Citalopram can do both. Trouble sleeping is one of its listed common side effects, yet over weeks of treatment many people end up sleeping better than they did before they started.1nhs.uk. Citalopram: an antidepressant medicine Poor sleep is often part of the depression or anxiety the drug treats, so as the illness eases, sleep tends to recover. The disruption citalopram does cause is also usually milder than with many antidepressants, and it is something you can often work around.
How Often Citalopram Causes Insomnia
Citalopram is an SSRI, one of a family of antidepressants that raise serotonin, a brain chemical involved in mood and sleep. In one study, fewer than 2 in 100 people taking citalopram reported new insomnia, the lowest rate among the antidepressants compared.2PubMed Central. Effects of Antidepressants on Sleep The NHS still lists problems sleeping among its common side effects, alongside headache, nausea and sweating.3nhs.uk. Citalopram: an antidepressant medicine
Dose matters too. The chance of insomnia changes little between low and moderate doses of citalopram but climbs at higher doses.4The Better Sleep Clinic. Antidepressants And Sleep: Unpacking Insomnia And Sleepiness Side Effects
Your genes play a part too. A common variation in a liver enzyme gene means some people break citalopram down slowly, and they report side effects more often.5PubMed Central. Large-scale analysis demonstrates the influence of CYP2C19 genotype on specific SSRI side effects The enzyme normally clears citalopram from the blood, so slow processors end up with higher levels from the same dose. Such slow processors are also more likely to stop the drug because of side effects, about 26 in 100 versus 20 in 100.6PubMed Central. Large-scale analysis demonstrates the influence of CYP2C19 genotype on specific SSRI side effects If side effects are strong, a doctor may lower the dose.
It can be hard to tell drug insomnia from depression insomnia. Depression itself often causes early waking or broken sleep. New trouble that begins right after you start the pill suggests the drug, while sleep that was bad before and slowly improves suggests recovery, though the patterns can overlap. A simple sleep diary helps you and your doctor see which pattern you’re in.
Trouble sleeping in the first days is common and isn’t a sign the drug is wrong for you. The better question is whether the trouble fades, stays steady or gets worse over the first few weeks.
Why Citalopram Changes Your Sleep
Serotonin generally pushes the brain toward wakefulness, so drugs that raise it can cause insomnia. That is why it shows up with this family of antidepressants.7PubMed Central. Neuropharmacology of Sleep and Wakefulness Serotonin also suppresses dreaming sleep.8PubMed Central. Neuropharmacology of Sleep and Wakefulness
Sleep moves through cycles of lighter sleep, deep sleep and dreaming sleep, repeating several times. Dreaming sleep is more concentrated in the later cycles, toward morning. Citalopram reduces dreaming sleep from the first dose, more so at higher doses, and the reduction continues with long-term use.9PubMed. Citalopram: differential sleep/wake and EEG power spectrum effects after single dose and chronic administration Because it trims this stage, the shape of the night can change even when your total time in bed stays the same.
Most people don’t notice less dreaming sleep directly. What you may notice is sleep that feels lighter or more broken, and dreams that feel different. The reduction isn’t considered harmful in itself. Across this family of antidepressants, overnight sleep recordings show taking longer to fall asleep, sleeping less and waking more often.10PubMed. Effects of selective serotonin reuptake inhibitors on objective and subjective sleep quality In depressed people on citalopram, though, one study found sleep continuity did not worsen, while light sleep increased.11PubMed. Changes in sleep polygraphic variables and clinical state in depressed patients during treatment with citalopram
The effect is often strongest early. The brain adjusts to higher serotonin over the first weeks, and early side effects often fade during that period.
When Citalopram Improves Sleep
In people with both insomnia and anxiety, citalopram improved time to fall asleep, sleep quality, sleep length and daytime functioning over 12 weeks.12PubMed Central. Efficacy and safety evaluation of citalopram and doxepin on sleep quality in comorbid insomnia and anxiety disorders Gains in sleep quality and length appeared within the first 8 weeks.13PubMed Central. Efficacy and safety evaluation of citalopram and doxepin on sleep quality in comorbid insomnia and anxiety disorders It did not reduce the need for sleeping pills in that study, though.14PubMed Central. Efficacy and safety evaluation of citalopram and doxepin on sleep quality in comorbid insomnia and anxiety disorders
A realistic timeline starts rough. The first one to two weeks may bring lighter or broken sleep. Improvement often follows as mood and worry lift, and benefits build over two to three months. If sleep is still poor after that, raise it with your doctor.
