Prescription

What's the difference between Celexa and Lexapro?

October 1, 2021

While you probably already know that medication can be an important and effective part of treating major depressive disorder (MDD) and generalized anxiety disorder (GAD), the number of medication options available may seem overwhelming. A good place for you and your doctor or prescribing nurse to start may be to narrow your focus to a specific category of medication that is used to treat anxiety or depression. Selective serotonin reuptake inhibitors (SSRIs) are one type of medication that is commonly used to treat both of these conditions. And Celexa and Lexapro are two regularly used SSRIs that you may want to consider.


Whether this is your first time taking one of these medications (or any medications) or you are thinking about switching from Celexa to Lexapro (or switching from Lexapro to Celexa), this Minded Medication Guide will take a closer look at Celexa and Lexapro to help you understand which may be the better choice for you. This information can be helpful to you when talking with your doctor, prescribing nurse, or Minded provider in choosing the medication used in your treatment plan.


Read on to learn more about these two medications, including:

-An introduction to Celexa vs Lexapro

-A closer look at Celexa vs Lexapro

  • Dosage information
  • How long it takes for each medication to work
  • Side effects and warnings for Lexapro vs Celexa

-Similarities and differences between Celexa vs Lexapro

  • Celexa vs Lexapro side effects
  • Celexa vs Lexapro weight gain
  • Celexa vs Lexapro for depression
  • Celexa vs Lexapro for anxiety
  • Celexa vs Lexapro for social anxiety
  • Switching from Lexapro to Celexa (or switching from Celexa to Lexapro)


Minded Medication Guides, including Zoloft vs Prozac and Wellbutrin vs Lexapro, are intended as educational aids only. They are not intended as medical advice for individual conditions or treatment. They are not a substitute for a medical exam, nor do they replace the need for services provided by medical professionals. Talk to your doctor, nurse, or pharmacist before taking any prescription medication or following any treatment or regimen.

Lexapro and Celexa overview

As mentioned above, Celexa and Lexapro are both selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant medication that also is used to treat anxiety. Antidepressant medications are usually categorized by how and which neurotransmitters they affect to relieve depression symptoms. (Neurotransmitters are small molecules in your brain that relay messages between nerves.)


As their name suggests, SSRIs affect serotonin levels in your brain. Serotonin is a neurotransmitter that helps keep your mood balanced and plays a role in emotions such as contentment, optimism, and satisfaction. It also affects your overall sense of well-being. SSRI medications boost the level of serotonin in your brain by stopping it from being reabsorbed into the neurons (nerves in your brain), where it is broken down and inactivated.


While Celexa and Lexapro are both SSRIs, this does not mean they are identical. Taking a closer look at each medication can help you decide which may be the better choice for your depression or anxiety treatment plan.

A closer look at Celexa

Celexa is the brand name of the generic drug citalopram. It is used to treat major depressive disorder (MDD). Celexa also may be prescribed for “off-label” uses. “Off-label” use, which is a common and acceptable medical practice, means taking a medication for a condition that it has not been approved by the FDA to treat.


Celexa is also used “off-label” to help treat:

  • Eating disorders (such as binge eating disorder)
  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)
  • Social anxiety disorder


Celexa (citalopram) is available in tablet and liquid forms:

-Celexa/citalopram tablet

  • 10 mg
  • 20 mg
  • 40 mg

-Citalopram liquid

  • 10 mg/5 ml


When you first begin taking Celexa, your doctor or prescribing nurse may start you on a lower dose, such as 20 mg once daily. They may gradually increase the dosage up to the maximum recommended dose of 40 mg per day if needed. While 40 mg is the maximum recommended dose, some people may need a higher dose to achieve symptom relief. 


However, the maximum recommended dose for some people—including adults over the age of 60 and people with liver problems—is 20 mg per day. This is because Celexa may stay in their body longer and add to its side effects. 


Celexa is taken once daily (in the morning or the evening—whichever is more convenient for you), with or without food.


If you miss a dose of Celexa, you will want to either take the missed dose as soon as you remember or, if it is closer to the time when you should take your next dose, just take the next dose.

