Celexa Withdrawal & Tapering Guide
citalopram
Boxed Warning
Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.
In short
Celexa (citalopram) is an SSRI with a half-life of 35 hours. Liquid formulation available. It is also sold as Cipramil.
- Class
- SSRI
- Half-life
- 35 hours
- Common doses
- 10mg, 20mg, 40mg
Educational reference only. Dose changes are decided with the prescriber who knows your history.
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)
Need a clinician who understands tapering?
Browse our map of deprescribing-informed providers worldwide.
Other Drug Profiles
The arithmetic of a proportional reduction
The Maudsley Deprescribing Guidelines and NICE NG222 describe reducing SSRI medications by a proportion of the previous dose rather than by a fixed amount, so each cut is smaller than the last. The table shows what that arithmetic produces at 10% per step, using 20 mg only as a worked example. How large each step is, how long it is held, and whether this pattern applies at all are decisions for the person and their prescriber.
| Step | % of starting dose | Worked example (20 mg start) |
|---|---|---|
| Start | 100% | 20 mg |
| Step 1 | 90% | 18 mg |
| Step 2 | 81% | 16.2 mg |
| Step 3 | 73% | 14.6 mg |
| Step 4 | 66% | 13.1 mg |
| Step 5 | 59% | 11.8 mg |
| Step 6 | 53% | 10.6 mg |
| Step 7 | 48% | 9.57 mg |
| Step 8 | 43% | 8.61 mg |
This is an illustration of a published method, not a schedule for anyone. It does not account for how long you have taken Celexa, your current dose, formulation, or history. TaperCommunity does not recommend doses or dose changes; those are agreed with your prescriber.
Frequently asked questions about Celexa
What are the withdrawal symptoms of Celexa (citalopram)?
Common withdrawal symptoms of Celexa (citalopram) include: brain zaps, dizziness, nausea, irritability, insomnia. Symptom severity varies by individual, dose, and duration of use.
How should I taper off Celexa (citalopram)?
Liquid formulation available. Hyperbolic taper recommended for final reductions. Oral solution (10mg/5mL) available for precise dose reductions. Follow hyperbolic tapering schedule.
Can I stop Celexa cold turkey?
Stopping Celexa abruptly is not recommended. Its half-life is 35 hours, and the receptor adaptations built up during treatment do not reverse at that speed, so a sudden stop tends to produce the sharpest withdrawal. Prescribing guidance favours gradual, proportional reductions agreed with your prescriber.
How long does Celexa stay in your system?
Celexa (citalopram) has a half-life of 35 hours. A drug is mostly cleared after about five half-lives, so Celexa is largely out of the body about 7 days after the last dose, longer in older adults or with liver or kidney impairment. Withdrawal symptoms often begin before the drug has fully cleared and continue after it has, because the adaptations the brain made during treatment reverse more slowly than the drug leaves the blood.
Recent discussions about Celexa
What members tapering Celexa are asking and reporting right now. Personal experience, not medical advice.
- Celexa Tapering ThreadThis is the forum for everyone tapering Celexa. When you log a check-in in My Taper, it will appear here. That way you can see how others on the same medication are…Based · 8 months ago
- Tapering or holding dilemmaI have a dilemma. I've had inner akathisia ever since I reinstated the ssri and my doctor titrated me all the way up to 40mg despite it continuing. I've been holding for…Stephanie M · 26 days ago · 9 replies
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.