted into human milk. Most reports suggest low-to-moderate infant exposure; monitor for sedation, poor feeding, or irritability. Shared decision-making with your clinician and pediatrician is recommended.

Fertility: Limited data indicate minimal impact on fertility; discuss concerns with your healthcare provider.

Monitoring and safety checks

Depending on your risk factors, your clinician may recommend baseline and follow-up monitoring, such as:

• Electrocardiogram (ECG) in patients at risk for QT prolongation or taking QT-prolonging drugs.
• Serum electrolytes (potassium, magnesium) in those with risk factors for electrolyte abnormalities.
• Sodium levels in older adults or patients on diuretics to screen for hyponatremia.
• Assessment for suicidality, especially early in treatment and after dose changes.
• Monitoring for serotonin syndrome in patients on multiple serotonergic agents.

Citalopram vs. escitalopram (Lexapro)

Citalopram is a racemic mixture, while escitalopram contains only the S-enantiomer (the active isomer). Some studies suggest escitalopram may be effective at lower milligram doses with potentially fewer adverse effects for certain patients, although individual responses vary. Cost, side-effect profile, prior treatment response, and comorbidities help clinicians determine the best option. Both are SSRIs with similar warnings and interactions.

Citalopram and anxiety symptoms

Though not FDA-labeled for anxiety disorders, citalopram can reduce anxiety symptoms in many patients with depression and is sometimes used off-label for generalized anxiety, panic, and social anxiety disorders. Initial activation (feeling more keyed-up or restless) may occur in the first weeks. Your clinician may recommend starting at a lower dose, adjusting timing, or using temporary adjunctive strategies to manage early side effects.

Patient counseling tips

Practical guidance to get the most from treatment:

• Take your medication daily at the same time; set reminders to improve adherence.
• Limit alcohol, which can worsen drowsiness or impair judgment.
• Ask before taking new OTC medicines or supplements to avoid interactions.
• Report any new or worsening mood changes, anxiety, agitation, or suicidal thinking immediately.
• Use caution when driving or operating machinery until you know how citalopram affects you.
• Stay hydrated and maintain balanced nutrition; consider light exercise as tolerated to support mood and sleep.
• Never share your medication with others.

Storage and handling

Store citalopram tablets at room temperature, away from excessive heat and moisture. Keep the medication in its original container with the lid tightly closed and out of reach of children and pets. Do not use after the expiration date. Properly dispose of unused tablets per local guidelines or pharmacy take-back programs.

Frequently asked questions (USA)

How long before I feel better?

Some people notice improved sleep or appetite in 1–2 weeks, but mood and interest in activities may take 4–6 weeks or more. Continue taking citalopram as directed unless your clinician advises otherwise.

Can I take citalopram at night?

Yes. If it makes you drowsy, nighttime dosing may be preferable; if it causes insomnia, morning dosing may work better. Keep timing consistent once you find what works for you.

Is citalopram addictive?

No. Citalopram is not considered habit-forming. However, stopping suddenly may cause discontinuation symptoms; taper under medical supervision.

Will it affect my sex life?

Sexual side effects, such as decreased libido or delayed orgasm, can occur. If bothersome, talk to your clinician; options include dose adjustments, timing strategies, or alternative therapies.

Can I use citalopram with pain relievers or cold medicines?

Use caution with NSAIDs (ibuprofen, naproxen), aspirin, and anticoagulants due to bleeding risk. Many cough/cold products contain dextromethorphan or other serotonergic agents—ask a pharmacist or clinician before use.

Do I need lab tests?

Your clinician may order labs or an ECG depending on your health history, age, and concurrent medications. Older adults may need sodium checks; patients at QT risk may need an ECG and electrolyte monitoring.

Guidance from our US clinicians

Depression is treatable, and many patients improve significantly with an SSRI like citalopram plus supportive care. We encourage open communication with your care team, especially during the first two months of therapy. If citalopram is appropriate for you, our streamlined online process connects you with US-licensed clinicians and pharmacies to provide timely prescriptions, refills, and shipment directly to your home.

Getting started: your next steps

Ready to take the first step toward feeling better? Our platform simplifies access to care:

• HIPAA-compliant online questionnaire
• Evaluation by a US-licensed clinician
• Prescription sent to a licensed pharmacy if appropriate
• Fast, discreet delivery to your door
• Responsive customer support for questions and refills

We’re committed to helping you find a safe, effective, and affordable treatment plan that fits your life. If citalopram isn’t the right choice, your clinician may suggest alternatives such as escitalopram or sertraline based on your health history and preferences.

For your safety: citalopram is a prescription medication in the USA and should be used only under the supervision of a qualified healthcare professional. If you experience chest pain, fainting, racing or irregular heartbeat, severe dizziness, or thoughts of self-harm, seek immediate medical help.

Ready to support your mental health? Start Citalopram treatment today

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