A range of selective serotonin reuptake inhibitor (SSRI) formulations are suitable for adults with swallowing difficulties.

Licensed medicines in suitable formulations

There are no suitable licensed formulations of fluvoxamine. Other SSRIs are available in suitable formulations and may be preferred.

Citalopram 40mg/ml oral drops

Available as a licensed product and should be mixed with water, orange juice or apple juice before administration.  The drops have an expiry of 12 or 16 weeks once opened (depending on brand) and do not require fridge storage.

Citalopram drops are not bioequivalent to citalopram tablets; four drops (8mg) is equivalent in effect to one 10mg tablet.

Escitalopram 20mg/ml oral drops

Available as a licensed product and can be mixed with water, apple juice or orange juice before administration. They have an eight-week expiry once opened and do not require fridge storage.

Fluoxetine 20mg/5ml oral solution

Available as a licensed product. Some brands have a one-month expiry once opened (check the relevant SPC for details); they do not require fridge storage.

Fluoxetine 20mg dispersible tablets

Available as a licensed product. A whole or half tablet can be dispersed in half a glass of water. The tablets should not be crushed or chewed.

Sertraline 100mg/5ml concentrate for oral solution

Available as a licensed product that must be diluted before use. Each dose should be diluted with around 120ml water, ginger ale, lemon/lime soda, lemonade or orange juice and given immediately. The concentrate has an expiry of 30 days once opened and does not require fridge storage.

Licensed medicines used in an unlicensed manner

Citalopram, escitalopram, paroxetine or sertraline tablets

Can be crushed and/or dispersed in water, or crushed and given with soft food. The tablets are film-coated and contents may taste bitter or unpleasant. Crushed sertraline and paroxetine tablets may have a local anaesthetic effect on the tongue.

Fluoxetine capsules

Can be opened and the contents dispersed in water or given with soft food.

Special-order medicines

In view of the licensed products available, special-order preparations may not be required.

There are no SSRI preparations listed in Part VIIIB of the Drug Tariff.

Update history

  1. Sertraline 100mg/5ml concentrate for oral solution added to Licensed medicines in suitable formulations. Expiry date of citalopram oral drops updated.
  1. Sertraline oral suspensions removed from Special-order medicines. Sertraline 25mg/5ml, 50mg/5ml and 100mg/5ml oral suspensions have been removed from Part VIIIB of the Drug Tariff.
  1. Content reviewed: Minor changes for clarity. 'Using our advice' added
  1. Paroxetine oral suspension removed from licensed medicines - product has been discontinued.
  1. Published