Sleep and mood improve together because anxious thoughts and low mood keep the brain alert at night. Easing them removes a main driver of poor sleep. Better sleep helps mood in return, so the two can lift each other over time.
To tell whether you’re improving, look at trends across weeks rather than single nights, since even people who are getting better still have bad ones. Falling asleep faster, fewer wake-ups and feeling more alert during the day are signs of progress. A quick morning note on how long you took to fall asleep and how rested you feel makes the trend easier to see.
Vivid Dreams, Nightmares and Restless Legs
Citalopram can make people remember more of their dreams.15PubMed Central. Dreams, Sleep, and Psychotropic Drugs In one reported case, an older man developed vivid nightly nightmares two weeks after starting it. They lessened when he lowered the dose and were gone a month after stopping.16Journal of Pharmaceutical Care. Citalopram Induced Nightmare in an Elderly Man: A Case Report One case can’t say how common this is, and most people never get nightmares like these. Dreams that clearly track dose changes are a useful clue to share with a prescriber.
Feeling that you dream more doesn’t mean you are dreaming more. Everyone dreams every night, and most dreams are forgotten by morning. If you wake more often, you’re more likely to catch a dream and remember it, so lighter sleep can make dreams seem more frequent.
Occasional vivid dreams are usually harmless. Nightly nightmares that wake you are worth reporting. Never stop or cut the dose on your own; ask first.
Several studies link citalopram to restless legs syndrome, an urge to move the legs when resting, usually in the evening.17PubMed Central. Parasomnias and sleep‐related movement disorders induced by drugs in the adult population: a review about iatrogenic medication effects It feels like a crawling or tugging deep in the legs, worse when you lie still and eased by moving. It can delay falling asleep, and it is different from an ordinary leg cramp. New leg discomfort at bedtime after starting the drug is worth mentioning to your doctor.
What to Do If Citalopram Keeps You Awake
If citalopram keeps you awake, taking it in the morning is the usual suggestion. If it makes you drowsy instead, taking it in the evening can help.18Pillo. Best Time to Take Citalopram: Morning or Night Pick a time, such as with breakfast, and hold it for at least a week before judging the result.
Because insomnia rises at higher doses, a lower dose may help if sleep problems persist.19The Better Sleep Clinic. Antidepressants And Sleep: Unpacking Insomnia And Sleepiness Side Effects Ask your prescriber rather than changing the dose yourself.
If you remember a missed morning dose only in the evening, ask your pharmacist or check the leaflet whether to take it or skip it. A late dose close to bedtime might worsen sleep for that night in someone who is sensitive. Do not double up to make up for a missed dose.
A few habits help while you adjust. Keep a fixed wake time, even after a poor night. Cut caffeine after midday and avoid long daytime naps. Morning daylight helps anchor your body clock.
If you do see your doctor, bring when the trouble started relative to your first dose, your dose and the time of day you take it, and whether the problem is falling asleep, staying asleep or dreams. Add any other medicines or supplements you use.
Taking Melatonin or Sleep Aids With Citalopram
In one reported case, a 19-year-old taking citalopram with a pain opioid and another antidepressant became severely sedated after adding melatonin.20Journal of Pharmacy & Pharmaceutical Sciences. Melatonin Interaction Resulting in Severe Sedation Combinations of drowsy-making medicines can add up. Tell your pharmacist before adding melatonin, sleep aids or antihistamines. Herbal products like St John’s wort also raise serotonin, and taking them with citalopram can push serotonin dangerously high, so check with your pharmacist first. Alcohol worsens sleep quality and mood.
Sleep When You Stop Citalopram
Stopping an antidepressant often brings mild, short-lived symptoms such as dizziness, headache, sleep trouble and mood swings.21PubMed Central. Antidepressant Withdrawal and Rebound Phenomena Reduce the dose gradually with your doctor rather than stopping suddenly.
Your brain has adapted to the drug’s effects on serotonin, and a sudden drop can leave it briefly out of balance. A taper lowers the dose in steps over weeks, giving the brain time to readjust, which usually softens symptoms. The pace depends on your dose, how long you have taken it and how you feel along the way.
Sleep may be lighter or interrupted and dreams unusually vivid for a while, often most noticeably in the days after each reduction. Regular sleep habits help steady the nights. Symptoms that persist or worsen could be depression returning, so report returning low mood promptly.