Citalopram Vs. Sertraline: Drug Comparison

Citalopram is the active ingredient in the brand-name medication Celexa^®. The information below is about brand name Celexa. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

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.

Sertraline is the active ingredient in the brand-name medication Zoloft^®. The information below is about brand name Zoloft. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial treatment period.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Celexa (citalopram) is indicated:

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

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• Typically taken orally once daily

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

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

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

• Ejaculation disorder (primarily ejaculation delay)

Most common adverse reactions (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• 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

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• 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

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal 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

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

*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 Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.