What Celexa is prescribed for

How long does it take for Celexa to work?

Like most SSRIs, you might notice improvements in your sleep, energy, and/or appetite within the first two weeks of starting Celexa. However, it can take 6 to 8 weeks or more for an improvement of other symptoms—such as depressed mood or decreased interest in daily activities—to become noticeable.

Celexa side effects

Common side effects of Celexa include:

  • Anxiousness
  • Appetite loss
  • Constipation
  • Diarrhea
  • Difficulty sleeping
  • Dizziness
  • Dry mouth
  • Nausea
  • Respiratory infections
  • Sexual problems
  • Shaking
  • Sleepiness
  • Sweating
  • Weakness
  • Yawning


Some Celexa side effects may improve over the first week or two as you continue to take the medication. However, sexual side effects may not go away, even over time.


Talk to your doctor or the experts at Minded if you experience any of these or other side effects.


Rare or serious side effects of Celexa include:

  • Angle-closure glaucoma (symptoms of this could include: pain in your eye, vision changes, or swelling or redness in or around your eye)
  • Low sodium levels in your blood (symptoms of this could include: headaches, feeling weak, or having a hard time concentrating or remembering things)
  • Seizures
  • Serotonin Syndrome (symptoms of this could include: shivering, diarrhea, confusion, severe tightness in your muscles, fever, or seizures). Serotonin Syndrome is a very serious condition and can be fatal if not recognized and treated.
  • Teeth grinding


Celexa and other SSRI antidepressant medications may also increase your risk for potentially life-threatening bleeding—especially if they are taken with medications such as aspirin, nonsteroidal anti-inflammatories (NSAIDs—like ibuprofen or naproxen), and warfarin (an anticoagulant medication), or other anticoagulants, like Eliquis. Celexa taken with one or more of these medications may make your gums, nose, stomach, or intestines bleed more easily.


Seek medical attention right away if you experience any of these or other serious side effects.


It is also very important to always let your prescribing doctor, nurse, or Minded professional know about any and all other medications (and/or supplements—often called nutraceuticals) you are taking to make sure that Celexa does not have negative interactions with them. 

Warnings

Celexa comes with an FDA “Black Box” warning. This means the FDA has identified certain serious safety risks from taking this medication. But while these are serious safety warnings, the actual risk may be low or even rare.


The Black Box warning for Celexa states that children, adolescents, and young adults under the age of 24 who are taking antidepressants may be at a higher risk of suicidal thoughts or behaviors. Studies did not show an increased risk in people older than 24 years of age, and the risk actually decreased in people 65 and older. The warning also states that Celexa is not approved for use in children under the age of 18.

Celexa and pregnancy

Because SSRIs like Celexa may affect your baby during pregnancy or while breastfeeding, it is important to discuss your medication treatment plan with your doctor or prescribing nurse if you are planning on becoming pregnant or breastfeeding.

Celexa and alcohol

You should not drink alcohol if you are taking Celexa or other antidepressant medications, for many reasons. Alcohol may seem to boost your mood short-term, but it can worsen symptoms of anxiety and/or depression long-term. Alcohol can also decrease the positive effects of antidepressant medications and increase the negative effects, such as sedation. Additionally, there is a risk of unintentionally overdosing on Celexa if it is taken with alcohol.


Symptoms of a Celexa overdose may include:

  • Dizziness
  • Nausea
  • Sinus tachycardia (abnormally fast heartbeat)
  • Sleepiness
  • Sweating
  • Tremors
  • Vomiting


SSRI medications (like Celexa) need to be taken regularly in order to avoid withdrawal symptoms and to effectively treat depression and/or anxiety. You should not skip doses of Celexa in order to drink alcohol.

Celexa withdrawal symptoms

If you need to stop taking Celexa for any reason, you will want to work with your prescribing nurse or doctor to come up with a plan to carefully and gradually taper down your dose to avoid withdrawal symptoms. Antidepressant medication withdrawal symptoms are sometimes mild and last a week or two, but for some people, symptoms can last weeks or even months.


