What are the differences between Zoloft and Celexa?

What are Zoloft and Celexa?

Zoloft (sertraline) and Celexa (citalopram hydrobromide) belong to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Other drugs in this class are fluoxetine (Prozac, Sarafem), paroxetine (Brisdelle, Paxil, Paxil CR, Pexeva), and fluvoxamine (Luvox CR).

Zoloft and Celexa are used for treating depression. Zoloft is also used to treat obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). It is also used for treating social anxiety disorder and premenstrual dysphoric disorder (PMDD).

What are the side effects of Zoloft and Celexa?

Zoloft

WARNING

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

The most common side effects of Zoloft are:

Possible serious side effects of Zoloft include:

Important side effects are irregular heartbeats, allergic reactions and activation of mania in patients with bipolar disorder. If Zoloft is discontinued abruptly, some patients experience side effects such as:

A gradual dose reduction of Zoloft is recommended when therapy is discontinued.

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.

What is the dosage of Zoloft vs. Celexa?

Zoloft

  • The recommended dose of sertraline is 25-200 mg once daily. Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25-50 mg once daily. Doses are increased at weekly intervals until the desired response is seen.
  • The recommended dose for PMDD is 50-150 mg every day of the menstrual cycle or for 14 days before menstruation.
  • Sertraline may be taken with or without food.

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.

What drugs interact with Zoloft and Celexa?

Zoloft

All SSRIs, including Zoloft, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example

  • isocarboxazid (Marplan),
  • phenelzine (Nardil),
  • tranylcypromine (Parnate),
  • selegiline (Eldepryl, Emsam, Elazar), and
  • procarbazine (Matulane).

Other drugs that inhibit monoamine oxidase include

Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between Zoloft and MAOIs.) Similar reactions occur when Zoloft is combined with other drugs for example, tryptophan, St. John's wort, meperidine (Demerol, Meperitab), tramadol (ConZip, Synapryn FusePaq, Ultram) that increase serotonin in the brain.

Cimetidine (Cimetidine Acid Reducer, Tagamet HB ) may increase the levels in blood of Zoloft by reducing the elimination of Zoloft by the liver. Increased levels of Zoloft may lead to more side effects.

Zoloft increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and Zoloft.

Through unknown mechanisms, Zoloft may increase the blood thinning action of warfarin (Coumadin, Jantoven). The effect of warfarin should be monitored when Zoloft is started or stopped.

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.

Are Zoloft and Celexa safe to take during pregnancy?

Zoloft

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.

Summary

Zoloft (sertraline) and Celexa (citalopram hydrobromide) are antidepressants called selective serotonin reuptake inhibitors (SSRIs) prescribed to treat depression. Zoloft is also used to treat obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

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