Cipram Tablet (Citalopram) Side Effects in Pakistan

Complete guide to Cipram (Citalopram) side effects. Common effects that usually resolve on their own, serious warnings, and when to see a doctor immediately.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

Side Effects

Quick Answer

Cipram (Citalopram) common side effects include nausea, dry mouth, headache, sexual dysfunction, and insomnia. Serious effects: QT prolongation (dose-dependent — ECG monitoring), serotonin syndrome (with MAO inhibitors — EMERGENCY), hyponatraemia (elderly), and suicidal thoughts. Never stop abruptly — discontinuation syndrome.

Side Effects at a Glance

Common

Nausea
Dry mouth
Headache
Sweating (abnormal)
Insomnia or sedation
Sexual dysfunction (anorgasmia, delayed ejaculation — very common, persists)
Weight gain
Diarrhea

Serious — See a Doctor

QT prolongation
Serotonin syndrome (with MAO inhibitors or serotonergic drugs — EMERGENCY)
Hyponatraemia (low sodium — especially elderly — SIADH; confusion, fits)
Increased bleeding (antiplatelet effect — with NSAIDs/warfarin)
Discontinuation syndrome (on abrupt cessation)
Mania precipitation
Suicidal ideation (especially under-25, first 1-4 weeks or dose change)

When to See a Doctor Immediately

Suicidal thoughts or self-harm urges — IMMEDIATELY
Agitation, tremor, hyperthermia, confusion (serotonin syndrome signs — EMERGENCY)
Irregular / fast / abnormal heartbeat (QT prolongation)
Confusion, seizures, extreme weakness
Severe withdrawal symptoms after stopping abruptly

Cipram Tablet (Citalopram) Side Effects (Nuksanat)

Cipram Tablet (Citalopram) is well-tolerated in most patients — however some side effects can occur, detailed below.

IMPORTANT WARNING — Suicidal Ideation (BLACK BOX)

Antidepressants — especially in the first 1-4 weeks — can increase the risk of suicidal thoughts or self-harm urges in some patients (especially under 25 years of age). This is a Black Box Warning from the US FDA and international regulators.

Patients and family should:

Monitor closely at every dose change or initiation
Report any unusual mood, behavior change, agitation, or self-harm urges to the doctor immediately
Never stop the antidepressant on their own — that is also dangerous

Common Side Effects (Aam Nuksanat)

Nausea — early on, generally resolves within 1-2 weeks
Dry mouth
Headache
Sweating
Insomnia or sedation — depends on individual
Sexual dysfunction (very common — anorgasmia, delayed ejaculation) — may persist; discuss with your doctor
Weight gain — with long-term use
Diarrhea
Tremor (uncommon)

These side effects are usually mild. If they persist, inform your doctor.

Serious Side Effects (Sanjeedah Nuksanat — Foran Dhyan Dein)

QT prolongation
Serotonin syndrome — with MAO inhibitors or serotonergic drugs (tramadol, triptans): agitation, tremor, diarrhea, hyperthermia, muscle rigidity — EMERGENCY
Hyponatraemia: confusion, extreme weakness, seizures — see a doctor immediately
Increased bleeding — antiplatelet effect; caution with NSAIDs/warfarin
Mania precipitation — in bipolar patients
Discontinuation syndrome — on abrupt cessation: dizziness, nausea, "brain zaps"

When to See a Doctor (Kab Doctor Se Milna Zaroori Hai)

Suicidal thoughts or self-harm urges — IMMEDIATELY (especially under-25, first 4 weeks)
Agitation, tremor, hyperthermia, confusion — serotonin syndrome signs — EMERGENCY
Irregular heartbeat (QT prolongation)
Confusion, seizures, extreme weakness (hyponatraemia)
Severe withdrawal symptoms after stopping

Side Effects Summary Table

Type	Side Effect	Action
Common	Nausea (early)	Monitor — usually resolves
Common	Dry mouth	Monitor / inform doctor
Common	Sexual dysfunction	Discuss with doctor
Common	Insomnia/sedation	Discuss timing with doctor
Serious	QT prolongation	ECG; doctor immediately
Serious	Serotonin syndrome	EMERGENCY — stop, hospital
Serious	Hyponatraemia	See a doctor immediately
Critical	Suicidal ideation	IMMEDIATELY — especially under-25

Reporting Side Effects

If you notice any unexpected side effect, report it on the DRAP pharmacovigilance portal: https://www.dra.gov.pk/pharmacovigilance

The information in this guide is for educational purposes only. If you notice any side effect, contact your doctor or pharmacist.

Frequently Asked Questions

Cipram (Citalopram) ke common side effects kya hain?

Common side effects include nausea, dry mouth, headache, sweating, insomnia or sedation, and sexual dysfunction (very common — anorgasmia, delayed ejaculation). Nausea generally resolves within 1-2 weeks.

Citalopram se sexual problems kyun hoti hain?

Being an SSRI, citalopram very commonly causes sexual dysfunction — anorgasmia and delayed ejaculation. This may persist. Discuss with your doctor — dose adjustment or an alternate medicine may be considered.

Citalopram se suicidal thoughts kyun hoti hain?

Antidepressants — especially in the first 4 weeks — can increase the risk of suicidal thoughts or self-harm urges in some patients (especially under 25). This is a black box warning. Patients and family should remain alert — report any unusual change to the doctor immediately.

Citalopram se QT prolongation kya hai?

QT prolongation is a cardiac side effect — prolongation of the QT interval on ECG. It is dose-dependent (hence the 40mg/day limit). ECG monitoring is necessary in cardiac patients. If the heartbeat becomes irregular, see a doctor immediately.

Serotonin syndrome kya hai aur Citalopram se kab hota hai?

Serotonin syndrome is a serious emergency — it can occur when Citalopram is taken with MAO inhibitors or other serotonergic drugs (tramadol, triptans). Signs: agitation, tremor, diarrhea, hyperthermia, muscle rigidity. Go to hospital immediately.

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

Other ssris and antidepressants

Sibling medicines in the SSRIs and Antidepressants class.

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Used for the same conditions

Other medicines commonly used for anxiety and overlapping conditions.

Anxiety hub →

Sources

DRAP Registered Products Database — Drug Regulatory Authority of Pakistan
WHO Model List of Essential Medicines, 23rd ed. (2023) — World Health Organization
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.