Symptoms of Celexa withdrawal may include:

  • Dizziness
  • Headaches
  • Irritability
  • Nausea
  • Nightmares
  • Prickling and/or tingling sensation on the skin (paresthesias)
  • Vomiting

A closer look at Lexapro

Lexapro is the brand name of the generic medication escitalopram. It is used to treat generalized anxiety disorder (GAD) and major depressive disorder (MDD). Like Celexa, Lexapro may also be prescribed for “off-label” uses. Lexapro is sometimes used “off-label” to help treat obsessive-compulsive disorder (OCD), eating disorders (including binge eating disorder and/or bulimia nervosa), panic disorder, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).


Lexapro (escitalopram) is available in tablet and liquid forms:

-Lexapro tablet

  • 5 mg
  • 10 mg
  • 20 mg

-Lexapro liquid

  • 1 mg/ml


Whether you are taking Lexapro for depression or anxiety, the starting dose is usually 10 mg taken once daily. If needed, your doctor or prescribing nurse might gradually increase your dosage over several weeks. While the maximum recommended dose of Lexapro is 20 mg, some people may need higher doses in order to achieve relief from their depression and/or anxiety symptoms.


As with Celexa, Lexapro is a once-daily medication that can be taken in the morning or the evening, with or without food.


If you accidentally miss a dose of Lexapro, you will want to either take the missed dose as soon as you remember or, if it is closer to the time when you would take your next dose, just take the next dose.

How long does it take for Lexapro to work?

Similar to other SSRIs, when you begin taking Lexapro, you might notice your sleep, energy levels, and/or appetite start to improve within the first two weeks. That being said, it can take 6 to 8 weeks or more for other common symptoms—like depressed mood or decreased interest in day-to-day activities—to noticeably improve.

What Lexapro is prescribed for

Lexapro side effects

Common side effects of Lexapro include:

  • Anxiousness
  • Appetite loss
  • Constipation
  • Difficulty sleeping
  • Dizziness
  • Dry mouth
  • Infections
  • Nausea
  • Sexual problems
  • Shaking
  • Sleepiness
  • Sweating
  • Weakness
  • Yawning


While some of the side effects of Lexapro may improve during the first week or two as you continue taking the medication, other side effects—such as sexual side effects—may not go away over time.


Always talk to your doctor, prescribing nurse, or the experts at Minded if you experience these or any other side effects.


Rare or serious side effects of Lexapro include:

  • Angle-closure glaucoma (symptoms of this could include: pain in your eye, vision changes, or swelling or redness in or around your eye)
  • Low sodium levels in your blood (symptoms of this could include: headaches, feeling weak, or having a hard time concentrating or remembering things)
  • Seizures
  • Serotonin Syndrome (symptoms of this could include: shivering, diarrhea, confusion, severe tightness in your muscles, fever, or seizures). Serotonin Syndrome is a very serious condition and can be fatal if not identified early and treated.
  • Teeth grinding


Because Lexapro is an SSRI medication, it also may increase your risk for potentially life-threatening bleeding in your gums, nose, stomach, or intestines. This risk is further increased if you are also taking medications such as aspirin, nonsteroidal anti-inflammatories (NSAIDs—like ibuprofen or naproxen), and warfarin (an anticoagulant medication), or other anticoagulants, like Eliquis.


Seek medical attention right away if you experience any of these (or other) serious side effects.


Always let your doctor, prescribing nurse, or Minded professional know about any other medications and/or supplements you are taking to determine if Lexapro might have negative interactions with them.

Warnings

As with Celexa, Lexapro also has an FDA “Black Box” warning. The Black Box warning for Lexapro says that antidepressants may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults. It also states that Lexapro is not approved for use in children under 12 years of age.

Lexapro and pregnancy

Always discuss your depression or anxiety treatment plan with your doctor or prescribing nurse if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed. This is because Lexapro and other SSRI medications can affect your baby during pregnancy and by being passed on to your baby when breastfeeding.

Lexapro and alcohol

If you are taking Lexapro or other antidepressant medications, you should not drink alcohol. Alcohol may temporarily seem to improve your mood, but it can actually make your anxiety or depression symptoms worse in the long term. Alcohol can also decrease the benefits of your antidepressant medications as well as increase their negative effects, such as sedation. Plus, there is a risk of accidentally overdosing on Lexapro if it is taken with alcohol.


