Does citalopram lower cortisol? (+cortisol-lowering tips)

This article will explore whether citalopram lowers cortisol levels. It will also explain the mechanisms by which antidepressants like citalopram regulate cortisol and discuss the research findings surrounding this topic.

Additionally, this article will examine the factors that can influence cortisol levels while taking citalopram and provide recommendations for managing cortisol levels effectively.

Does citalopram lower cortisol?

Citalopram may lower cortisol levels in some individuals. To illustrate, cortisol is a hormone secreted in response to stress. Since citalopram is an antidepressant that enhances mood, manages anxiety, and reduces stress, it can decrease cortisol levels in some people.

However, it is important to understand that Celexa mainly works by increasing serotonin and doesn’t directly regulate cortisol levels. Thus, it may not reduce cortisol levels in everyone. Moreover, it can’t be relied on alone to treat high cortisol levels. 

If you’re suffering from elevated cortisol levels, it is recommended that you visit a doctor. They will determine the primary cause of your increased cortisol and decide on an appropriate treatment accordingly.

How can antidepressants like citalopram lower cortisol?

Antidepressants, including citalopram, have been found to regulate cortisol levels by affecting p-glycoprotein and other corticosteroid transporters. These transporters prevent cortisol from entering brain cells, causing it to accumulate in the blood and other systems.

By inhibiting these transporters, antidepressants allow more cortisol to access the brain. This leads to the hypothalamus and pituitary gland suppressing cortisol release through glucocorticoid-mediated negative feedback.

Additionally, antidepressants activate glucocorticoid receptors that bind to cortisol, decreasing circulating cortisol levels and similarly enhancing the negative feedback mechanism described earlier.

To illustrate, the pituitary gland and hypothalamus control cortisol secretion and normalize it when they detect that it is functioning adequately. Therefore, this negative feedback mechanism helps reduce cortisol levels.

Consequently, antidepressants, including Celexa, can contribute to reduced circulating cortisol levels. Other antidepressants, like sertraline and trazodone, can also lead to these effects.

What does research suggest?

One study found that citalopram increased morning cortisol levels in the saliva by 47%. Additionally, it increased the suppression of cortisol by prednisolone, with suppression levels increasing from around 22% to 45% after citalopram treatment.

These findings suggest that citalopram enhances glucocorticoid-mediated negative feedback on the HPA axis, which is commonly overactive in depressed patients.

Another investigation found that acute oral administration of citalopram increases salivary cortisol levels in healthy people.

The researchers concluded that acute administration of citalopram increased the release of corticotrophin-releasing hormone (CRH) in the hypothalamus, leading to elevated levels of corticotropin (ACTH) release from the pituitary gland.

Finally, this results in greater cortisol secretion from the adrenal gland. The findings of both of these studies indicate that chronic treatment with citalopram increases cortisol suppression, while acute administration increases HPA axis activity. 

What factors influence cortisol levels while taking citalopram?

While citalopram may lower cortisol in certain individuals, it’s important to note that medication responses can vary among different people. Various factors can influence cortisol levels while taking citalopram, including concurrent medications, underlying health conditions, and comorbidities.

Some individuals may experience lower cortisol levels while taking citalopram, while others may have elevated cortisol levels.

Factors that may increase cortisol while on citalopram

High cortisol levels can be caused by high stress levels, abdominal obesity, unhealthy diets, lazy lifestyles, diseases that increase the production of adrenocorticotropic hormone (ACTH) from the pituitary gland, or conditions that directly increase cortisol production from the adrenal gland [4].

People suffering from pituitary corticotrophic adenoma, ectopic ACTH syndrome (such as small cell lung cancer), or adrenocortical tumors are most likely to have high cortisol levels while on citalopram. Additionally, long-term administration of corticosteroids can also lead to elevated cortisol levels [4].

Factors that may lower cortisol while on citalopram

Extremely low cortisol levels can also be dangerous. Thus, knowing the factors that may lead to low cortisol is important, especially while taking citalopram. Some examples of these factors are mentioned below [4].

  • Sudden discontinuation of long-term glucocorticoid administration suppresses cortisol levels.
  • Surgical removal of the adrenal gland can also lead to low cortisol levels while taking citalopram.
  • Congenital adrenal hyperplasia is a disease that involves an insufficiency of cortisol and aldosterone.
  • Addison’s disease is an autoimmune disease where the body’s immunity damages the adrenal gland, leading to very high levels of cortisol.
  • People who take anticoagulants for a very long time may suffer from bilateral adrenal hemorrhages, which can impair the adrenal gland’s ability to secrete cortisol sufficiently.
  • People who take the drug mitotane are more likely to have low cortisol levels while taking citalopram.

What to do if citalopram doesn’t lower your cortisol levels?

If you’re suffering from high cortisol levels and citalopram isn’t normalizing, you must visit a doctor. Citalopram can help reduce cortisol levels through its stress-reducing effects, but it can’t be used alone for this condition.

Your doctor will assess your medical and medication history to determine the appropriate treatment for your high cortisol levels. Moreover, if they find that citalopram isn’t effectively reducing your stress or managing your anxiety or depression, they may consider switching you to another antidepressant.

Furthermore, here are some natural management strategies that can help reduce your cortisol levels:

Cortisol-lowering food Lifestyle modifications 
Dark chocolate  Ensure that you are getting enough quality sleep. It is also recommended to avoid sleeping after midnight for optimal cortisol levels.
Green tea Regular exercise is effective in lowering cortisol levels, including cardiovascular exercises, like running or swimming, and resistance exercises like weightlifting.
Omega-3 fatty acids can be obtained from fatty fish, nuts, seeds, or supplements. Try to reduce your stress levels.
Whole fruits and vegetables Limit your caffeine intake, as it increases cortisol levels.
Dark chocolate Try incorporating meditation, yoga, or tai chi into your daily routine.
Foods containing probiotics, such as yogurt.  


Based on my research, I found that citalopram may lower cortisol levels in some individuals. However, it should not be solely relied upon to treat high cortisol levels.

Research suggests that citalopram treatment can enhance the balance between hormones in the HPA axis. However, acute administration of citalopram can increase activity in the HPA axis.

From my perspective, certain risk actors, such as chronic administration of glucocorticoids, can influence cortisol levels while taking citalopram. If citalopram does not effectively lower your cortisol levels, I recommend consulting with a doctor.

Additionally, based on my knowledge, there are natural management strategies such as stress management, regular exercise, and incorporating cortisol-lowering foods that can help reduce cortisol levels.

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Carmine M. Pariante, Sarah A. Thomas, Simon Lovestone, Andrew Makoff, Robert W. Kerwin, Do antidepressants regulate how cortisol affects the brain?, Psychoneuroendocrinology, Volume 29, Issue 4, 2004, Pages 423-447, ISSN 0306-4530.


Pariante CM, Papadopoulos AS, Poon L, Cleare AJ, Checkley SA, English J, Kerwin RW, Lightman S. Four days of citalopram increase suppression of cortisol secretion by prednisolone in healthy volunteers. Psychopharmacology (Berl). 2004 Dec;177(1-2):200-6. doi: 10.1007/s00213-004-1925-4. Epub 2004 Jun 4. PMID: 15179544.,citalopram%20(P%3D0.05).


Nadeem, H., Attenburrow, MJ. & Cowen, P. Comparison of the Effects of Citalopram and Escitalopram on 5-Ht-Mediated Neuroendocrine Responses. Neuropsychopharmacol 29, 1699–1703 (2004).


Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

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