 - Antidepressant treatment within 4 days of study 1 week if fluoxetine. Subjects currently on antidepressant medication with subtherapeutic results in terms of depression management after providing informed consent, will undergo a medication taper and discontinuation prior to initiation of citalopram treatment. The subject must be off of previous antidepressants for at least 4 days week prior to starting citalopram 1 week if fluoxetine. The subject will be closely monitored by the research study psychiatrist with or without additional monitoring from primary clinical psychiatric providers. The medication taper is left up to the research study psychiatrist in consultation with patients primary care or psychiatric provider. Study subjects who cannot be safely tapered from their medication or experience adverse effects during the taper will be excluded from the study 