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 regard to prescription medication.
Celexa is a drug that's FDA-approved for the treatment of depression and anxiety. The generic form of the drug is called citalopram, and we will use these two terms interchangeably throughout this article because they refer to the same active chemical compound.
But is Celexa actually proven to treat both depression and anxiety? Is it more effective for one or the other? What are the side effects of Celexa? And is the generic version a better value?
In this article we’ll answer all of these questions and more, as we analyze research studies on Celexa to determine if it's effective for depression and anxiety.
We'll also discuss potential side effects, compare the drug to two other commonly-prescribed antidepressants (Lexapro and Zoloft), and explain why the generic version may be a better value (along with where to access it).
Key takeaways:
- Clinically proven to reduce depression scores
- Clinically proven to reduce anxiety scores
- Can increase suicidal thoughts
Is Celexa Proven to Work?
Celexa has been studied extensively in clinical trials. It’s been approved by the Food and Drug Administration (FDA) since 1998.
A 2000 medical review found that Celexa was significantly more effective against depression than placebo pills, and was comparably effective to other first-line antidepressants.
A meta-study published in the Journal of Stroke & Cerebrovascular Diseases analyzed data from 20 clinical trials on Celexa for treating depression in patients who had experienced a stroke.
Celexa was shown to be 4% more effective for reducing depression symptoms than other selective serotonin reuptake inhibitor (SSRI) drugs, and 1% more effective than serotonin and norepinephrine reuptake inhibitor (SNRI) drugs.
A 2012 medical review compared the effectiveness of Celexa with other leading antidepressants. Celexa was shown to be “significantly less effective” than escitalopram (brand name Lexapro) but more effective than paroxetine (brand name Paxil).
Celexa is also approved to treat generalized anxiety disorder (GAD), which is the medical classification for persistent anxious thoughts that are disproportional to events in the patient's life.
As an example, it's somewhat normal for an individual to be extremely stressed during a breakup, but if a patient was feeling similar stress levels during a regular workday they may be diagnosed with GAD.
A 2002 meta-study found that Celexa reduced anxiety symptoms by 72% after 12 weeks of treatment. This is a significant decrease.
We will conclude that Celexa is effective for reducing symptoms of both depression and anxiety, which is unsurprising given that the drug is approved by the FDA for both indications.
In our opinion, the clinical results achieved for anxiety are more impressive than those for depression.
Does Celexa Cause Side Effects?
As shown in the "black box" warning label below (which is the most severe category of warning issued by the FDA), Celexa may increase the risk of suicide in pediatric and young adult patients:
A review on the suicide risk of various medications published in the Pharmaceuticals journal found that Celexa nearly doubled this risk, with 7.1% of Celexa users experiencing suicidal thoughts or behaviors compared to only 3.6% of users taking placebo.
The FDA has also published a safety warning about 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.
The side effects listed above are rare. According to medical studies, the most common side effects of Celexa are more mild in nature: nausea, sleepiness, dry mouth, and increased sweating.
Given the increased risk of suicidality, it may be beneficial for young adults and guardians of adolescents to speak with their doctor about alternative medications that do not increase this risk.
Celexa vs. Lexapro
Patients are often curious about whether Celexa or Lexapro is more effective, given that these are two of the most commonly-prescribed antidepressants.
We referenced in the research review section how Lexapro was shown to be more effective than Celexa for depression, and there have actually been clinical trials directly comparing the two drugs.
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 comparative study published in the Current Medical Research and Opinion journal showed that elderly patients taking Lexapro were significantly less likely to be hospitalized, and were less likely to discontinue treatment.
This suggests that Lexapro has a more favorable safety profile.
A 2011 meta-analysis analyzed eight clinical trials comparing Celexa and Lexapro and concluded that Lexapro was more effective as an antidepressant.
Based on the available research, we would recommend that patients speak with their doctor about Lexapro instead of Celexa.
Is Celexa Generic a Better Option?
The generic form of Celexa is called citalopram.
Purchasing generic drugs is often cheaper than buying the brand-name drug, but patients are often curious about whether one is more effective than the other.
A 2016 meta-study analyzed results from over 1 million patients and compared the safety and efficacy of brand name drugs versus their generic alternatives. The researchers found that there was no difference on average.
This suggests that generic citalopram is a more logical option than Celexa, given that it should be just as effective but may be cheaper.
The retail price of Celexa is currently over $300 at the time of updating this article, according to GoodRx.
The retail price of generic citalopram is currently under $6 at Cost Plus Drugs.
Celexa vs. Zoloft
Zoloft is another commonly-prescribed SSRI antidepressant, so patients are often curious about which is more effective.
We published an extensive breakdown on the clinical research backing Zoloft in our recent Zoloft reviews article for those who are interested.
These two drugs have been directly compared in clinical studies.
A medical review published in the Human Psychopharmacology journal found that Celexa was more effective than Zoloft on average.
After six weeks of treatment, 40% of Celexa patients responded to treatment (meaning they experienced symptom reduction or elimination) compared to only 31% of Zoloft patients.
Another comparative study on Zoloft and Celexa for 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.
Based on these studies, patients may wish to speak with their doctor about Celexa rather than Zoloft.
Does Celexa Cause Withdrawals?
We cannot identify any large-scale medical studies on the withdrawal risk of Celexa.
One medical case report documented a woman who developed high blood pressure after quitting the drug, but there are millions of users of this drug annually so this does not necessarily prove much on a population basis.
Even if Celexa may not have as high of a withdrawal risk as other medications, we still recommend that patients speak with their doctor about setting up a tapering schedule if they plan on quitting Celexa, rather than abruptly stopping use.
This can reduce the risk of withdrawal symptoms and negative health effects.
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.
Depressed and anxious patients may have lower circulating levels of serotonin than neurotypical patients.
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