Symptoms of a Lexapro overdose may include:

  • Convulsions
  • Coma
  • Dizziness
  • Drowsiness/sleepiness
  • Hypotension (low blood pressure), including fainting
  • Insomnia
  • Irregular heartbeat
  • Nausea and/or vomiting


SSRI medications—including Lexapro—need to be taken regularly both in order to be effective and to avoid withdrawal symptoms. Do not skip doses of Lexapro to drink alcohol.  

Lexapro withdrawal symptoms

As with other SSRIs, if you need to stop taking Lexapro, it is important that you work with your doctor or prescribing nurse to develop a plan to do so gradually and carefully in order to avoid withdrawal symptoms. While antidepressant medication withdrawal symptoms are sometimes mild and last just a week or two, for other people, withdrawal symptoms may last weeks or even months.


Lexapro withdrawal symptoms may include:

  • Dizziness
  • Headache
  • Irritability
  • Nausea
  • Nightmares
  • Paresthesias (a prickling and/or tingling sensation on your skin)
  • Vomiting

What is the difference between Celexa and Lexapro?

Which works faster: Lexapro or Celexa?

Whether you are taking Celexa or Lexapro, it can take several weeks for improvement in your anxiety or depression symptoms to become noticeable. However, some studies suggest that Lexapro may start working faster than Celexa. (Editor’s note: While many of these studies were published more than ten years ago, because these medications have been around for a while, more recent studies have not necessarily focused on the time it takes for these treatments to be noticeably effective.)


A study published in CNS Spectrums found people taking Lexapro reported significant improvements in their depression symptoms in the first week of taking the medication, compared to the fourth week for people taking Celexa. A study published in L'Encéphale also found that people taking Lexapro reported improvements in their symptoms earlier than people taking Celexa.


Generally speaking, you may begin to notice that your sleep, energy, and appetite are better within the first two weeks or so of starting Celexa or Lexapro. However, it may take 6 to 8 weeks or more for other symptoms (such as depressed mood or decreased interest in daily activities) to show an improvement.

Celexa vs Lexapro for depression

Even though both Lexapro and Celexa are approved to treat major depressive disorder (MDD), some studies suggest that Lexapro may have an edge over Celexa in terms of efficacy in treating MDD. For instance, a study published in the International Journal of Neuropsychopharmacology also found Lexapro to be more effective in treating MDD when compared to Celexa over an 8-week period.

Celexa vs Lexapro for anxiety

While Lexapro is approved to treat generalized anxiety disorder (GAD), Celexa is also used “off-label” to treat GAD. Even though both medications have been found to effectively treat anxiety symptoms compared to a placebo, Lexapro was found to be more effective overall, according to a study published in Depression and Anxiety. The CNS Spectrums study (mentioned above) that found that Lexapro may begin working faster than Celexa also found that Lexapro may be more effective (and quicker) in treating anxiety as well.

Celexa vs Lexapro for social anxiety

While head-to-head comparisons of how Celexa and Lexapro stack up in treating social anxiety disorder are not available, some studies suggest that both may be effective treatment options, especially for people who have found other medications typically used to treat social anxiety to be ineffective.


For instance, a study in CNS Spectrums found that Celexa was both well tolerated and effective by people who had not tolerated or failed to respond to other treatment options. A study published in Depression and Anxiety suggested that Celexa may be a good treatment option for people whose primary diagnosis is social anxiety


Similarly, a study published in Clinical Practice & Epidemiology in Mental Health found that Lexapro may also be a good treatment option for people with social anxiety who have failed to respond to other treatments. And a study in Depression and Anxiety suggested that Lexapro can be a well-tolerated and effective treatment option for both short-term and long-term management of social anxiety symptoms.

Celexa vs Lexapro side effects

While Celexa and Lexapro have some potential side effects in common, they each have their own more common side effects. Keep an eye out for these and bring them to your doctor’s attention. 


