Does Citalopram affect heart rate? (+5 studies)

This article will answer the question, “Does Citalopram affect heart rate?” We will also explore FDA recommendations and precautions for managing irregular heart rate while using this medication.

Does Citalopram affect heart rate?

Yes, Citalopram can affect heart rate. It’s advised to keep a close watch on your heart rate when using this medication.

Notably, higher doses of Citalopram have been linked to irregular heart rate and rhythm disturbances, such as QT prolongation and Torsade de Pointes, which can lead to sudden, adverse outcomes.

Citalopram, often prescribed under the brand name Celexa, is commonly used to treat depression, OCD, anxiety and mood disorders.

It is a selective serotonin reuptake inhibitor (SSRI) that enhances serotonin levels in the brain. It is usually taken once daily, either in the morning or at night.

What does the research suggest?

Several researches suggest that high doses of Citalopram can affect heart rate. The FDA has issued several drug safety communications regarding the use of Citalopram and its potential effects on heart rate. 

Citalopram can lead to a dose-dependent QT interval prolongation. QT interval is a crucial parameter in cardiac electrical activity. The QT interval prolongation can result in serious cardiac arrhythmias, including Torsades de Pointes, ventricular tachycardia, and even sudden death. (1)

Researchers conducted a study to investigate the effects of Citalopram on heart rate variability in women with generalised anxiety disorder. The study’s findings suggested that Citalopram had a notable impact as it significantly decreased heart rate variability, indicating a potential influence on the autonomic nervous system. (2)

In another case report, a dose-dependent bradycardia was described in an elderly patient undergoing Citalopram treatment. After the patient’s dose was increased to 20 mg/d, their mean heart rate dropped to 53 bpm. The dose was subsequently reduced to 10 mg/d to address this issue, and close monitoring of the patient’s heart rate was continued. (3)

Another study indicated that higher doses of Citalopram could lead to abnormal changes in heart rate and rhythm, emphasising the need for cautious dosage management. (4)

A population-based cohort study found that initiators of these medications faced a higher risk of severe arrhythmia, particularly during the initial 30 days of treatment and among those with pre-existing cardiovascular conditions. (5)

What is the maximum recommended dose of Citalopram?

The maximum recommended dose of Citalopram for depression is typically 40mg per day. However, the initial dose is often set at 10-20mg once a day with the possibility of increasing it to 40 mg after at least one week of therapy. 

Notably, the FDA has issued a cautionary warning against prescribing Citalopram doses exceeding 20mg daily for patients aged 60 and above and for patients with heart conditions. This precautionary measure arises from concerns regarding QT prolongation. (1)

Healthcare professionals should exercise caution when prescribing higher doses of Citalopram, particularly in these groups.

Who is more susceptible to Citalopram-induced irregular heart rate?

The key groups susceptible to Citalopram-induced heart rate side effects are: (1,2,3)

  • Patients taking Citalopram more than 40mg a day
  • Patients above the age of 60 and above
  • Patients with congenital long QT syndrome
  • Patients with bradycardia (slow heart rate)
  • Patients with hypokalemia (low potassium levels)
  • Patients with hypomagnesemia (low magnesium levels)
  • People who have experienced acute myocardial infarction (heart attack)
  • Patients with uncompensated heart failure
  • Patients on Medications Affecting Heart Rhythm like amiodarone, chlorpromazine, and methadone
  • Elderly Women with Generalized Anxiety Disorder
  • Patients with Kidney Disease

These groups should be closely monitored when using Citalopram due to their increased susceptibility to heart rate changes.

What to do if Citalopram affects your heart rate?

If you notice any abnormal changes in your heart rate such as dizziness or palpitations while taking Citalopram, contact your healthcare professional immediately. (1)

  • If your current Citalopram dose exceeds 40 mg per day, consult your healthcare professional about potentially adjusting your dosage.
  • Your doctor may order an electrocardiogram (ECG, EKG) to monitor your heart rate.
  • Your healthcare professional may order blood tests to assess your electrolyte levels. Any imbalances may need correction before continuing Citalopram.
  • If you experience withdrawal symptoms after discontinuing Citalopram abruptly, such as mood changes, irritability, dizziness, or other symptoms, contact your healthcare professional for guidance and support.


In conclusion, Citalopram can affect heart rate. If you notice irregular heart rate, seek immediate medical attention. Discuss potential dose adjustments with your healthcare professional and follow their recommendations for monitoring your heart rate and electrolyte levels.

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