Celexa vs. Zoloft: Choosing Which Is Right for You

Key Differences Between Celexa & Zoloft

Celexa and Zoloft are selective serotonin reuptake inhibitor (SSRI) antidepressant medications. Antidepressants are primarily used as a medication for depression and sometimes for other mental health disorders as well. Since they are both SSRIs, they have similar impacts on the brain’s chemical balances that regulate mood.

Celexa and Zoloft can be prescribed by:

• In-person or Online Psychiatrists
• Nurse practitioners
• Primary care physicians
• Clinicians

The table below compares the different components of each medication:^1,2

How Do Zoloft & Celexa Work?

Celexa and Zoloft are SSRI antidepressants used to treat depression. Zoloft is also approved to treat other conditions including obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD).

These antidepressants work by supporting a balanced level of the neurotransmitter (chemicals in the brain that send messages) serotonin which is known for regulating mood. When serotonin levels are inadequate in the brain, this can trigger anxiety and depression. Celexa works by preventing the central nervous system from clearing serotonin too quickly (blocking reuptake), increasing the brain’s access to this balancing neurotransmitter.

Even though Zoloft and Celexa are SSRI antidepressants from the same drug class, those taking either medication should not use them interchangeably. An essential factor to consider is that these medications will work differently in patients depending on their health condition and other medications they have tried before. A randomized study found Celexa to be more effective at improving symptoms of depression at a 40mg dose.³

What Are Celexa & Zoloft Used to Treat?

Celexa and Zoloft are primarily used as FDA-approved treatments for depression. However, they are also known to be used by prescribers to treat other mental health conditions, such as mood disorders or traumatic disorders.

When a drug is prescribed for a medical condition that the FDA does not approve it to treat, it is called an “off-label” prescription. Physicians may prescribe antidepressants such as Celexa and Zoloft for off-label uses because the primary medications for a given condition may not provide relief for or have a higher risk of producing side effects in a patient.
The table below compares the different medical conditions used for each medication:^1,2

Who Should Take Zoloft & Celexa?

Zoloft and Celexa are antidepressants used to treat depression and other mental health conditions. However, prescribers may recommend one medication over the other based on the drug’s effectiveness in treating the health condition and the medications that someone has tried before.

Both medications have been shown to be effective in placebo controlled clinical trials for the treatment of depression. Your doctor will work with you to decide which one is best for your individual treatment.

Side Effects of Celexa & Zoloft

Taking Celexa and Zoloft can lead to side effects that may be mild or serious. If the side effects are severe, you may need immediate medical assistance.

Celexa and Zoloft have similar side effects, including:⁵

• Nausea
• Diarrhea
• Sweating
• Dry mouth
• Constipation

However, each SSRI has a different chemical makeup which can make the prevalence of side effects vary between Celexa and Zoloft.

The table below compares a few of the possible side effects of each medication:^1,2

Severe Side Effects

Severe side effects are rare, but possible with both Celexa and Zoloft.

Severe side effects of Celexa and Zoloft may include:

• An increased risk of suicide in kids and young adults. Both medications carry a black box warning for this risk.
• Serotonin syndrome, a serious and sometimes fatal side effect of having too much serotonin in your body.
• Increased risk of manic episodes in people who have bipolar disorder.
• Low level of sodium which can lead to serious side effects.
• QTc prolongation, which affects your heart beat and can lead to serious and dangerous side effects.

These are not comprehensive lists of possible side effects. You should talk with your doctor about the risks and benefits of any medication before starting it.

Insurance Coverage and Cost Effectiveness

Most American health insurance plans include mental health benefits. This coverage is mainly attributed to the Affordable Care Act (ACA) that mandates mental health and substance abuse benefits be included as one of the ten essential health insurance benefits.

For those without insurance, the out of pocket cost for generic citalopram and sertraline will depend on the pharmacy you use. However, patients with insurance coverage can have the prescription covered, but may pay a copay or a deductible. To find out the cost of your medication, talk to your pharmacist or insurance carrier.

The cost for Celexa and Zoloft is usually completely covered by Medicare for Medicare-eligible patients. However, the cost of a Medicare prescription drug plan will depend on the specific plan. Medicare plans can have a copay or deductible.

Precautions of Zoloft & Celexa:

Taking Celexa or Zoloft is not a safe option for everyone, so speaking with a prescriber can provide guidelines for using these drugs if you have certain medical conditions.

