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Cipram Tablet (Citalopram) Dosage Guide in Pakistan

Taking the correct dose of Cipram Tablet (Citalopram) is essential for treatment success. This guide provides complete information on the adult dose, maximum dose limit, missed dose, and discontinuation.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated:

Dosage Guide

Quick Answer

The usual starting dose of Cipram (Citalopram) is 20mg daily, generally in the morning. Full antidepressant effect develops in 2-4 weeks. Maximum dose is 40mg/day — the old 60mg limit was removed due to QT prolongation risk. Never stop suddenly — reduce gradually under doctor's guidance (tapering).

Dose at a Glance

Adult Dose

As prescribed — generally starting at 20mg/day, dose titration done by doctor

Once daily

Max: 40mg/day maximum

Child Dose (Psychiatrist supervision required for paediatric use)

Weight-based dose — consult your doctor; caution required with citalopram in paediatric use

As directed by your doctor

Missed Dose

If you miss a dose, take it as soon as you remember. If the next dose is close, skip the missed dose. Never take a double dose. Consistency is essential with antidepressants — take at the same time every day.

Overdose

Citalopram overdose is serious — QT prolongation, seizures, cardiac arrhythmia can occur. In case of excessive dose, contact emergency IMMEDIATELY and inform a doctor. Overdose may be intentional in mental health patients — the family should remain alert.

Cipram Tablet (Citalopram) Dosage

Correct dose of Cipram Tablet (Citalopram) is essential for treatment success. In antidepressants, the dose is always determined by the doctor or psychiatrist — do not adjust yourself.

Adult Dose

  • Starting dose: Generally 20mg once daily
  • Usual dose: As prescribed — doctor adjusts based on condition and response
  • Maximum dose: 40mg/day — regulatory maximum due to dose-dependent QT prolongation (old 60mg limit removed)
  • Frequency: Once daily — morning or evening

Starting Dose: As prescribed by your doctor (generally 20mg)

Usual Dose: As prescribed — titrated by doctor

Max Daily Dose: 40mg/day (do not exceed — cardiac risk)

Child Dose

Psychiatrist supervision is required for paediatric use. Weight-based dose — consult your doctor. The risk of suicidal ideation is higher in children — close monitoring is necessary.

How to Take

  • Once daily — at the time prescribed by the doctor
  • Can be taken with or without food — if nausea occurs, take after food
  • Swallow the whole tablet with water — do not crush or chew
  • Consistency is necessary — take at the same time every day

Best Time to Take

  • Morning preferred — if insomnia occurs
  • Evening — if sedation is a side effect and sleep is better at night
  • As per doctor's advice — then the same time every day

With Food or Empty Stomach

Can be taken either way. If nausea occurs at the start, taking after food is better — this generally resolves within 1-2 weeks.

Missed Dose

Take as soon as you remember. If the next dose time is close, skip it and continue the normal schedule. Never take a double dose. Daily consistency is important with antidepressants.

Stopping Citalopram

Never stop suddenly — discontinuation syndrome can occur:

  • Dizziness, nausea, flu-like symptoms
  • "Electric shock" sensations (brain zaps)
  • Anxiety, irritability, insomnia

Reduce the dose gradually under the doctor's guidance (tapering) — often reducing week by week. The process can take weeks depending on duration of use.

Overdose

Citalopram overdose is serious — QT prolongation, seizures, cardiac arrhythmia can occur. Contact emergency IMMEDIATELY. Intentional overdose is possible in mental health patients — family should remain vigilant.

Dose Summary Table

PatientDoseNotes
AdultAs prescribed (generally 20mg start)Max 40mg/day
ChildWeight-based — psychiatrist decidesClose monitoring required
ElderlyLower dose — 20mg max often recommendedQT risk + SIADH risk

The information in this guide is for educational purposes only. Always confirm the dose with your doctor or psychiatrist. Do not start or stop on your own.

Frequently Asked Questions

What is the starting dose of Cipram?

The usual starting dose of Cipram (Citalopram) is 20mg/day — in sensitive patients the doctor may start at 10mg. The dose is always determined by the doctor.

What is the maximum dose of Citalopram?

Maximum is 40mg/day. The old 60mg limit was removed from regulatory guidance due to the risk of QT prolongation. Never take more than 40mg.

How long does Cipram take to work?

Full antidepressant effect becomes apparent in 2-4 weeks. Some relief from anxiety may be felt from the first week. Patience is necessary — do not discontinue yourself.

What is the correct way to stop Cipram?

Never stop abruptly. Reduce the dose gradually under the doctor's guidance (tapering) — often week by week. Sudden discontinuation can cause dizziness, nausea, electric shock sensations (discontinuation syndrome).

What to do if a dose is missed?

Take as soon as you remember. If the next dose time is close, skip it and continue the normal schedule. Never take a double dose.

Brand alternatives, same-class options, and other medicines used for the same conditions as Cipram Tablet.

Sources

  1. DRAP Registered Products Database Drug Regulatory Authority of Pakistan
  2. WHO Model List of Essential Medicines, 23rd ed. (2023) World Health Organization
  3. British National Formulary (BNF) BMJ Group & Pharmaceutical Press

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.