Cilift contains citalopram 20 mg, an SSRI antidepressant. It is prescribed for depression and for anxiety conditions including panic disorder and obsessive-compulsive disorder. It takes several weeks to work, has a dose limit related to heart rhythm, and should not be started or stopped without medical guidance.
What is Cilift?
Cilift contains citalopram 20 mg in tablet form and is Schedule 5 in South Africa — prescription-only.
Citalopram is also available under other South African names, including generic citalopram. Being dispensed one rather than another is ordinary generic substitution.
Citalopram is a selective serotonin reuptake inhibitor (SSRI). Nerve cells communicate by releasing serotonin into the gap between them and then reabsorbing it. Citalopram blocks that reabsorption, leaving serotonin available for longer.
Citalopram is the most selective of the SSRIs — it acts on serotonin with very little effect on other neurotransmitter systems. That relative cleanness is why it tends to cause fewer of the effects associated with older antidepressants.
But the mechanism does not explain the timing, and the timing matters. Serotonin levels rise within hours, yet the benefit takes weeks. The improvement therefore comes from slower adaptive changes in nerve circuits, not simply from more serotonin. Judging the medicine after a few days is judging it before it has done anything — while the early side effects have already appeared. That pattern, all cost and no benefit in week one, is expected and is the most common reason people stop too soon.
Citalopram has a specific dose ceiling. At higher doses it can prolong the QT interval, an electrical measure in the heart, which can lead to dangerous rhythm disturbances. Maximum doses are therefore capped, and lower limits apply to people over 65, those with liver impairment, and those taking interacting medicines. This is why the dose should not be increased without medical direction.
What is Cilift commonly used for?
- Depression — the most common reason, including moderate to severe episodes.
- Panic disorder, with or without agoraphobia.
- Obsessive-compulsive disorder, often needing higher doses and longer to respond.
- Generalised anxiety disorder and social anxiety.
- Post-traumatic stress disorder, in some cases.
- Premenstrual dysphoric disorder.
Expect a realistic timeline. Sleep and appetite often improve within one to two weeks. Mood usually lifts over four to six weeks, sometimes longer. In anxiety conditions, symptoms occasionally feel worse in the first week or two before improving — worth knowing in advance, since it is otherwise alarming.
Once it works, treatment usually continues for at least six months after recovery, because stopping early markedly increases relapse risk.
Medicine is rarely the whole treatment. Psychological therapy works at least as well for many people and better in combination.
How Cilift fits into this medicine category
| Group | Examples | Typical role |
|---|---|---|
| SSRIs | Citalopram (Cilift), escitalopram, fluoxetine | First-line for depression and anxiety |
| SNRIs | Venlafaxine, duloxetine | Depression, anxiety; duloxetine also nerve pain |
| Tricyclics | Amitriptyline | Older; nerve pain, sleep, depression |
| Benzodiazepines | Diazepam | Short-term anxiety only |
| Antipsychotics | Risperidone | Psychosis, bipolar; sometimes added |
| Mood stabilisers | Valproate, lithium | Bipolar disorder |
SSRIs are generally first choice because they are effective and much safer in overdose than older antidepressants. See the mental health, nerve and neurological medicines hub.
What to check before using Cilift
Do not stop it abruptly. Citalopram has a shorter duration than fluoxetine, so discontinuation symptoms are more likely — dizziness, electric-shock sensations, nausea, irritability, vivid dreams and flu-like feelings. These are unpleasant but not dangerous, and are avoided by tapering gradually under medical guidance. They are not withdrawal in the addiction sense, and citalopram is not addictive.
Do not increase the dose yourself, given the heart rhythm limit.
Tell your doctor or pharmacist if you:
- Have any heart condition, a rhythm disorder, a slow heart rate, or a family history of sudden cardiac death.
- Have low potassium or magnesium.
- Have bipolar disorder, or have ever had a manic episode — an antidepressant alone can trigger mania.
- Have epilepsy.
- Have liver or kidney disease.
- Have glaucoma, or a bleeding disorder.
- Have diabetes, as blood sugar control may shift.
- Are over 65, where a lower maximum dose applies.
- Are pregnant, planning pregnancy or breastfeeding. Untreated depression in pregnancy also carries risks — this is a balance to discuss.
- Are under 25, where closer monitoring is advised early in treatment.
- Take medicines affecting heart rhythm — some antibiotics, antifungals, antipsychotics and antiarrhythmics.
- Take tramadol, triptans for migraine, linezolid, St John’s wort, or another antidepressant — all raise serotonin.
- Take an MAOI antidepressant. This must be avoided, with a gap when switching.
- Take warfarin, aspirin or an anti-inflammatory such as ibuprofen — SSRIs increase bleeding risk.
- Take cimetidine or omeprazole, which raise citalopram levels.
Possible cautions and when to ask a pharmacist or doctor
Common effects, mostly early and often settling within two weeks, are nausea, dry mouth, sweating, drowsiness or insomnia, headache, tremor, diarrhoea and reduced appetite.
Sexual side effects are common and often under-discussed — reduced desire, difficulty reaching orgasm, or erectile difficulty. They affect a substantial minority and do not always settle. Raise it if it happens; a dose adjustment or different antidepressant often helps, and this is a frequent reason people quietly stop medicine that is otherwise working.
Seek medical attention urgently if you or those around you notice:
- New or worsening thoughts of suicide or self-harm, or marked agitation — especially in the first weeks or after a dose change. This needs same-day attention.
- Agitation, confusion, fever, sweating, shivering, muscle twitching, a racing heart or diarrhoea — possible serotonin syndrome, particularly with another serotonergic medicine.
- Palpitations, fainting, or an irregular heartbeat — relevant given the QT effect.
- A seizure.
- Unusual bruising or bleeding, vomiting blood, or black stools.
- Elevated mood, racing thoughts, reduced need for sleep or unusually impulsive behaviour — possible switch into mania.
- Confusion, marked drowsiness, headache or nausea — possible low sodium, more likely in older people.
- A rash, or swelling of the face or lips.
Tell your doctor if there is no improvement after four to six weeks, if side effects are limiting, or if your circumstances change. Many people need a dose adjustment or a different antidepressant before finding the right one — needing a second try is common and is not a failure.
Related medicine guides
- Browse Mental Health, Nerve & Neurological Medicines guides
- Read: Trepiline used for
- Read: Nurika used for
Frequently asked questions
What is Cilift used for? Depression and anxiety conditions including panic disorder, obsessive-compulsive disorder and generalised anxiety. It contains citalopram.
What is Cilift 20 mg used for? 20 mg is the standard tablet strength and a common effective dose for depression. Doses are capped because of a heart rhythm effect at higher levels.
How long does it take to work? Sleep and appetite may improve in one to two weeks; mood usually lifts over four to six weeks. Side effects often appear first and then settle.
Is Cilift addictive? No. SSRIs do not cause craving or dose escalation. Stopping abruptly can cause discontinuation symptoms, which is different from addiction.
Can I stop when I feel better? Not on your own. Treatment usually continues at least six months after recovery, and stopping should be tapered gradually.
Why is there a maximum dose? At higher doses citalopram can affect the heart’s QT interval and rhythm. Lower limits apply over 65 and with liver problems or interacting medicines.
Will it change my personality? It should not. The aim is to return you to yourself. Feeling emotionally flat or numb is a recognised effect worth reporting.
Can I drink alcohol on it? Alcohol can worsen depression and add to drowsiness. Discuss it with your doctor.