In clinical trials, 16% of people stopped taking Celexa because of the side effects, compared to 8% of the people who received the placebo. While dry mouth, sweating, nausea, sleepiness, and/or insomnia were reported by over 10% of the people who were taking Celexa during the trial, these side effects were similarly reported in people who were taking the placebo. The only side effect that occurred in at least 5% of people taking Celexa and was at least twice as common compared to people taking the placebo was ejaculation disorder.


On the other hand, 6% of people stopped taking Lexapro in clinical trials because of the side effects, compared to 2% of people who received the placebo. Side effects that occurred in 5% or more of the people taking Lexapro and were at least twice as common compared to people taking the placebo included:

  • Ejaculation disorder
  • Fatigue
  • Insomnia
  • Nausea
  • Sleepiness/drowsiness
  • Sweating

Celexa vs Lexapro weight gain

You may have heard that antidepressant medications can cause weight gain. While this is a common concern, the truth behind it is more complicated than just concluding that the medication was the cause.


For instance, some people actually lose weight when they are depressed and have not yet begun treatment. Once their depression is treated effectively, their appetite returns and they may begin to gain back the weight they lost. This weight gain is not necessarily caused by the antidepressant medication, but rather by the reduction in depression symptoms.


While there are few head-to-head comparisons of weight gain for Celexa vs Lexapro, a study in General Hospital Psychiatry found that Celexa, Lexapro, and other antidepressants may lead to weight gain.


According to a study published in Current Medical Research and Opinion, people taking Lexapro over an 8-month period gained an average of 4 pounds. On the other hand, a study in the Journal of Clinical Medicine found that people taking Celexa over a 2-year period gained an average of 5.9 pounds.

Can you take Lexapro and Celexa together?

Because they are both SSRIs, Celexa and Lexapro should not be taken together. Taking these medications together could lead to dangerously high levels of serotonin collecting in your body, causing serotonin syndrome, which can be fatal if not diagnosed and treated as soon as possible.

Switching from Lexapro to Celexa (or switching from Celexa to Lexapro)

You may consider switching medications if:

  • You have been on Celexa or Lexapro at the correct dose (as determined by you and your doctor or prescribing nurse) for four to six weeks and have not seen a significant improvement in your anxiety or depression symptoms
  • You are experiencing side effects that you find too difficult to tolerate
  • You have been on Lexapro or Celexa for a while but find that it is no longer as effective as it first was


In all of these cases, switching to a different medication may be just what you need to get your anxiety or depression treatment plan back on track.


Because both Celexa and Lexapro can cause withdrawal symptoms if stopped suddenly, it is very important that you work with your doctor, prescribing nurse, or a Minded professional to come up with a plan to switch or stop the medication gradually and carefully. This may mean tapering down the dose of the medication you are on currently and then beginning the new medication.

Final thoughts on Celexa vs Lexapro

Celexa and Lexapro are both options worth considering for your anxiety or depression treatment plan. While they are similar in a lot of ways, they also have notable differences, making each come with its own pros and cons.


For example, Lexapro is approved to treat generalized anxiety disorder (GAD) and major depressive disorder (MDD). It is also used “off-label” to treat other conditions. Celexa is approved to treat MDD and is also used “off-label” to treat GAD and other conditions.


While both medications have been found to be effective treatment options for MDD and GAD, Lexapro may be more effective—and it may start to work faster than Celexa.


Both Celexa and Lexapro may be effective treatment options for social anxiety disorder—particularly for people who have tried other medications for this condition and found them ineffective.


And while more people may stop taking Celexa if they experience side effects, Lexapro also may cause side effects. It is also important to understand that not everyone who takes a medication will experience the potential side effects of that specific medication. And some people may find the side effects of one medication more tolerable compared to the side effects of another medication.


Your prescribing doctor or nurse or the experts at Minded can help you decide which medication may be the better choice for you.


‍Sources Referenced:

Author Byline

Ilchi Lee is a visionary, educator, and a New York Times bestselling author. He has penned more than 40 books including his most recent title, Water Up Fire Down. He founded the mind-body practices of Body & Brain Yoga and Brain Education and established the Earth Citizen Movement.

Medically reviewed by

Dr. Jin Hee Yoon-Hudman

Psychiatrist

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