Can citalopram cause migraines? (5+ factors)

This article will discuss whether citalopram may cause migraines. It will mention the incidence of this side effect and explore research studies on this topic. The article will also mention factors that may increase citalopram-induced migraines and provide recommendations on what to do if you experience them. 

Can citalopram cause migraines?

Citalopram may cause migraines in some people, but this is very uncommon. In the premarketing trials conducted to evaluate the safety of citalopram, it caused migraines in approximately 1% of the participants. In fact, citalopram is more commonly known for helping with migraines [1].

The mechanism by which citalopram may cause migraines is not fully understood. Migraine attacks are caused by the vasodilation of cranial arteries. Multiple neurotransmitters contribute to the functioning of cranial arteries, including serotonin [2].

Citalopram is a selective serotonin reuptake inhibitor that increases the levels of serotonin in the brain. This change in serotonin balance may increase the risk of migraines in people who already have risk factors for migraines [1,2].

Citalopram can cause various side effects, including headaches, but migraine is not a common side effect. However, if you experience migraine headaches while taking citalopram, you should consult with a doctor for proper assessment and management.

What does research suggest?

In a case study, a patient with a history of migraines was admitted to the hospital. Despite treatment attempts, her migraines persisted, and she required hospitalization. After a few days, her symptoms improved, and she was prescribed citalopram for anxiety management [3].

Unfortunately, taking citalopram triggered pain and a vision disturbance in her left eye, followed by throbbing headaches. She also experienced increased sensitivity to light and sound, dizziness, nausea, and vomiting, which were not relieved by pain medication [3].

Finally, the citalopram-induced migraine attacks resolved after she stopped taking the drug. However, it is important to consider that the patient had a pre-existing history of migraines, indicating that citalopram was likely a triggering factor rather than the primary cause [3].

Other research suggests that citalopram can also improve migraine symptoms. One study found that people who took a 30 mg dose of citalopram for 2 months experienced a significant reduction in the frequency, duration, and severity of migraine headaches compared to those taking a placebo [4].

What factors increase the risk of migraines while taking citalopram?

Migraine is not a common side effect of citalopram. However, certain triggering factors can contribute to the occurrence of migraines while taking citalopram. These factors may include [5]:

  • Overuse of analgesics for a long time.
  • Low blood sugar can lead to migraines while taking citalopram.
  • Women are more likely to suffer from migraine headaches during their menstruation period.
  • The concurrent administration of certain drugs can increase the risk of experiencing migraines. Examples of these drugs include estrogenic drugs (like hormone replacement therapy and oral contraceptives), beta-blockers, nitroglycerin, and certain antidepressants like Pristiq
  • Poor sleep patterns, dehydration, an unhealthy diet, excessive alcohol intake, high consumption of caffeine, smoking, and cocaine use increase the risk of migraines while taking citalopram.
  • Certain diseases, such as fibromyalgia, can cause migraines. Cymbalta is very effective in treating this condition.

What to do if citalopram causes migraines?

If you are experiencing migraines and suspect that citalopram is causing them, you must discuss this with your doctor. They will assess your condition and medical history to determine the appropriate management plan for you.

If the doctor finds that citalopram is causing your migraines, they may consider reducing your dose and monitoring your symptoms. If your migraines persist despite the dose adjustment, they may recommend gradually discontinuing citalopram and switching to another antidepressant.

Furthermore, the doctor will most likely prescribe certain medications to help with migraine attacks when they occur.

What medications can help with citalopram-related migraines?

Some of the medications that can reduce the frequency and intensity of citalopram-related migraines are demonstrated in the following table [5]:

Medication Side effects or contraindications
Analgesics, such as non-steroidal anti-inflammatory drugs and Tylenol (acetaminophen). NSAIDs may cause cardiovascular, renal, and gastrointestinal side effects in people with risk factors.
Triptans like sumatriptan They may cause serotonin syndrome if used with citalopram. They’re also contraindicated for patients with hypertension or heart disease.
Dihydroergotamine or ergotamine They may also cause serotonin syndrome if used with citalopram. They shouldn’t be used by patients with cardiovascular problems.
Opioids can be used for severe and persistent migraines. Improper use of opioids can lead to dependence or tolerance.

Antiemetics, such as metoclopramide, can also be prescribed for managing migraine-related nausea and vomiting.

Tips for managing citalopram-related migraines

Here are some recommendations that may help reduce the frequency of migraines [5]:

  • Avoid excessive use of analgesics.
  • Avoid excessive intake of caffeine, alcohol, and nicotine.
  • Identify the trigger factors for your migraines and try to avoid them. Examples of migraine trigger factors include stress, exercise, bright lights, loud noise, chocolates, certain cheeses, processed meat, exercise, and insomnia.
  • Try to ensure getting enough quality sleep; aim for 7-9 hours of uninterrupted sleep per day.
  • Incorporate stress-reducing activities into your day, such as yoga or meditation.
  • Keep a “headache diary”; record the frequency, duration, timing, severity, and possible triggers of your headache. This is useful in monitoring your response to your migraine treatment.

Understanding the link between citalopram and migraines

Based on my research, I concluded that citalopram may cause migraine headaches in some individuals, particularly those with a history of migraine or risk factors. However, this is very rare.

In my perspective, certain factors may increase the risk of experiencing migraine headaches while taking citalopram, including analgesic overuse, hypoglycemia, menstruation, certain concurrent medications, poor sleep patterns, poor eating habits, smoking, caffeine, alcohol, illicit drugs, noise, and bright lights.

If you experience migraines while taking citalopram, I recommend consulting with your doctor, reducing the medication dosage, or switching to different medications. I also believe that taking anti-migraine drugs, practicing a healthier lifestyle, avoiding triggers, and keeping a headache diary can be helpful.

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Highlights of Prescribing Information. Citalopram tablets, for oral use.


Humphrey PP, Feniuk W, Perren MJ, Beresford IJ, Skingle M, Whalley ET. Serotonin and migraine. Ann N Y Acad Sci. 1990;600:587-98; discussion 598-600. doi: 10.1111/j.1749-6632.1990.tb16912.x. PMID: 2252337.,involvement%20may%20be%20just%20epiphenomenal.


Alemdar M, Selekler HM. Migraine with aura triggered by citalopram. Neuropsychobiology. 2007;55(2):121-2. doi: 10.1159/000104469. Epub 2007 Jun 27. PMID: 17596740.


Torabipour, S., Roohani, Y., Davati, A., Ansari, I., Roghani, M., Akhavirad, S. M. B., Pourfarzam, S., Moghadamnia, M., Afshinmajd, S. Preventive effect of citalopram on migraine headaches: a double-blinded randomized clinical trial. Journal of Basic and Clinical Pathophysiology, 2020; 8(2): 1-6. doi: 10.22070/jbcp.2020.13785.1137,severe%20and%20shorter%20migraine%20episodes.


Pescador Ruschel MA, De Jesus O. Migraine Headache. [Updated 2023 Aug 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

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