Medication·Interactions & depletion·Reviewed June 9, 2026
Citalopram interactions.
Citalopram has 9 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Citalopram at a glance.
A quick, data-grounded summary. The full tables are below.
Citalopram has 9 documented interactions in the NutriStack database, including 4 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Sodium and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with citalopram.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| 5-HTP | Contraindicated | 5-HTP combined with citalopram creates serotonin syndrome risk. Citalopram also prolongs QTc, and serotonin excess can worsen cardiac effects. details → |
| L-Tryptophan | Contraindicated | L-Tryptophan is the upstream precursor to serotonin. Combined with citalopram's serotonin reuptake blockade, supplemental tryptophan can push... details → |
| MDMA | Contraindicated | Citalopram blocks the serotonin transporter MDMA uses to release serotonin, blunting the subjective effect while still permitting serotonergic load.... details → |
| St. John's Wort | Contraindicated | Dual serotonin reuptake inhibition from citalopram and St. John's Wort creates serotonin syndrome risk. |
| Ginkgo Biloba | Caution | Citalopram impairs platelet aggregation by depleting platelet serotonin; Ginkgo's ginkgolides inhibit platelet-activating factor. The combination... details → |
| Melatonin | Caution | Severe sedation has been reported after melatonin was added to a regimen that included citalopram, with the authors judging a melatonin-citalopram... details → |
| Rhodiola Rosea | Caution | Citalopram is serotonergic. Rhodiola has preclinical monoamine and MAO-related findings, but direct human evidence for serotonin syndrome with... |
| SAMe | Caution | SAMe has independent serotonergic and antidepressant activity. Combined with citalopram, the additive serotonergic effect raises the risk of... |
| Magnesium Citrate | Synergy | Citalopram produces dose-dependent QT interval prolongation and carries a black-box warning at doses above 40 mg/day (or 20 mg in older adults).... details → |
What citalopram can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Sodium | Significant | SSRI-induced SIADH can lower serum sodium, especially in older adults and during the first weeks of therapy. | – | Serum sodium |
| Folate | Mild | Lower folate status is associated with poorer SSRI response and may be reduced in some chronic users through altered one-carbon metabolism. | Methylfolate | Serum folate or RBC folate |
The full citalopram profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common citalopram questions.
Quick answers drawn from the tables above.
What interacts with Citalopram?
In the NutriStack database, Citalopram has 9 documented interactions. The most notable include 5-HTP, L-Tryptophan, MDMA, St. John's Wort, and Ginkgo Biloba. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Citalopram?
Citalopram is flagged against 4 substances in the database, including 5-HTP, L-Tryptophan, MDMA, and St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Citalopram deplete any nutrients?
Citalopram is associated with lowering Sodium and Folate with prolonged use. Useful biomarkers to monitor include Serum sodium and Serum folate or RBC folate. Ask your prescriber before adding any replacement supplement.
Is it safe to take 5-HTP with Citalopram?
NutriStack classifies the 5-HTP and Citalopram pairing as contraindicated: 5-HTP combined with citalopram creates serotonin syndrome risk. Citalopram also prolongs QTc, and serotonin excess can worsen cardiac effects. Do NOT take 5-HTP with citalopram. Always confirm with your prescriber.
Check your whole stack
See how citalopram fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.