Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.
Celexa is the brand name for a generic drug called citalopram which is prescribed for depression. We will use these two terms interchangeably throughout this article. It’s a selective serotonin reuptake inhibitor (SSRI), which is one of the most common classes of drugs used to treat depression.
In this article we’ll review the medical research on Celexa to determine if it’s likely to be effective, and cover side effects shown in medical trials. We’ll also highlight a natural alternative treatment for depression that patients may want to talk with their doctor about.
Does Celexa Work?
Celexa has been studied extensively in medical trials. It’s approved by the Food and Drug Administration (FDA) in the U.S. to treat depression in adults. It’s also one of the oldest drugs, having launched in the U.S. in 1998.
A medical review from 2000 found that Celexa was significantly more effective for depression than placebo, and was comparably effective to other first-line depression drugs.
A more recent medical review, published in 2018 in the Journal of Stroke & Cerebrovascular Diseases, analyzed 20 individual studies on Celexa for depression. The researchers found that the drug was more effective than placebo for treating depression, and also noted that Celexa was effective in a shorter timeframe than other SSRIs.
One medical study compared the effectiveness of Celexa with other leading antidepressants. While all of the drugs reviewed helped treat depression on average, there were some interesting results.
Celexa was shown to be “significantly less effective” than escitalopram (brand name Lexapro) but more effective than paroxetine (brand name Paxil). Researchers also noted that fewer patients withdrew from trials involving Celexa when compared with a class of antidepressants called tricyclics.
Overall this data suggests that Celexa is effective for treating depression. This shouldn’t be surprising, given that the FDA has very stringent requirements for the efficacy of pharmaceutical drugs. We should note that the clinical data shows that Celexa works on average, and does not mean it will work for every individual patient.
How Does Celexa Work?
Celexa works by inhibiting reuptake of serotonin, which is a neurotransmitter that facilitates nerve signaling and proper brain function. Interestingly, the vast majority of serotonin is released into the gut and not the brain, which may explain why probiotics can benefit mental health.
Inhibition of reuptake means that Celexa delays natural processing of serotonin by the body, resulting in artificially elevated levels of serotonin in the brain.
Since serotonin is shown in research to directly influence mood, this is thought to be the main biochemical pathway by which Celexa (and other SSRIs) are effective for treating depression.
Celexa Side Effects
As with most pharmaceutical drugs, Celexa does have side effects to consider. According to medical studies, the most common side effects of Celexa are: nausea, sleepiness, dry mouth, and increased sweating. These side effects are relatively minor.
The more rare side effects of Celexa are more concerning in our opinion.
The FDA published a safety announcement on the risk of Celexa causing abnormal heart rhythms. The agency recommended the drug not be used at doses higher than 40 milligrams (mg) daily to minimize this risk.
A medical review of various antidepressants found that Celexa nearly doubled the rate of suicidal ideation or attempted suicide, with 7.1% of Celexa users in the cited study reporting one of these issues compared to only 3.6% of users taking placebo.
Most users of Celexa will not suffer from rare and severe side effects based on the data, but it’s unfortunate that the potential for such serious adverse events exists.
Celexa Vs. Lexapro
We referenced in a previous section how Lexapro was more effective than Celexa for depression in a medical review, but there have actually been clinical trials directly comparing the two. Since these are two of the most popular SSRI medications for depression, consumers are often curious which of the two has a stronger medical backing.
One clinical trial comparing Celexa and Lexapro for major depressive disorder found that Lexapro was significantly more effective, and that the effects were observable in the data as early as week 1.
Another study on Celexa vs. Lexapro in elderly patients found that patients taking Lexapro were significantly less likely to be hospitalized, and were less likely to discontinue treatment (indirectly suggesting that the treatment was more effective or tolerable).
One medical review analyzed 8 different individual trials on Celexa vs. Lexapro and concluded that Lexapro was more effective as an antidepressant.
Based on the available research, we conclude that Lexapro is more effective overall for treating depression than Celexa.
Celexa Vs. Zoloft
Another popular SSRI is Zoloft, which is the brand name of a drug called sertraline.
A medical review published in the Human Psychopharmacology journal found that Celexa was more effective on average than Zoloft on average and had a higher number of patients that responded positively to the treatment.
Another study (this one double-blinded, making the results more trustworthy) comparing Zoloft and Celexa in patients with major depression found that Celexa was more effective, but not to a statistically significant degree. 81% of participants responded favorably to Celexa, while 76% responded favorably to Zoloft.
It appears based on clinical data that Celexa is slightly superior to Zoloft as an antidepressant.
Should I Take Celexa Generic?
The generic form of Celexa is called citalopram. Purchasing generic drugs is often cheaper than buying the brand-name drug.
A study on the effectiveness of generic drugs vs. brand-name drugs found that there was no difference. The study analyzed data on hundreds of thousands of patients taking brand-name and generic drugs of the same compound.
For patients with a tight budget who are prescribed Celexa, we do think it makes sense to ask your doctor about the generic form, since the active chemical compound is exactly the same. Citalopram should be just as effective as Celexa, since they are the same compound just named differently.
Natural Depression Alternative - St. John’s Wort
Given that Celexa has rare but significant side effects, patients considering medication for depression may wish to speak with their doctor about an herbal supplement called St. John’s Wort which has been studied extensively for antidepressant effect, and doesn’t have any significant side effects at proper doses.
For mild-to-moderate (but not major) depression, St. John’s Wort was shown in an extensive medical review to be as effective as SSRIs. The researchers conducting this review analyzed 27 individual trials on St. John’s Wort for depression. The studied ranged from 4-12 weeks so the long-term safety of this supplement isn’t as well-established as the long-term safety data of prescription medication.
Since herbal supplements can vary so much in terms of quality as they aren’t as strictly regulated as prescription drugs, we think it’s worth noting that most of the St. John’s Wort extract used in the medical trials was standardized to 2-5% hyperforin and 0.3% hypericin.
Patients considering St. John’s Wort may wish to speak to their doctor about sourcing a supplement which mirrors those standardization ratios used in medical trials on the herb.