Does Citalopram induce panic attacks? (5+ factors)

In this article, we will explore whether Citalopram can induce panic attacks. Additionally, we will discuss research findings, why patients experience panic attacks with Citalopram, what factors and doses can trigger them, and what to do if Citalopram causes panic attacks.  

Does Citalopram induce panic attacks?

No, Citalopram does not induce panic attacks. However, Citalopram is used to treat panic disorder. Citalopram has been approved by the FDA for its use in the treatment of depression, and it may also be used to treat related mental health conditions. 

What does research suggest?

In a clinical study involving 20 patients with panic disorder who were administered Citalopram, panic symptoms were also accompanied by feelings of anxiousness, different fears, and other symptoms related to stress and anxiety.

Most patients responded well to Citalopram treatment, with improvements in their panic symptoms. A few patients reported mild symptoms of panic attacks initially, but these symptoms improved as their bodies adjusted to the medication. 

Some patients who took Citalopram for longer periods also experienced improvements in their panic disorder symptoms. These positive effects of Citalopram are due to the increase in serotonin levels in the brain, which contributes to the antidepressant’s anti-panic effects (1). 

Another research study suggested that low doses of Citalopram, ranging from 20 to 60mg per day, may be a safe and well-tolerated long-term treatment option for people with panic disorder (2). These research findings support Citalopram’s effectiveness in treating panic disorder and overall anxiety symptoms (3). 

Why do patients experience panic attacks with Citalopram?

Some patients may experience panic attacks when they begin taking Citalopram. This initial discomfort occurs because Citalopram takes about 1-4 weeks to start working. During the first few days of taking Citalopram, some patients may experience episodes of panic attacks, stress or anxiety. 

However, these symptoms of panic attacks may go away as the body adjusts to the medication and you may start to feel better after 1-4 weeks.

Improvements in appetite, sleep, mood, and energy levels may indicate that you are responding well to the medication. However, Citalopram may take around 8-12 weeks to show its complete therapeutic effects (4).

What are the factors that may cause panic attacks with Citalopram?

Certain factors may induce panic attacks while using Citalopram, including: 

  • If you are taking a low dose of Citalopram, which is insufficient to treat panic disorder.
  • Worsening of panic disorder while taking Citalopram. 
  • High consumption of caffeine and alcohol.
  • Women might be more prone to experience panic attacks compared to men. 
  • A family history of panic disorder.
  • Use of medications such as tranquillizers. 
  • Any other underlying health conditions like patients with bipolar disorder may have increased response to SSRIs in terms of panic attacks. 

What doses of Citalopram can trigger panic attacks?

If you experience panic attacks while taking Citalopram, please inform your doctor. You may be taking more than the necessary dose to treat panic disorder. Your doctor may adjust the dosage based on your body’s response to Citalopram.

If you are currently taking a lower dose than what is required to treat panic disorder, your doctor may gradually increase it. However, Citalopram should be taken once daily, either in the morning or evening, as prescribed by your doctor.

The initial recommended dose of Citalopram is 20mg per day, however, it may be increased gradually up to 40mg per day at weekly intervals. Elderly patients should not take more than 20mg per day (5). 

What to do if Citalopram causes panic attacks?

If you continue to experience panic attack symptoms after consuming Citalopram for more than 4 weeks, it is crucial to inform your doctor.

They will evaluate your current symptoms, the dose of Citalopram you are taking, and the frequency of panic episodes. If necessary, your doctor may adjust the dosage and closely monitor your response to the medication.  


This article has discussed that Citalopram does not induce panic attacks; in fact, it is used to treat panic disorders along with depression and related mental health conditions. Research studies have shown that Citalopram is effective in reducing panic symptoms even in long-term use. 

Some patients may experience panic attacks when they start taking Citalopram, but these symptoms may disappear as your body adjusts to the medication. However, if panic symptoms persist even after two months of treatment, you should consult your doctor. 


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Humble M, Wistedt B. Serotonin, panic disorder and agoraphobia: short-term and long-term efficacy of citalopram in panic disorders. Int Clin Psychopharmacol. 1992 Jun;6 Suppl 5:21-39. PMID: 1431019. Available from: 


Lepola UM, Wade AG, Leinonen EV, Koponen HJ, Frazer J, Sjödin I, Penttinen JT, Pedersen T, Lehto HJ. A controlled, prospective, 1-year trial of citalopram in the treatment of panic disorder. J Clin Psychiatry. 1998 Oct;59(10):528-34. doi: 10.4088/jcp.v59n1006. PMID: 9818634. Available from: 


Andrisano C, Chiesa A, Serretti A. Newer antidepressants and panic disorder: a meta-analysis. Int Clin Psychopharmacol. 2013 Jan;28(1):33-45. doi: 10.1097/YIC.0b013e32835a5d2e. PMID: 23111544. Available from: 


Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32119293. Available from: 


FDA Label. Celexa (Citalopram). [Internet]. Available from: 

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