Citalopram Review: The Best Depression Treatment?

Citalopram Review: The Best Depression Treatment?


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​​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.

Citalopram, sometimes referred to by its full chemical name citalopram hydrobromide, is approved by the FDA to treat anxious and depressive disorders. The brand-name version of the drug is called Celexa. The medication is part of a drug class called selective serotonin reuptake inhibitors (SSRI), which is one of the most commonly-prescribed medications for depression.

But is citalopram backed by research? How much can it reduce depression and anxiety symptoms? Does the drug cause side effects and withdrawal symptoms? And how do real users respond to citalopram treatment?

In this article we'll answer all of these questions and more as we do a deep dive into the clinical research on citalopram, documenting whether the drug is effective for anxiety and depression and what its side effects are. We'll share real, unsponsored user reviews of citalopram and explain whether the drug can improve sleep quality.

Does Citalopram Resolve Anxiety and Depression?

Citalopram has been studied in clinical trials for decades.

A meta-study published in the ​​Annals of Pharmacotherapy journal found citalopram to be more effective for depression than placebo. More than 80% of patients responded favorably to citalopram (response meaning a reduction or elimination of depression symptoms).

A medical review from 2018 analyzed 20 individual studies on citalopram and depression. The study authors documented that citalopram was effective at reducing depression scores to a statistically significant degree, and also noted that it took the drug a shorter time to provide relief than most SSRIs.

Citalopram has also been studied for its ability to reduce anxiety.

meta-study published in the International Clinical Psychopharmacology journal found that citalopram reduced anxiety symptoms by 72% after 12 weeks of treatment.

A clinical trial tested the efficacy of citalopram for panic disorder, which is considered a more severe form of anxiety than generalized anxiety disorder (GAD). Patients on all doses of citalopram experienced fewer panic attacks than patients on placebo pills. The study authors reported that 20 milligrams (mg) to 30 mg was the most effective dosing range for panic disorder.

Overall, citalopram is proven to be effective for reducing symptoms of both depression and anxiety in medical studies, and may be effective for reducing panic attacks as well.

Citalopram Side Effects

Citalopram does cause side effects in some patients. According to a 2003 medical review, the most common side effects of the drug are nausea, sleepiness, dry mouth, and increased sweating.

The more rare side effects of citalopram are the more concerning ones in our opinion.

In 2017, the FDA published a safety announcement about how citalopram could cause abnormal heart rhythms. The agency recommended against using the drug at daily doses higher than 40 mg to reduce the risk of this side effect.

Suicidal thoughts and behaviors also appears to be a rare side effect of citalopram, which unfortunately seems to be the case for a number of prescription antidepressants.

medical study on antidepressants and suicide found that citalopram nearly doubled the rate of suicidal ideation or attempted suicide. 7.1% of those taking citalopram in a clinical trial experienced suicidal thoughts or behaviors, compared to only 3.6% of users taking a placebo pill.

We would consider a rate of suicidality 3.5% greater than placebo to be concerning, as this is rare but not extremely rare. We strongly recommend that patients speak with their doctor about the potential for increased suicidal thoughts and behaviors if they have a personal or family history of suicidal attempts.

A YouTube creator named Lauren Worthy tracked daily side effects that she experienced from citalopram over the course of her first week using the medication:

Benefits of Taking Citalopram at Night

For patients prescribed citalopram, it may make sense to take the medication at night rather than in the morning. 

Patients experiencing anxiety or depression often have insomnia, and citalopram was shown in a medical review published in the Experimental and Therapeutic Medicine journal to improve sleep duration and reduce sleep disturbances.

60.5% of patients using citalopram in this study reported "significantly improved" sleep quality. This may have more of an effect on patients with anxiety disorders than those with depression, because anxiety disorders tend to overlap with sleep disorders at a higher rate according to the researchers.

It's important to note that citalopram is not approved by the FDA to treat sleep disorders, so using the medication for that purpose alone is potentially unsafe. This should be considered a potential secondary benefit of the drug for patients with insomnia and anxiety or depression, but not a reason to take citalopram for insomnia alone.

Real, Unsponsored User Review of Citalopram

One of the most popular YouTube reviews of citalopram comes from a creator named Amanda DiPrato. The video is unsponsored and she shares her experience using citalopram and how the drug has affected her anxiety levels:

Should I Take The Branded Version of Citalopram?

As we discussed in the intro of this article, the branded version of citalopram is called Celexa. Many patients consider branded versions of drugs to be more effective due to advertising, but there should be no difference in efficacy because both drugs contain the exact same active chemical compound.

study comparing generic drugs to branded drugs found that there was no average difference in efficacy. The study analyzed data from millions of patients taking prescription medication; some taking branded versions of a drug and some taking generics.

We would recommend that patients speak with their doctor about citalopram rather than brand-name Celexa if they’re interested in taking this medication. Generic versions of drugs are often cheaper, and can be more accessible in some cases.

SingleCare currently reports the average retail price for Celexa to be $350.73, while the average retail price for citalopram is just $40.38.

