Celexa vs. Lexapro: What Are the Differences?

Vicky Davis

Reviewed by Vicky Davis, FNP

Written by Geoffrey C. Whittaker

Published 10/31/2022

Updated 08/27/2021

It seems like medications for mood disorders are everywhere, and frankly, that’s a good thing. 

While there may seem to be too many ads on TV and the internet to count peddling the newest antidepressant or anti-anxiety medication, society’s progress over the last century has made it so that a once-taboo set of illnesses is now a topic of frequent public conversation. (Hello, mental health.)

The downside, if there is one, is that the abundance of new and different medications could make the research for the right medication and the choice of what to take almost as overwhelming as the disorder symptoms themselves. 

Celexa and Lexapro are two popular medications, and whether you’ve previously dealt with mood disorders or not, you’ve likely heard of them. 

Perhaps you’ve even heard them mentioned by their generic names: citalopram and escitalopram.

Our guess is, the names are probably where your familiarity stops. After all, these are complex medications, and the differences between them can take careful study for even medical experts to understand. 

Whether your healthcare provider has mentioned one or both of these medications to you for a condition you’re experiencing, or whether you’re just down the internet rabbit hole learning more about what you could expect from treatment for depression or anxiety, we’re here to break this all down and show you the differences between Lexapro and Celexa. 

Here’s what to know about Celexa vs. Lexapro, along with info on some basics about anxiety and depression.

When exploring antidepressants, it’s important to understand the condition they treat: depression. 

Depression is a well-known mood disorder characterized by patterns of ongoing sad, empty feelings and/or a loss of interest in daily activities. 

Certain types of depression including Seasonal Affective Disorder (SAD) can occur over certain periods of time or with certain conditions, while other depressive disorder types can be constant and persist over months or even years. 

Typically, healthcare professionals will be able to diagnose depression if a person is experiencing down feelings for a period of two weeks (or more).

Various genetic, biological, environmental and psychological factors can lead to or even exacerbate depression. 

And depression itself will typically show its symptoms in the form of moodiness, or anger, or exhaustion and irritability. 

Depression can lead to more serious issues including sleep loss, reckless behavior, periods of substance abuse, mild or extreme weight fluctuations and in some cases it can cause suicidal thoughts. 

It’s a pretty miserable condition, and warrants immediate and active treatment.

According to the National Institute of Mental Health, anxiety disorders are a group of disorders representing intense feelings of anxiety, unease, or panic. 

In many cases, these disorders can have overlapping symptoms — anxiety sufferers may experience occasional panic, and panic disorder sufferers may experience anxiety. 

Typically, anxiety symptoms must be felt for at least a few weeks to qualify as a disorder like generalized anxiety disorder; in some cases (like with chronic anxiety) they must have been ongoing for much longer.

Symptoms include feeling wound-up, restless, on edge, having difficulty concentrating, being easily fatigued or irritable, having muscle tension, difficulty sleeping or having uncontrollable feelings of worry. 

Anxiety is also common: More than 30 percent of American adults will experience an anxiety disorder in their lives.

Citalopram (the generic form of Celexa®) is a prescription drug for the treatment of anxiety most frequently used to treat depression and depressive disorders including major depression and seasonal affective disorder. 

Celexa is an antidepressant of the classification known as selective serotonin reuptake inhibitors (SSRIs), which are used to balance levels of serotonin in the brain.

SSRIs can prevent the brain and its many neurons from soaking up serotonin, thereby reducing the total available supply. Preventing this leaves more serotonin readily available for the important tasks you actually need serotonin to perform. 

Having a large volume of serotonin available can, in turn, treat depression symptoms (which scientists believe are caused by serotonin level imbalances).

Citalopram can also be used as a treatment for alcoholism or other psychiatric disorders, including eating disorders, panic disorder and anxiety.

SSRIs often have multiple capabilities; while they aren’t designed for non-depression benefits, the FDA label validates many SSRIs for treatment of conditions like anxiety disorder.

Several peer reviewed studies have shown Celexa is an effective depression treatment for adults. 

Research has also proven citalopram safe and effective for the treatment of anxiety as well as depression.

Lexapro is also a SSRI, and a very similar one at that. Its generic name is escitalopram, and aside from the extra letter in the same, there are just a few differences between the two. 

One of the major differences? The effective dose of Lexapro is half that of Celexa at just 10-20mg. 

This may have something to do with another slight difference between the two drugs. 

One study with a small sample size found that patients who use escitalopram were less likely to experience side effects or discontinue or switch medications than those using citalopram — and in this case, that would mean that Lexapro had less likelihood of adverse effects than Celexa.