Taking Celexa or Zoloft is generally considered safe for pregnant and breastfeeding individuals, but more research is needed to know for sure. This population should take any antidepressants under the close guidance of their prescribers to ensure they can safely stop the medication if severe side effects occur. Clinical studies of these medications in animals did not show any birth defects in offspring or potential risks. It’s important to note that animal studies don’t always predict the same results in humans. Some data shows that exposure to SSRIs in the third trimester may put the baby at risk of side effects that may be serious.⁷

You should discuss with your doctor before taking Celexa or Zoloft if you:

• Have liver problems
• Experience suicidal ideation
• Are pregnant
• Are breastfeeding
• Experience sexual problems
• Experience QT prolongation
• Have bleeding problems

Interactions for Celexa & Zoloft

Taking certain medications, herbs, or supplements alongside Celexa and Zoloft can change how Celexa and Zoloft work in your body 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 Zoloft or any medicines without your doctor’s approval.

Using these antidepressants with other substances, such as NSAIDs and blood thinners, can increase the risk of excessive bleeding that can be fatal and require medical attention.

Mixing either Celexa or Zoloft with alcohol can worsen side effects. Seeing as alcohol is a depressant and Celexa and Zoloft are antidepressants, mixing these substances can worsen the side effects and reduce their effectiveness.

Patients who have stopped taking MAOIs within the last 14 days, those taking pimozide, and patients with known hypersensitivity to citalopram, the active ingredient in Celexa, have increased risk of serious side effects when taking Celexa or Zoloft. The concerns for these individuals come from their heightened risk of QT prolongation, serotonin syndrome, and seizures.

Some substances that may need to be avoided when taking with Celexa and Zoloft include:

• Blood thinners
• NSAIDs
• MAOIs
• Migraine drugs
• Other antidepressants

Celexa or Zoloft: Which Drug is More Effective?

Celexa and Zoloft are both effective at treating depression, but how effective antidepressants will be depends on a person’s condition and their health history.

Which One Works Faster or Lasts Longer?

Both antidepressants are expected to start working within four to six weeks of starting the medication. Small studies of patients taking Celexa show an improvement in symptoms in one to two weeks after starting the medication, but more research is needed to know if this applies to the larger population. Both Celexa and Zoloft are taken once daily, so they are considered to last the same amount of time in the body.

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

Different antidepressants are meant for different lengths of time in treatment, with some being more suitable for short-term use while others are applicable for long-term use. Celexa and Zoloft are meant for long-term use. Long-term use of Celexa or Zoloft can lead to dependency. Abruptly stopping Celexa or Zoloft medication can lead to withdrawal symptoms. Therefore, you must consult your doctor before taking the antidepressants or consider stopping the medication.

Can You Take Celexa & Zoloft Together?

Some people taking antidepressants to treat depression or other mental health disorders may not show desirable results. This will likely lead some to consider mixing multiple antidepressants to “increase the benefits” of the medications with the idea that more is better.

However, because antidepressants such as Celexa and Zoloft perform the same function, combining these drug can increase physiological changes past an acceptable threshold, resulting in worsening side effects of both substances.⁹ If you consider mixing Celexa and Zoloft, you should consult your prescriber for further guidance.

Questions to Ask Your Health Team About Celexa

Before taking Celexa or Zoloft medication to treat depression, you should consult your doctor regarding your health conditions. You can ask your doctor if mixing antidepressants are good for your health. Also, be sure to review any potential side effects you are likely to experience when taking Celexa or Zoloft to treat your mental condition.

Here are 11 questions to ask your care team when considering Celexa or Zoloft:

1. Is it safe to take Celexa or Zoloft with my other medications?
2. Will my insurance cover Celexa or Zoloft?
3. Which one will work best for treating my depression?
4. Does my medical history increase the risk for side effects?
5. How long can I expect side effects to last?
6. Which one is the best for the treatment of my anxiety?
7. How often should I see you for checkups while taking Celexa vs. Zoloft?
8. What should I do if I am unsure if psychotropics are right for me?
9. What are the best online psychiatry options to get a prescription?
10. What will happen if I stop my Celexa or Zoloft abruptly?
11. I stopped taking my medication. Can I start it again?

Final Thoughts

Antidepressants such as Celexa and Zoloft are used to treat depression and other symptoms of mental health conditions. Even though they have different chemical makeup, these drugs are similarly effective in treating mental illnesses. Taking these antidepressants will likely result in common side effects, which might worsen due to several contributing factors, such as mixing the antidepressants with alcohol or MAOIs. Before taking these antidepressants, it is necessary to consult your doctor on possible side effects and which medication best suits you.