Introduction
Finding the right medication to treat your depression can be difficult. You may have to try several different medications before you find the right one for you. The more you know about your options for medication, the easier it will be for you and your doctor to find the right treatment.
Celexa and Lexapro are two popular drugs used to treat depression. Here’s a comparison of these two drugs to help you as you discuss options with your doctor.
Both Celexa and Lexapro belong to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a substance in your brain that helps control your mood. These medications work by increasing serotonin levels to help treat symptoms of depression.
For both drugs, it may take some time for your doctor to find the dosage that works best for you. They may start you at a low dosage and increase it after one week, if needed. It may take one to four weeks for you to start to feel better and up to eight to 12 weeks to feel the full effect of either of these drugs. If you’re switching from one medication to the other, your doctor may start at a lower strength to find the dosage that’s right for you.
The following table highlights features of these two drugs.
| Brand name | Celexa | Lexapro |
| What is the generic drug? | citalopram | escitalopram |
| Is a generic version available? | yes | yes |
| What does it treat? | depression | depression, anxiety disorder |
| What ages is it approved for? | 18 years and older | 12 years and older |
| What forms does it come in? | oral tablet, oral solution | oral tablet, oral solution |
| What strengths does it come in? | tablet: 10 mg, 20 mg, 40 mg, solution: 2 mg/mL | tablet: 5 mg, 10 mg, 20 mg, solution: 1 mg/mL |
| What is the typical length of treatment? | long-term treatment | long-term treatment |
| What’s the typical starting dosage? | 20 mg/day | 10 mg/day |
| What’s the typical daily dosage? | 40 mg/day | 20 mg/day |
| Is there a risk of withdrawal with this drug? | yes | yes |
Do not stop taking Celexa or Lexapro without talking to your doctor. Stopping either drug suddenly can cause withdrawal symptoms. These can include:
- irritability
- agitation
- dizziness
- confusion
- headache
- anxiety
- lack of energy
- insomnia
If you need to stop taking either medication, your doctor will decrease your dosage slowly.
The prices are similar for Celexa and Lexapro. Both medications are available in most pharmacies, and health insurance plans normally cover both drugs. However, they may want you to use the generic form.
Celexa is the brand-name version of the generic drug citalopram. Lexapro is the brand-name of the generic drug escitalopram. Brand-name products tend to be more expensive then the generic forms.
Celexa and Lexapro both have a warning for an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults (ages 18–24 years), especially in the first few months of treatment and during dosage changes.
Stay safe: What to know about antidepressants and suicide risk »
Stay safe: What to know about antidepressants and suicide risk »
Celexa has one warning that Lexapro does not. Celexa doses greater than 40 mg per day are not recommended. This is due to the risk of electrical changes in your heart (or, fast or slow heart rate).
The chart below lists examples of side effects of Celexa and Lexapro.
| Side effect | Celexa | Lexapro | |
| Common | nausea | X | X |
| sleepiness | X | X | |
| weakness | X | X | |
| dizziness | X | X | |
| anxiety | X | X | |
| trouble sleeping | X | X | |
| sexual problems | X | X | |
| sweating | X | X | |
| loss of appetite | X | X | |
| shaking | X | X | |
| dry mouth | X | X | |
| constipation | X | X | |
| respiratory infections | X | X | |
| yawning | X | X | |
| diarrhea | X | ||
| Serious side effects | suicidal actions or thoughts | X | X |
| serotonin syndrome | X | X | |
| severe allergic reactions | X | X | |
| abnormal bleeding | X | X | |
| seizures or convulsions | X | X | |
| manic episodes | X | X | |
| changes in appetite or weight | X | X | |
| low salt (sodium) levels in your blood | X | X | |
| visual problems | X | X |
Sexual problems from these drugs can include:
- impotence
- delayed ejaculation
- decreased sex drive
- inability to have an orgasm
Visual problems from these drugs can include:
- blurry vision
- double vision
- dilated pupils
Celexa and Lexapro can interact with other medications. The specific drug interactions of both drugs are similar. Before you start treatment with either medication, tell your doctor about all prescription and over-the-counter drugs, supplements, and herbs that you take.
The table below lists possible drug interactions for Celexa and Lexapro.
| Interacting drug | Celexa | Lexapro |
| MAOIs*, including the antibiotic linezolid | X | X |
| pimozide | X | X |
| blood thinners such as warfarin and aspirin | X | X |
| NSAIDs* such as ibuprofen and naproxen | X | X |
| carbamazepine | X | X |
| lithium | X | X |
| anxiety drugs | X | X |
| mental illness drugs | X | X |
| seizure drugs | X | X |
| ketoconazole | X | X |
| migraine drugs | X | X |
| drugs for sleep | X | X |
| quinidine | X | |
| amiodarone | X | |
| sotalol | X | |
| chlorpromazine | X | |
| gatifloxicin | X | |
| moxifloxacin | X | |
| pentamidine | X | |
| methadone | X |
*MAOIs: monoamine oxidase inhibitors; NSAIDs: nonsteroidal anti-inflammatory drugs
If you have certain health problems, your doctor may start you on a different dosage of Celexa or Lexapro, or you may not be able to take the drugs at all. Discuss your safety with your doctor before taking Celexa or Lexapro if you have any of the following medical conditions:
- kidney problems
- liver problems
- seizure disorder
- bipolar disorder
- pregnancy
- heart problems, including:
- congenital long QT syndrome
- bradycardia (slow heart rhythm)
- recent heart attack
- worsening heart failure
In general, Celexa and Lexapro work well to treat depression. The drugs cause many of the same side effects and have similar interactions and warnings. Still, there are differences between the medications, including dosage, who can take them, what drugs they interact with, and if they also treat anxiety. These factors may influence which drug you take. Talk to your doctor about these factors and any of your other concerns. They’ll help choose the drug that’s best for you.