Can I take Sertraline and Citalopram together?

It is generally not recommended that you take sertraline and citalopram together as they are the same class of SSRI (antidepressant) and work in the same way to increase serotonin levels.

Taking them together creates an 'additive effect' where the levels become dangerously high, increasing the risk of serotonin syndrome. Additionally, both drugs can affect the electrical activity of the heart in a similar way.

You should not take these two medicines together unless specifically instructed and closely monitored by a specialist.

How to know if you're having a drug interaction

You may be experiencing a drug interaction between sertraline and citalopram if you notice:

• Agitation, restlessness or confusion.

• Shivering or sweating.

• Muscle twitching, stiffness or jerking movements.

• Fast heartbeat.

• Diarrhoea.

• Headache.

• Feeling unusually anxious or overactive.

These may be signs of serotonin syndrome, which can be serious.

Seek urgent medical help if you have:

• A high fever.

• Severe confusion or agitation.

• Seizures.

• Irregular heartbeat.

• Loss of consciousness.

If you are currently taking both, do not stop taking them suddenly, but contact your doctor immediately to discuss a safe plan.

Depression and anxiety disorders

These medicines can cause an increase in suicidal thoughts or the urge to self-harm, particularly in the first few weeks of treatment or when the dose is changed. Monitor your mood closely.

Serotonin Syndrome

Combining these with other medicines that affect serotonin (such as St John’s Wort, tramadol, or triptans) can cause a life-threatening reaction involving high fever, agitation, and muscle stiffness.

Bleeding disorders

These medicines can increase your risk of bleeding, especially in the stomach. Use with caution if you take aspirin, ibuprofen (NSAIDs), or blood-thinning medicines like warfarin.

Heart rhythm disorders (QT prolongation)

Citalopram can affect the electrical rhythm of your heart. It must be avoided if you have a pre-existing heart rhythm problem or are taking other medicines that affect the heart rate.

Low sodium levels (Hyponatraemia)

Citalopram can cause a serious drop in blood sodium levels, especially in the elderly. Seek medical help if you experience extreme tiredness, confusion, or muscle twitching.

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Alcohol can increase the drowsiness and dizziness caused by the medication, and may also make your symptoms of depression or anxiety worse.

Grapefruit juice

You should avoid drinking large amounts of grapefruit juice while taking sertraline. Grapefruit can increase the level of sertraline in your blood, which may increase the risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

Citalopram can sometimes cause feelings of restlessness or jitteriness, especially when you first start taking it. Caffeine is a stimulant that can worsen these side effects and may increase feelings of anxiety. It is advisable to monitor your caffeine intake.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.