Downsides

If you are between the ages of 18 and 60, do not take any other medications, and have no other medical conditions, you are more likely to experience the following side effects:

• Insomnia, dry mouth, drowsiness, nausea, increased sweating, and sexual dysfunction are all possible symptoms. When compared to escitalopram, citalopram may be associated with more side effects.
• Suicidal thoughts or behavior in young adults may be increased (similar to other antidepressants).
• Serotonin syndrome may result from a drug interaction or overdosage (symptoms include agitation, hallucinations, fast heart rate, dizziness, muscle tremor, nausea, vomiting, diarrhea).
• If abruptly stopped or interrupted, it may result in a discontinuation syndrome (symptoms include nausea, vomiting, diarrhea, headaches, sweating, tremors, vivid dreams, insomnia).
• Your judgment may be impaired, and you may be unable to drive or operate machinery. Alcohol should be avoided.
• It may increase the risk of bleeding, especially when combined with other drugs that increase the risk of bleeding.
• In people with undiagnosed bipolar disorder, it may trigger a manic episode.
• This may result in a decrease in total body sodium (hyponatremia); elderly people, those taking diuretics, or those who are already dehydrated may be more vulnerable.
• Drugs metabolized by hepatic enzymes CYP 3A4 and 2C19, other antidepressants, and medicines that cause serotonin release (such as tramadol, St John's wort, and opioids) may interact. It should not be used in conjunction with or within 14 days of a monoamine oxidase inhibitor.
• When used in conjunction with other QT-prolonging medications, it may cause QT interval prolongation. The maximum recommended dose is 40 mg/day due to the risk of QT prolongation. People over 60, those with severe liver disease, or those taking certain interacting medications (such as cimetidine or omeprazole) should not exceed 20 mg daily.
• In people who are sensitive to overstimulation effects such as anxiety or insomnia, a lower dose of 10 mg/day may be required.
• Seizures are infrequent.
• In neonates exposed to citalopram during the third trimester of pregnancy, complications such as prolonged hospitalization, respiratory support, and tube feeding have been reported. In women exposed to citalopram during the third trimester, weigh the potential benefits against the risks. Citalopram is excreted in breast milk, and reports of drowsiness, decreased feeding, and weight loss in breastfeeding infants have been reported.

Note: People over the age of 65, children, people with certain medical conditions (such as liver or kidney disease, heart disease, diabetes, seizures), or people who take other medications are more likely to experience a broader range of side effects.