Celexa vs. Lexapro: Choosing Which Is Right for You

Main Differences & Similarities Between Lexapro & Celexa

Lexapro and Celexa are both selective serotonin reuptake inhibitors (SSRIs), which are antidepressants that reduce serotonin reuptake, increasing the concentration of the neurotransmitter in the brain.¹ SSRI medications are commonly prescribed by doctors to treat multiple mental health disorders such as depression, anxiety, and several others. Celexa and Lexapro can be prescribed by primary care providers, psychiatrists, psychologists in some states, and nurse practitioners and physician’s assistants.

The table below compares the different components of each medication:^2,3

How Do Celexa & Lexapro Work?

SSRI antidepressants boost serotonin levels in the brain (a hormone that plays an essential role in metabolism, sleep, and mood) by inhibiting the recycling process of serotonin at the reuptake sites between neurons.¹
Doing so helps to level the chemical balance for those with lower levels of naturally occurring serotonin, such as those with depression.⁴

Based on their effectiveness, Celexa (citalopram) and Lexapro (escitalopram) are FDA-approved to treat major depressive disorder (MDD) in adults. Lexapro is also FDA-approved to treat generalized anxiety disorder and depression in children 12 years or older.

It’s important to note that the active ingredients in Celexa and Lexapro are closely related. The ingredient in Lexapro, escitalopram, is the active metabolite of Celexa (citalopram). This means that when taking Celexa, your body breaks down the medication to escitalopram while Lexapro is already in the active form.

What Do Lexapro & Celexa Treat?

The FDA approves medications through extensive clinical trials for the treatment of specific conditions, thus determining the primary on-label uses of each drug. Still, there are times when a prescriber may use them for off-label purposes (not FDA-approved), given a patient’s extenuating circumstances and their professional judgment. A prescriber will normally consider off-label uses when depression and anxiety symptoms may not respond well to psychotherapy or other forms of on-label depression medication or anxiety medications.

The table below compares the different FDA-approved and off-label uses of Celexa and Lexapro:^2,3

Side Effects of Lexapro & Celexa

Taking Celexa and Lexapro can lead to mild side effects as the body adjusts to the medication. These side effects will likely occur within the first week or two of taking these antidepressants, but they may last longer.

While side effects vary, common side effects of both Celexa and Lexapro include:^2,3

• Nausea
• Dry mouth
• Sweating
• Sleeping problems
• Ejaculation problems

The table below compares the prevalence of side effects for each medication:^2,3

Severe Side Effects & Allergic Reactions

Taking Celexa and Lexapro can lead to mild side effects that will pass over time and not require immediate medical assistance. However, if milder side effects become worse, it is imperative to consult with your prescribing physician so they either adjust your dosage or prescribe an alternative. There is also the chance for more severe side effects that may occur on their own or when mixed with other antidepressants, medications, or substances.

Possible serious adverse reactions to taking Lexapro or Celexa include:^2,3

• Suicidal thoughts and behaviors
• QT-prolongation and torsade de pointes
• Serotonin syndrome
• Discontinuation syndrome
• Hyponatremia

Symptoms of severe allergic reactions to Celexa or Lexapro can include:^2,3

• Breathing problems
• Swelling of the mouth or throat
• Rash/hives
• Tightness in the chest or throat
• Wheezing
• Talking difficulties

If any of these side effects occur, you should call 911 or see your closest emergency department to prevent further health complications. Before taking the medication, providing a full medical history of all your medical conditions to your prescriber will help identify the possible predisposition of severe side effects.

Insurance Coverage & Cost Effectiveness

Celexa and Lexapro are available as their brand-name or generic versions in the U.S. These medications are covered by insurance and Medicare. The standard monthly prescription for Celexa is 30 20mg tablets, while Lexapro is 30 10mg tablets. The typical Medicare out-of-pocket copay for Celexa and Lexapro is less than $10. Ultimately the price will depend on your health insurance.

The average retail price of Celexa for the same monthly prescription without insurance is roughly $350.73. However, you can get citalopram tablets at a reduced price of $4.00 for 30 20mg tablets using a SingleCare or generic Celexa coupon. The retail price for Lexapro is $496.45. Similarly, with a generic Lexapro coupon from SingleCare, you can get the escitalopram at the lowest price of $3.90 for 30 10mg Tablets.

As always, to prevent further costs when purchasing Lexapro or Celexa, using coupons or mental health insurance through private insurance or Medicare would be best.

Celexa vs. Lexapro: Warnings & Associated Risks

Celexa and Lexapro can cause mild side effects within the first one or two weeks of the initial dosage. Still, as with any drug, Lexapro and Celexa can have a heightened risk of causing severe side effects for those with specific health conditions and in certain populations.

