Can you reduce citalopram dose from 20mg to 10mg? (3+facts)

In this article, we will discuss whether the citalopram dose can be reduced from 20mg to 10mg, what research suggests, what factors to consider when reducing the dose of citalopram, what the recommended dose of citalopram is, if there are any side effects to reducing the dose of citalopram, and what to do if this dose reduction is not helping.

Can you reduce citalopram dose from 20mg to 10mg?

Yes, the citalopram dose can be reduced from 20mg to 10mg if you are experiencing any side effects or if your depression is stable and you have no other risk factors associated with your health. However, dose reduction should only be done under a healthcare provider’s supervision.

Generally, 20mg is considered the standard dose of citalopram. Individual responses to medication may vary. However, dose reduction in cases of dose-dependent side effects can certainly help. (1,6)

What does research suggest?

Research on citalopram dose reduction is limited. A study published in the Journal of the Mental Health Clinician suggested that individuals with depression and anxiety who responded positively to citalopram treatment could reduce their dosage successfully without compromising therapeutic benefits. (2)

Another study reported the occurrence of antidepressant discontinuation syndrome upon a marked reduction in citalopram doses. However, more comprehensive studies are needed to establish general guidelines for dose reduction. (5)

What factors to consider when reducing the dose of citalopram?

Citalopram is an antidepressant and belongs to the class of selective serotonin reuptake inhibitors. It influences serotonin levels in the brain and regulates our emotions. It is used to treat stress, anxiety, and depressive disorders. (6)

Before considering a reduction in the citalopram dose, several factors must be considered:

  • Individual response: Responses to medication vary, and what works for one person may not be suitable for another. Assessing how an individual responds to the medication before considering any changes is crucial.


  • The severity of symptoms: The severity of the symptoms is a crucial factor in determining the appropriate treatment. Mild to moderate symptoms may be more tolerant of dose reduction, while severe symptoms may require a consistent or increased dose. (1)


  • Duration of treatment: Patients who have been on citalopram for a long period may have developed a stable response. In such cases, healthcare providers should cautiously approach any dose changes. (3)

What is the recommended dose of citalopram?

The recommended dose of citalopram varies based on the severity of the condition being treated and the age of the patient. Typically, starting doses range from 20 to 40mg per day for the 18 to 65 age group and shouldn’t be used in the below-18 age group.

The recommended dose for the 65 and above age group is 10mg, and 20mg is the maximum dose. However, individual response and tolerability should guide the prescribing physician in determining the most suitable dose for each patient. (3,5)

If you are experiencing side effects at the recommended dose of citalopram, your doctor may decide to lower the dose temporarily. This gives the body time to adjust to citalopram.

Are there any side effects to reducing the citalopram dose?

The abrupt stoppage or marked reduction of the dose of citalopram may lead to antidepressant discontinuation syndrome, withdrawal symptoms, or a recurrence of depressive symptoms. Individuals need to be aware of potential side effects, which may include:

  • Nausea
  • Headache
  • Fatigue
  • Irritability
  • Insomnia
  • Dizziness
  • Vertigo
  • Burning
  • Tingling
  • Aggression
  • Mania (4)

What are the potential benefits of reducing citalopram dose? 

Tapering down from 20mg to 10mg of citalopram may be beneficial for various reasons. Here are some potential benefits associated with the gradual reduction of citalopram dosage:

Minimizing side effects: Tapering down the dosage may help minimize potential side effects associated with citalopram use, as sudden discontinuation can lead to withdrawal symptoms.

Individualized treatment: What works for one person may not be suitable for another. Tapering allows for a more personalized approach to medication management, adjusting the dosage based on individual response and tolerability.

Improved tolerance: Some individuals may experience side effects or reduced tolerance to the 20mg citalopram dosage. Tapering down to 10mg provides an opportunity to find an optimal balance between therapeutic effects and side effect management.

Gradual adjustment to a lower dosage: For patients who have been on citalopram for an extended period, tapering down allows for a gradual adjustment to a lower dosage. This approach may be especially important for individuals who have been stable on the medication and are considering a long-term management plan.

Reducing long-term exposure: Long-term use of antidepressants has been associated with certain concerns, such as the potential for weight gain, sexual side effects, and interactions with other medications. Tapering down may help minimize long-term exposure to these potential concerns.

What to do if citalopram dose reduction is not helping?

If a reduction in citalopram dose does not produce the desired effects, whether you are taking the reduced dose to mitigate side effects or your mental health is stable, so you are trying to reduce the citalopram dose, it is crucial to consult with a healthcare professional.

They may recommend returning to the previous dose, adjusting the treatment plan, or exploring alternative medications. While the citalopram dose reduction from 20mg to 10mg may be a consideration for some individuals, it is a decision that your doctor should make.

Your doctor may also choose to discontinue the medication through a gradual and controlled tapering process to avoid unwanted withdrawal effects.

You should be vigilant for potential side effects if the adjusted dose is causing unwanted symptoms and immediately report it to your healthcare provider.


I believe this specific dosage adjustment is limited; consideration of individual variations and close monitoring is essential. I strongly recommend that patients should communicate openly with their healthcare providers to ensure the best possible outcomes in managing their mental health.

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Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. [Updated 2021 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


McCarrell, J. L., Bailey, T. A., Duncan, N. A., Covington, L. P., Clifford, K. M., & Blaszczyk, A. T. (2019). A review of citalopram dose restrictions in the treatment of neuropsychiatric disorders in older adults. The Mental Health Clinician, 9(4), 280-286.


Celexa, prescribing information by The U.S. Food and Drug Administration,,021046s019lbl.pdf


Gabriel, M., & Sharma, V. (2017). Antidepressant discontinuation syndrome. CMAJ : Canadian Medical Association Journal, 189(21), E747.


Fabo, K. R., Nye, A. M., Gagliardi, J. P., Dennis, C. R., & Muzyk, A. J. (2015). Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study. The Primary Care Companion for CNS Disorders, 17(1).


PubChem [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2004-. PubChem Compound Summary for CID 2771, Citalopram; [cited 2023 Nov. 17]. Available from:

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