Can I Drink Alcohol While Using Citalopram?

Citalopram’s FDA label indicates that use of alcohol while taking the medication is not advised. SSRI drugs may enhance the effects of alcohol, which can make routine tasks such as driving dangerous.

Given that the drug manufacturer recommends against using alcohol for safety reasons, we believe it may be logical for patients with alcoholism or substance abuse disorders to speak with their doctor about alternatives to citalopram which may allow for alcoholic drinks concurrent with the medication.

The ultimate goal of course would be to reduce dependence on alcohol, but if that is unlikely in the short-term it seems logical to consider medications that don’t have negative interactions with alcohol.

Does Citalopram Cause Withdrawal Symptoms?

There doesn’t appear to be conclusive evidence about whether citalopram is likely to cause withdrawal symptoms in most patients. Citalopram’s FDA label does not contain a warning about withdrawals and a medical review of antidepressants and withdrawal syndrome found citalopram to cause no negative effects to cognitive function when abruptly stopped.

That being said, there are some strange case reports about citalopram withdrawal in medical literature.

One such report documented premature ejaculation apparently caused by citalopram withdrawal.

Another report noted hypertension (high blood pressure) as a withdrawal symptom in a patient who had abruptly stopped using citalopram.

A YouTube creator named Eve Hemingway shared her experience of withdrawal symptoms after one month of quitting citalopram:

Citalopram Dosage

Citalopram may be prescribed at a wide range of doses and in various formats. As documented by StatPearls, which is one of the leading free medical databases in the U.S., citalopram is available in both tablet and liquid form, and available at dosages of 10 mg, 20 mg and 40 mg.

The StatPearls page states that adult patients typically start at a 20 mg dose, but the dose can be increased to 40 mg if the patient isn’t experiencing benefit.

Doctors will typically prescribe a starting dose at the lower end of the effective range, because this reduces the risk of side effects. If a patient can experience relief at the lowest possible dose, this is a benefit to both the patient and provider.

Citalopram Vs. Lexapro

Lexapro is another commonly-prescribed antidepressant medication, so patients are often curious about which drug is more effective. There have been medical studies directly comparing the efficacy and safety of the two.

One comparative study on citalopram and Lexapro for treating major depressive disorder (MDD) found that Lexapro was significantly more effective, and that the differential effects were observable in the data as early as the first week of treatment.

Another clinical trial on citalopram versus Lexapro, published in the Current Medical Research and Opinion journal, compared effects of the drugs when used by an elderly patient population with depression. 

Those taking Lexapro were less likely to discontinue treatment, suggesting that Lexapro may be safer for elderly patients.

One medical study analyzed results from eight separate trials on citalopram versus Lexapro and concluded that Lexapro was more effective as an antidepressant.

Based on the available research, we would recommend that patients considering antidepressant medication speak with their doctor about Lexapro instead of citalopram.

Our Mental Wellness Recommendation

We recommend a platform called Brightside to patients on a mental health journey. It's an online therapy and medication platform that connects patients with licensed therapists and doctors from the comfort of their home.

medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.

Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both. The brand reports that 86% of members feel significantly better within 12 weeks of treatment.

Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.

The cost for medication without health insurance is capped at $95/month and the cost for therapy without health insurance is capped at $299/month.

Interested patients can check out Brightside at this link to the brand's website.

Citalopram User Reviews

Citalopram has been reviewed over 2,000 times on Drugs.com. This website allows users of prescription medications to publish personal reviews and rate the drugs they're taking.

Citalopram’s average rating for depression on Drugs.com is 7.2/10, which is higher than most antidepressants we’ve reviewed on Illuminate Health. 

The top positive review is written by a user named “Lefty” who claims the drug successfully treated both their depression and anxiety:

“I have taken [citalopram] for a month, and I feel normal. I realize now that I have been suffering from at least mild depression and anxiety for years. I don’t remember feeling normal like this ever. I believe I would have been a much better husband and father all of these years if I would have dealt with this earlier.”

The top negative review comes from a user named “Yikes” who gave the drug a 2/10 rating and claims it caused them to experience suicidal thoughts:

“After a year or so of all-consuming numbness, I began slipping. By the end of the 2nd year, I had spiraled into the darkest place I have ever been in my life. Suicide was the only thing on my mind. I had such violent intrusive thoughts that I could hardly sleep, I could hardly lay still even.”

Stay up-to-date on our research reviews

Conclusion

Citalopram is effective for treating major depression and generalized anxiety disorder, but it may cause some rare, life-threatening side effects such as heart arrythmias and suicidal thoughts and behaviors.

We would recommend that patients speak with their doctor about Lexapro over citalopram, as the former appears to be more effective based on medical studies.

Citalopram is the generic version of Celexa, and we would recommend that patients speak with their doctor about citalopram rather than Celexa, because both medications should be equally effective but citalopram is cheaper (especially for patients without health insurance).

Citalopram has relatively positive user reviews on Drugs.com when compared to other antidepressants.




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