Does Citalopram work for everyone? (+3 factors)

In this article, we will discuss whether Citalopram works for everyone. We will also discuss some research studies and what one should do if Citalopram is not working for you.

Does Citalopram work for everyone?

No, Citalopram may not work for everyone. The response to Citalopram varies among individuals; some individuals may benefit from Citalopram therapy and some individuals may not respond or experience side effects leading to discontinuation of the therapy.

Citalopram is an antidepressant which belongs to SSRIs (selective serotonin reuptake inhibitors), which is used to treat mental illnesses such as depression, and anxiety disorders in both men and women (1).

Citalopram works by inhibiting the reuptake of serotonin in the brain thereby increasing this neurotransmitter (serotonin) concentration in the brain cells. This serotonin helps to reduce the symptoms associated with anxiety and depression.

It is important to note that individual responses to medications vary, especially responses to those meds which affect brain chemistry. It is advisable to reach out to your healthcare provider before starting or stopping any antidepressant (2).

Why does Citalopram not work for everyone?  

There are several factors that can contribute to the reason why Citalopram does not work for everyone. These include:

Individual variability: Every individual has their own way of responding to medication because of the different metabolism and biochemistry of the body. Genetic variation also plays a role in how an individual reacts to the medication.

This is why some individuals may feel better after taking Citalopram treatment while others may not.

Tolerance: You can develop tolerance to the drug over time, which means the initial therapeutic effect of the drug decreases and the medication may not be effective at that particular dose (3).

The severity of the condition: The severity of your depression symptoms can influence your response to Citalopram. If your condition is severe, you may need a combination therapy or a high dose of a drug. 

Always remember not to make any changes to your dosage regimen without consulting your doctor first.

Adherence: Always take Citalopram as prescribed by your healthcare provider. Take Citalopram at the same time each day to maintain the same concentration of the drug in your body.

If you are not taking Citalopram regularly as prescribed by your doctor, you will not benefit from the treatment.

Concomitant medications: The use of other medications alongside Citalopram can impact its effectiveness. Drugs such as aripiprazole, aspirin, celecoxib etc can interact with Citalopram and may render Citalopram ineffective or produce adverse effects.

Always inform your doctor about all the medications or supplements you are taking to minimize the risk of drug interactions.

Physical and psychological factors: Factors such as stress, lifestyle and environment can influence the overall effectiveness of Citalopram. It is essential to address these factors for a better and more effective treatment of the illness.

Patient’s gender, age, weight and lifestyle can also influence Citalopram’s action and affect the efficacy of the drug.

What should you do if Citalopram is not working?

It is important to pay attention to any potential recurrence of symptoms that you may experience while taking Citalopram. These symptoms may include reduced interest in your day-to-day activities, decreased concentration and attention, changes in mood and an increase in pain.

If you notice any of these symptoms, it may indicate that the medication is not working. If you notice that your symptoms are not being treated and are worsening, consult your physician for further management. Your doctor may increase your dose or switch to another antidepressant.

Do not alter the dose of Citalopram and avoid self-medicating as it can lead to side effects and worsen your condition (4).

Your doctor may recommend another alternative antidepressant depending upon your condition. These include:

Antidepressant class Name of drug
SSRIs Sertraline, Escitalopram, Fluoxetine, Paroxetine
SNRIs Venlafaxine, Milnacipran, Desvenlafaxine
TCAs Amitriptyline, Nortriptyline, Imipramine
Atypicals Bupropion, Mirtazapine
MAOIs Isocarboxazid, Selegiline

What are the conditions where Citalopram should not be used?

There are some conditions where Citalopram is not recommended due to the potential risk. Citalopram should be consumed only under the guidance of a doctor to avoid side effects and withdrawal symptoms. Some of the situations where Citalopram is contraindicated are:

  • If you are allergic to the drug.
  • If you are taking monoamine oxidase inhibitor (MAOI) class of drugs, concomitant use of Citalopram is not recommended.
  • If you have glaucoma, increased intraocular pressure or visual disturbance.
  • If you have severe liver and kidney problems or if you have high blood pressure, consult your healthcare provider before taking Citalopram, as it may need a dose adjustment.
  • Avoid caffeine and alcohol consumption along with Citalopram, as it may exacerbate side effects.

In my opinion, not all individuals respond to Citalopram. Choosing an antidepressant to treat your symptoms may need trial and error. If you are experiencing any side effects such as nausea, insomnia, dizziness or drowsiness etc or any unwanted changes with Citalopram, make sure you consult your physician. Do not self medicate or adjust your dosage without proper guidance.


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