Citalopram side effects: can they last?
Sexual problems are common on citalopram. Most side effects ease, but the UK leaflet warns sexual ones can continue after stopping. This is called PSSD.
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Citalopram’s common side effects include feeling sick, sweating, poor sleep and sexual problems, such as a low sex drive or trouble reaching orgasm. Most ease after a couple of weeks, but the UK leaflet warns sexual problems have sometimes continued after stopping, a condition called post-SSRI sexual dysfunction (PSSD).
The NHS page on citalopram doesn’t mention that warning. Citalopram’s heart risk was measured to the millisecond, but nobody has counted how often its sexual side effects outlast the tablets.
The story in 3 lines
- Sexual problems, such as a low sex drive, are a common side effect of citalopram (NHS).
- The UK leaflet warns they have sometimes continued after stopping (leaflet).
- Nobody has counted how often this happens after citalopram. Patients call it PSSD (Healy and Mangin, 2024).
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Roy Whaley took citalopram briefly when he was 22. Sixteen years later, he told The New York Times, his penis still felt almost as if it had been injected with a local anaesthetic. His sex drive had gone, and orgasms brought no pleasure.
Over the years, doctors kept suggesting the problem was psychological. One note in his records, from 2009, called citalopram “exceptionally unlikely” to be the cause. “We feel very neglected,” he said.
What are the most common side effects of citalopram?
The UK leaflet lists these as the most common:
- feeling sick
- sweating and a dry mouth
- headaches
- sleeping badly, or feeling sleepy
- feeling weak
The leaflet says these are often mild. Some can also be signs of the illness itself, and may fade as you get better.
The leaflet lists sexual problems as common, too. In men that means a lower sex drive and trouble with ejaculation and erections. In women it means a lower sex drive and not being able to reach orgasm.
How common are sexual side effects on citalopram?
They’re common. Studies that ask about sex directly tend to find more of them. In one large US study, everyone took citalopram and filled in a questionnaire that asked about sex.
About half reported a lower sex drive. There was no placebo group, though, and depression can dull desire too.
The trials behind the US label recorded far fewer than that. The label itself warns its figures “may underestimate” the real rate, because patients and doctors may be reluctant to talk about sex.
Whether these problems can outlast the tablets is a different question. Joanna Moncrieff, a professor of psychiatry at University College London, talks about it in this 90-second film.
Can citalopram side effects last after stopping?
The UK leaflet says the sexual ones can: “In some cases, these symptoms have continued after stopping treatment.” In 2019 the EU medicines regulator asked for that warning on every SSRI and SNRI, citalopram included.
Patients and researchers call this PSSD. Its key sign, under diagnostic criteria published in 2022, is a lasting change in genital sensation, like Roy’s numbness.
For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.
Andy was 23 when he was prescribed citalopram. In an interview with Moral Medicine, he describes symptoms that have lasted more than 13 years and go far beyond sex.
Does citalopram affect your heart?
It can. The UK prescribing information says citalopram lengthens the QT interval, the time the heart takes to recharge between beats, and more so at higher doses.
If that interval runs too long, a rare but life-threatening rhythm becomes more likely. The leaflet says a fast, irregular heartbeat or fainting needs medical advice at once.
A heart study measured the effect at different doses. Then, in 2011, the UK medicines regulator capped the dose at 40 mg a day, or 20 mg for people over 65.
As far as we can find, nobody has run a study like that for sexual problems after stopping. We think it needs one.
What can I do if I have side effects?
These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly: the leaflet says stopping quickly can bring dizziness and sleep problems, and the dose is usually lowered gradually.
If sexual problems haven’t lifted after stopping, tell your GP. Many people say it took time to be taken seriously. Write the basics down first: “Citalopram 20 mg from January 2023, last tablet March 2024. Genitals numb since April.”
Report it: it helps everyone
A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.
- No proof needed. A suspicion is enough, even years after stopping.
- Where: the Yellow Card scheme in the UK, MedWatch in the US.
- Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208).
Our reporting guide walks you through it
Do citalopram side effects go away? Most ease after a couple of weeks, says the NHS, as your body gets used to the medicine. Sexual problems are different: the leaflet warns they have sometimes continued after stopping. Nobody knows how many people with PSSD fully recover: the researchers David Healy and Dee Mangin wrote in 2024 that this “has never been properly investigated”.
Can citalopram make you feel emotionally numb? It can: the UK leaflet lists “reduced emotions, indifference” among its common side effects. Many patients call this emotional blunting. The 2022 criteria for PSSD list emotional numbing as a possible feature after stopping, too.
Is citalopram the same as escitalopram? Not quite. Citalopram (Cipramil, Celexa) is an equal mix of two mirror-image molecules, and escitalopram (Lexapro, Cipralex) is one of them on its own. The 2019 EU warning about sexual problems after stopping covers both, and our Lexapro article has more.
Roy’s doctor believes him now, he said, partly because of that warning from European regulators. If your symptoms haven’t lifted, take that warning to your own doctor.
Sources
- Cipramil 20 mg film-coated tablets, patient information leaflet, last revised January 2025. Electronic Medicines Compendium. Sections 2 (sexual problems after stopping), 3 (doses and stopping) and 4 (side effects).
- Cipramil 20 mg film-coated tablets, summary of product characteristics, text revised November 2023. Section 4.4 (QT prolongation and sexual dysfunction) and section 5.1 (QTc study in healthy volunteers).
- NHS, Side effects of citalopram, last reviewed 26 June 2026.
- Celexa (citalopram), US prescribing information, revised October 2023. DailyMed. Section 6.1, on sexual dysfunction: figures “may underestimate their actual incidence”.
- MHRA, Citalopram and escitalopram: QT interval prolongation, Drug Safety Update, December 2011.
- European Medicines Agency, PRAC, new product information wording, signals adopted at the 13-16 May 2019 meeting, EMA/PRAC/265221/2019. Lists citalopram and escitalopram among the SSRIs concerned.
- Perlis RH, Laje G, Smoller JW and colleagues. Genetic and clinical predictors of sexual dysfunction in citalopram-treated depressed patients. Neuropsychopharmacology 2009;34(7):1819-28. STAR*D: 799 of 1,473 participants treated openly with citalopram for up to 14 weeks reported decreased libido; no placebo group.
- Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76.
- Healy D, Mangin D. Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence. Epidemiol Psychiatr Sci 2024;33:e40.
- The New York Times, After antidepressants, a loss of sexuality, by Azeen Ghorayshi, 9 November 2023. Subscription required.
- Videos: Moral Medicine, Andy’s 13 year battle with PSSD, 5 October 2024, 27 minutes; PSSD Network, Professor Joanna Moncrieff on PSSD, June 2026, 1:29.
- Picture: Citalopram20-40.jpg by Elbreapoly, public domain, via Wikimedia Commons; converted to WebP.
This information does not replace medical advice. Talk to your doctor before you make any decision about your treatment.
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