Celexa Vs. Prozac: Drug Comparison

Celexa^® (citalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression by increasing available serotonin levels in the brain, which helps improve mood and emotional balance. It is FDA approved for the treatment of major depressive disorder (MDD), and it is sometimes used off-label for conditions including anxiety, obsessive-compulsive disorder (OCD), and panic disorder. Celexa comes in tablet and liquid forms, typically taken once daily. Common side effects include nausea, dry mouth, drowsiness, and sexual dysfunction, and it can interact with other serotonergic drugs, increasing the risk of serotonin syndrome, as well as medications that affect heart rhythm. Celexa carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially during the initial treatment period.

Prozac^® (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD). Off-label uses may include managing post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and borderline personality disorder. Prozac is available in capsule, tablet, and liquid form, typically taken once daily. Common side effects include nausea, insomnia, headache, and sexual dysfunction. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults during the early stages of treatment.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Celexa (citalopram) is indicated:

• For the treatment of major depressive disorder (MDD) in adults

Prozac (fluoxetine hydrochloride) is a indicated for:

• Acute and maintenance treatment of major depressive disorder (MDD)

• Acute and maintenance treatment of obsessive compulsive disorder (OCD)

• Acute and maintenance treatment of bulimia nervosa

• Acute treatment of panic disorder, with or without agoraphobia

Prozac and olanzapine in combination for treatment of:

• Acute depressive episodes associated with bipolar I disorder

• Treatment resistant depression

• Typically taken orally once daily

• Comes in 10 mg, 20 mg (scored), and 40 mg (scored) tablets

• Typically taken orally once daily

• Comes in 10 mg, 20 mg, and 40 mg Pulvules^®

Most common adverse reaction (incidence ≥5% and twice placebo) is:

• Ejaculation disorder (primarily ejaculation delay)

Most common adverse reactions (≥5% and at least twice that for placebo) associated with:

Major depressive disorder, obsessive compulsive disorder, bulimia, and panic disorder:

• Abnormal dreams

• Abnormal ejaculation

• Anorexia

• Anxiety

• Weakness

• Diarrhea

• Dry mouth

• Indigestion

• Flu syndrome

• Impotence

• Insomnia

• Libido decreased

• Nausea

• Nervousness

• Inflammation of the throat

• Rash

• Inflammation of the sinuses

• Sleepiness

• Sweating

• Tremor

• Vasodilatation

• Yawn

Prozac and olanzapine in combination:

• Also refer to the adverse reactions section of the package insert for Symbyax

• Concomitant use of monoamine oxidase inhibitors (MAOIs) or use within 14 days of discontinuing a MAOI

• Concomitant use of pimozide

• Known hypersensitivity to citalopram or any of the inactive ingredients of Celexa

• Drug interactions: CYP2C19 Inhibitors

• Serotonin syndrome and MAOIs

• Pimozide

• Thioridazine

• When using Prozac and olanzapine in combination, also refer to the contraindications section of the package insert for Symbyax

• Drug interactions: monoamine oxidase inhibitors (MAOIs), drugs metabolized by CYP2D6, tricyclic antidepressants (TCAs), CNS acting drugs, benzodiazepines, antipsychotics, anticonvulsants, serotonergic drugs, drugs that interfere with hemostasis (e.g., NSAIDs, aspirin, warfarin), drugs tightly bound to plasma proteins, olanzapine, drugs that prolong the QT interval

• QT-prolongation and Torsade de pointes

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle-closure glaucoma

• Low blood sodium

• Sexual dysfunction

• Pregnancy: SSRI use, particularly late in pregnancy, may increase the risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulties, hypotonia, tremor, irritability) in the neonate

• Suicidal thoughts and behaviors in children, adolescents, and young adults

• Serotonin syndrome

• Allergic reactions and rash

• Activation of mania/hypomania

• Seizures

• Altered appetite and weight

• Increased risk of bleeding

• Angle-closure glaucoma

• Low blood sodium

• Anxiety and insomnia

• QT prolongation

• Potential for cognitive and motor impairment

• Long half-life

• Prozac and olanzapine in combination: When using Prozac and olanzapine in combination, also refer to the warnings and precautions section of the package insert for Symbyax

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Celexa is not approved for use in pediatric patients.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants.

Monitor for worsening and emergence of suicidal thoughts and behaviors.

When using Prozac and olanzapine in combination, also refer to Boxed Warning section of the package insert for Symbyax.

*This information is from the label for brand name Celexa^®. See the Full Prescribing Information for more complete information. Citalopram, the active ingredient in Celexa, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient citalopram.

*This information is from the label for brand name Prozac^®. See the Full Prescribing Information for more complete information. Fluoxetine, the active ingredient in Prozac, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient fluoxetine.