Does Citalopram help Paranoia? (+3 options) )

In this article, we will explore the potential and effectiveness of Citalopram (Celexa) in the treatment of paranoia. We will further discuss the alternative treatment options for managing paranoia if the symptoms are not getting better with Citalopram.

Does Citalopram help paranoia?

Citalopram may help manage paranoia, but it is not a first-line therapy for this condition. 
Citalopram is an antidepressant that works by selectively inhibiting serotonin reuptake in the brain and is primarily used in the treatment of major depressive disorder, anxiety, and obsessive-compulsive disorder (1). Paranoia often accompanies these conditions as a comorbidity so, Citalopram may indirectly help manage paranoia by treating its associated symptoms. 

What does research suggest?

According to research, Citalopram has the potential to alleviate paranoia by lowering dopamine levels in the prefrontal cortex of the brain. This is significant because excess dopamine in the brain can contribute to the development or exacerbation of symptoms of paranoia (2,3).

A study conducted on an 80-year-old patient with violent behavior and paranoia, unresponsive to typical and atypical antipsychotics, when treated with Citalopram experienced substantial relief within four days (4). 

In another study, Citalopram exhibited a promising role in alleviating paranoia-related symptoms, particularly agitation in dementia patients (4). 

Additionally, Citalopram elevates mood, reduces anxiety, promotes social interaction, improves decision-making, and stabilizes the emotional state (5). These benefits collectively help individuals manage paranoia and related symptoms. 

How do you know if you have paranoia?

Paranoia is characterized by irrational beliefs that others are deceiving you or trying to harm you. If you’re unsure whether you are experiencing paranoia, here are some signs and considerations (6):

  • Mistrust and suspicion toward people
  • Anxiety, leading to constant fear and worry
  • Poor relationships and social isolation
  • Palpitations
  • Substance dependence
  • Defensiveness
  • Irritability, aggression, and agitation

Benefits and limitations of Citalopram in treating paranoia

Citalopram is beneficial in alleviating the symptoms associated with paranoia such as anxiety, agitation, and negative thoughts. It not only helps in the stabilization of mood but also promotes emotional well-being in paranoids. 

Along with the benefits, citalopram like other medications can cause some side effects in individuals. The most common side effects of citalopram are (7):

If you experience any of the above-mentioned side effects, reach out to your healthcare provider right away, as this information can help them select appropriate medications for your condition. However, it is important to note that these side effects do not affect everyone, and their intensities can vary among individuals.

What to do if paranoia is not getting better with Citalopram?

If paranoia is not getting better with Citalopram, talk to your healthcare provider. There are several alternative treatment options for paranoia that are better than Citalopram.

Typically, antipsychotic medications such as olanzapine, risperidone, and paliperidone palmitate are prescribed for paranoia. However, there is currently no FDA-approved medication to completely eradicate this condition. 

Lifestyle changes and cognitive behavioral therapy are proven to be effective against paranoia. Embracing a healthy lifestyle, which includes a balanced diet, regular exercise, yoga, and adequate sleep can help individuals reduce paranoid symptoms. 

Some individuals may also find relief through holistic approaches including acupuncture, herbal medications, and meditation because such techniques can contribute to overall mental well-being and reduce paranoia.

It is important to note that Citalopram alone cannot completely treat paranoia. Starting any medication without proper diagnosis and prescription should be avoided. If you’re uncertain about which medication to take, it is advisable to consult a healthcare professional before starting the treatment. 


In this article, we have discussed the potential of Citalopram in the treatment of paranoia, and the alternative treatment options if the symptoms are not getting better with Citalopram.

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Bezchlibnyk-Butler K, Aleksic I, Kennedy SH. Citalopram–a review of pharmacological and clinical effects. J Psychiatry Neurosci. 2000 May;25(3):241-54. PMID: 10863884; PMCID: PMC1407724


Barnby JM, Bell V, Deeley Q, Mehta MA. Dopamine manipulations modulate paranoid social inferences in healthy people. Transl Psychiatry. 2020 Jul 5;10(1):214. doi: 10.1038/s41398-020-00912-4. PMID: 32624569; PMCID: PMC7335741.


Kaneko F, Kawahara Y, Kishikawa Y, Hanada Y, Yamada M, Kakuma T, Kawahara H, Nishi A. Long-Term Citalopram Treatment Alters the Stress Responses of the Cortical Dopamine and Noradrenaline Systems: the Role of Cortical 5-HT1A Receptors. Int J Neuropsychopharmacol. 2016 Aug 12;19(8):pyw026. doi: 10.1093/ijnp/pyw026. PMID: 27029212; PMCID: PMC5006198.


Kotbi N, Singh A, Kneifati-Hayek J, Odom A, Alexopoulos G. Citalopram in agitated and delusional demented patients who failed treatment with antipsychotic agents. J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E62. doi: 10.1176/appi.neuropsych.13060122. PMID: 24763800.


Zorick T, Okita K, Renard KB, Mandelkern MA, Brody AL, London ED. The Effects of Citalopram and Thalamic Dopamine D2/3 Receptor Availability on Decision-Making and Loss Aversion in Alcohol Dependence. Psychiatry J. 2022 Sep 20;2022:5663274. doi: 10.1155/2022/5663274. PMID: 36249526; PMCID: PMC9553840.


Iacovino JM, Jackson JJ, Oltmanns TF. The relative impact of socioeconomic status and childhood trauma on Black-White differences in paranoid personality disorder symptoms. J Abnorm Psychol. 2014 Feb;123(1):225-30. doi: 10.1037/a0035258. PMID: 24661172; PMCID: PMC4370342.



Feighner JP, Overø K. Multicenter, placebo-controlled, fixed-dose study of citalopram in moderate-to-severe depression. J Clin Psychiatry. 1999 Dec;60(12):824-30. doi: 10.4088/jcp.v60n1204. PMID: 10665628.


 Birkeland SF. Psychopharmacological treatment and course in paranoid personality disorder: a case series. Int Clin Psychopharmacol. 2013 Sep;28(5):283-5. doi: 10.1097/YIC.0b013e328363f676. PMID: 23820335.

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