Celexa vs. Lexapro

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What is the difference between Celexa and Lexapro?

What are Celexa and Lexapro?

Celexa (citalopram) is an antidepressant medication in the selective serotonin reuptake inhibitor (SSRI) class that affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Celexa works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by c Celexa results in more free serotonin in the brain to stimulate nerve cells. Other SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Lexapro (escitalopram) is an oral drug that is used for treating depression and generalized anxiety disorder. Lexapro is approved for the treatment of depression and generalized anxiety disorder. Drugs in the SSRI class also are used for treating obsessive-compulsive disorders and panic disorders, although Lexapro is not approved for these purposes.

What are the side effects of Celexa and Lexapro?

Celexa

The most common side effects associated with citalopram are

Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Citalopram is also associated with sexual dysfunction. Some patients may experience withdrawal reactions upon stopping citalopram. Symptoms of withdrawal include

  • dizziness,
  • tingling sensations,
  • tiredness, vivid
  • dreams, and
  • irritability or poor mood.

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Lexapro

WARNING

Some patients experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include

  • dizziness,
  • tingling,
  • tiredness,
  • vivid dreams,
  • irritability, or
  • poor mood.

In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Lexapro or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond 24 years of age. There was a reduction in risk of suicidality with antidepressants compared with placebo in adults 65 years of age and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.

Patients who are started on therapy with antidepressants should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Common side effects associated with Lexapro are

  • agitation or restlessness,
  • blurred vision,
  • diarrhea,
  • difficulty sleeping,
  • drowsiness,
  • dry mouth,
  • fever,
  • frequent urination,
  • headache,
  • indigestion,
  • nausea,
  • increased or decreased appetite,
  • increased sweating,
  • sexual difficulties (decreased sexual ability or desire, ejaculatory delay),
  • taste alterations, tremor (shaking), and
  • weight changes.

Other side effects include influenza-like symptoms and pain in neck or shoulders.

Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given Lexapro report difficulties ejaculating.

Possible serious side effects of Lexapro include:

  • Serotonin syndrome
  • Suicidal thinking and behavior
  • Abnormal bleeding
  • Seizures
  • Manic episodes
  • Low sodium
  • Angle closure glaucoma

What is the dosage of Celexa vs. Lexapro?

Celexa

  • The usual starting dose is 20 mg in the morning or evening.
  • The dose may be increased to 40 mg daily after one week.
  • A dose of 60 mg has not been shown to be more effective than 40 mg.
  • As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often slowly adjusted upwards to find the most effective dose.

Lexapro

  • The usual starting dose of Lexapro for treating depression in adults or adolescents is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 1 week.
  • Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be more effective than 10 mg daily for treatment of depression.
  • The dose for treating generalized anxiety disorder is 10 mg once daily.
  • Lexapro can be taken with or without food.

QUESTION

Depression is a(n) __________ . See Answer

What drugs interact with Celexa and Lexapro?

Celexa

All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started.

Tryptophan, a common dietary supplement, can cause headaches, nausea, sweating, and dizziness when taken with any SSRI. Linezolid and intravenous methylene blue are also MAO inhibitors and should not be combined with citalopram.

Use of an SSRI with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.

Lexapro

All SSRIs, including Lexapro, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing Lexapro before starting an MAO inhibitor. Conversely, at least 14 days should elapse after discontinuing an MAO inhibitor before starting Lexapro.

Similar reactions occur when SSRIs are combined with other drugs that increase serotonin in the brain, for example tryptophan, St. John's wort, meperidine (Demerol), lithium (Lithobid, Eskalith), triptans (for example, sumatriptan [Imitrex, Alsuma]), and tramadol (Ultram)

Use of selective serotonin inhibitors may increase the risk of gastrointestinal bleeding in patients taking warfarin (Jantoven, Coumadin), aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), and other drugs that cause bleeding.

Are Celexa and Lexapro safe to take while pregnant and breastfeeding?

Celexa

Exposure of neonates to citalopram in the third trimester may cause complications.

Citalopram is excreted in breast milk. Breastfeeding by a citalopram treated woman may cause adverse effects in the infant.

Lexapro

The safety of Lexapro during pregnancy and breastfeeding has not been established. Therefore, Lexapro should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to a patient outweigh unknown hazards to the fetus.

Lexapro is excreted in human milk. Lexapro should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.

Summary

Celexa (citalopram) and Lexapro (escitalopram) are selective serotonin reuptake inhibitors (SSRIs) type antidepressants used to treat depression and anxiety disorders. These drugs are also sometimes used for obsessive-compulsive disorders and panic disorders. Side effects of Celexa and Lexapro that are similar include nausea, dry mouth, increased sweating, headache, tremor (shaking), drowsiness, difficulty sleeping, and sexual difficulties.

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Medically Reviewed on 12/18/2017
References
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