The following populations may experience specific side effects from taking drugs that contain Celexa or Lexapro:^2,3

• Pregnant individuals: increased risk of miscarriage, premature birth, blood loss after childbirth, and the baby developing complications.
• Breastfeeding individuals: possible contaminated breast milk. It is recommended to discuss this with your prescriber before taking the medications while breastfeeding.
• Pediatric patients: increased risk of suicidal thoughts and behaviors in children and teens
• Hepatic impairment: possible life-threatening drug-induced liver injury (DILI) in some patients, involving fulminant liver failure requiring liver transplantation and even leading to death.
• Increased risk of bleeding: increased bleeding in those with a history of bleeding issues.
• History of seizures: possible increased risk of future seizures
• History of glaucoma: worsened symptoms of certain kinds of glaucoma

Those who are active drinkers of alcohol are not recommended to take Celexa or Lexapro. Alcohol is a depressant, while Celexa and Lexapro are antidepressants, meaning that mixing the substances would worsen each substance’s side effects. This can lead to increased depressive thoughts and sleep problems, and sudden death in some extreme cases.

The table below compares the medical conditions that you should discuss with your doctor before taking Lexapro or Celexa:^2,3

Interactions with Lexapro & Celexa

Taking certain medications, herbs, or supplements alongside Lexapro and Celexa can impact their effectiveness or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Substances that may have adverse interactions with Celexa and Lexapro include:^2,3,5

• St John’s Wort: increases the risk of bleeding
• Blood thinners: increases risk of bleeding, requires careful monitoring
• NSAIDs: increases risk of bleeding, requires careful monitoring
• Additional antidepressants: increases risk for serotonin syndrome. Only in exceptional cases will you be prescribed two different drugs that increase the development of serotonin.
• Water pills: can increase the risk of developing hyponatremia or low salt in the body
• Monoamine oxidase inhibitor (MAOIs): can cause a severe serotonin syndrome reaction when used with SSRIs. Tell your doctor if you are taking or have recently taken any of these medications.
• Benzodiazepines: may increase drowsiness
• Migraine drugs: may increase risk for serotonin syndrome
• Alcohol: may increase drowsiness
• Cimetidine: can increase the amount of Lexapro and Celexa that is active in the body, thus increasing the chance for side effects

Lexapro vs. Celexa: Which Drug is More Effective?

Celexa and Lexapro are both effective for treating depression. However, the efficacy of each depends largely on a person’s genetic profile and health. Still, a meta-analysis of over 2000 participants revealed that escitalopram was better than citalopram at improving symptoms of major depressive disorder.⁶ Furthermore, Lexapro proved more effective at modifying the activity of the brain’s neurotransmitters, resulting in a higher prevalence of remission of depressive symptoms. More research is needed to know if one is more effective than the other.

It’s important to note that the active ingredients in Celexa and Lexapro are closely related. The ingredient in Lexapro, escitalopram, is the active metabolite of Celexa (citalopram). This means that when taking Celexa, your body breaks down the medication to escitalopram while Lexapro is already in the active form.

Does Either Work Faster or Last Longer?

Both Celexa and Lexapro take several weeks before improvements in anxiety or depression symptoms become noticeable. More research is needed to know if Lexapro is better at relieving depression than Celexa.

Is Either Better for Short-Term or Long-Term Use?

Generally, an antidepressant takes approximately six to eight weeks for full effect. Some antidepressants are suitable for short-term use, while others are for long-term use. The antidepressant Celexa is meant for long-term use, while Lexapro can be used for either short or long-term treatment.⁶ It should be mentioned that suddenly stopping Celexa or Lexapro medication can lead to withdrawal symptoms. Therefore, before stopping the antidepressant medication, consult with your doctor.

Can You Take Lexapro & Celexa Together?

Some may mix Lexapro and Celexa together if their initial prescription (Celexa or Lexapro) does not yield desirable results. Even though these antidepressants work the same way to treat depression and other mental conditions, taking them together can lead to possible fatal side effects, such as serotonin syndrome.⁵ It is not recommended to mix these medications. Only in rare circumstances will a prescriber combine specific medications that increase the level of serotonin in the body, and you should not do so without direct guidance and supervision.

Questions to Ask Your Health Team About Lexapro

Before taking Celexa or Lexapro medication, you should consult with your doctor first to understand if you have any health issues that may lead to severe or fatal side effects.

Below are ten questions to ask your team when considering taking Lexapro or Celexa:

1. Is it safe to take Lexapro or Celexa with my other medications?
2. Will my insurance cover Lexapro or Celexa?
3. Which one is more effective for treating my depression?
4. Does my medical history increase the risk of side effects?
5. How long can I expect side effects to last?
6. Which one is the best for treating my anxiety?
7. How often should I see you for checkups while taking Lexapro or Celexa?
8. What are the best online psychiatry options to get a prescription?
9. What will happen if I stop taking the medication abruptly?
10. Can I mix Celexa with Lexapro to improve my symptoms?
11. What are some alternatives to Lexapro or Celexa?
12. How does Lexapro compare to Cymbalta?

Final Thoughts

Both Celexa and Lexapro are FDA-approved drugs used to treat depression. Even though these antidepressants belong to the same SSRI class, they may affect a person differently depending on their health and genetic profile. These antidepressants share common side effects and both can lead to severe side effects, especially when mixed with alcohol or other specific medications. Before taking Celexa or Lexapro, consult with your prescriber about possible side effects to determine which medication is right for you.