Lexapro is also FDA approved to treat anxiety, which is only an off-label use for Celexa. 

Citalopram and escitalopram (like most antidepressants) are oral medications. 

To be most effective, both Celexa and Lexapro need to be taken regularly, and at the prescribed intervals. This is also important in order to avoid some common antidepressant side effects

Celexa can typically be taken as a once-a-day tablet, but it can also be prescribed as a liquid. Lexapro is only available as a tablet.

There are no recommendations regarding whether these medications should be taken with or without food, but building the right concentrations in your system means taking your prescribed dose at the same time every day. 

With Celexa, it may take one to four weeks to see results; it’s important to keep taking Celexa at the prescribed times, even if you feel generally good. Lexapro has similar expectations of time for effective use.

Taking either drug less than you’ve been prescribed can cause withdrawal syndrome, and with citalopram, withdrawal symptoms can include anxiety, confusion, headaches, numbness, tingling, nausea and sweating. 

If you do need to discontinue either medication, your healthcare provider will help to slowly and safely wean off of the medication by prescribing lower doses, which reduces your risk of dependency.

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As mentioned above, Celexa may be the more likely of the two to cause side effects, but still it is generally considered safe and effective. 

Many common side effects will manifest in the first few weeks of treatment (if at all) and fade as your body gets used to the medication.

Antidepressants can be prescribed as quickly as two weeks after the above depressive symptoms have set in. 

The medications we’re talking about are neither addictive nor habit forming, but some unpleasant side effects can occur from abruptly stopping the medication.  

Consult with a healthcare provider before you decide to stop a course of antidepressants; in some cases (as mentioned above), side effects could be extreme, and might include suicidal thoughts.

You’ll also want to contact your healthcare professional if you experience any of these symptoms: stomach pain, sexual side effects like changes in sex drive, nausea, excessive tiredness, constipation, frequent urination, dry mouth, heartburn, decreased appetite or weightloss, diarrhea or joint pain.

If you experience more certain severe symptoms such as dizziness,fever, fainting, chest pain, shortness of breath, blood pressure issues, irregular heart beat or hallucinations, seek immediate medical care. 

Additional and more severe side effects could potentially include twitching muscles, hives, foggy memory, blisters, facial swelling or some loss of coordination.

A quick note: while citalopram does not have many prescription drug interaction conflicts, anyone taking monoamine oxidase inhibitors (MAOIs) should definitely inform their healthcare provider before starting a course of citalopram, as taking these two together has the potential to increase your risk of experiencing serotonin syndrome. 

Once you have a Celexa prescription (which can be given by a variety of healthcare professionals, including those online), it may take some time for the effects to become clear and balanced.

There are some factors to consider when determining how long it will take for Celexa to work. 

First, know that Celexa won’t be an overnight miracle. SSRIs take some time to build up in your body before the medication will show meaningful results. 

A healthcare professional might also prescribe you more a smaller dosage at first, before they find the right one for you. 

This process could potentially take months.

You could see these medications start to work in one to four weeks, but SSRIs often take as much as 12 weeks to display their full beneficial effects.

Trying different dosages to find your ideal balance could take more than half a year. 

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Whether you take Celexa or Lexapro is up to you and your healthcare professional. They can help you find the right option to treat your condition. 

There are a variety of treatment options available to you if you’re suffering from symptoms of depression. The first step is to talk to someone about your problems. 

There are always a lot of uncertainties ahead (it’s life), so seeking treatment can help you face anything with the right tools. The best treatment for you may not just be medication alone, though.

If you’re struggling right now, we suggest you talk to a friend, family member or trusted resource, and that you take the next step after that: schedule yourself an online psychiatry evaluation with a mental health professional for personalized advice and treatment. 

When you can finally look back on your progress, you’ll be glad you took the first step.

12 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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  3. U.S. National Library of Medicine. (n.d.). Citalopram: MedlinePlus Drug Information. MedlinePlus.
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  8. Cipriani, A., Purgato, M., Furukawa, T. A., Trespidi, C., Imperadore, G., Signoretti, A., Churchill, R., Watanabe, N., & Barbui, C. (2012). Citalopram versus other anti-depressive agents for depression. The Cochrane database of systematic reviews, 7(7), CD006534.
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  12. Wu, E., Greenberg, P. E., Yang, E., Yu, A., & Erder, M. H. (2008). Comparison of escitalopram versus citalopram for the treatment of major depressive disorder in a geriatric population. Current medical research and opinion, 24(9), 2587–2595.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Vicky Davis, FNP

Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education. 

Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families. 

She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing

She is also an active member of the American Academy of Nurse Practitioners.

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