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 anxiety and depression. The brand-name version of the drug is called Celexa.

But is citalopram proven in clinical studies to be effective against anxiety and depression?  Does the drug cause side effects and withdrawal symptoms? How do real users rate and describe its effects? And is the brand-name version more effective?

In this article we'll answer all of these questions and more, as we analyze clinical studies on citalopram to determine if the medication is effective for anxiety and depression, and if so, how effective it is.

We'll feature patient reviews of the drug, discuss if citalopram can improve sleep quality, and share our thoughts on whether or not the brand-name version is a better option.

Is Citalopram Proven to Work?

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 2018 medical review analyzed 20 clinical trials on citalopram as an antidepressant.

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 antidepressants.

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, which is unsurprising given that the drug is FDA-approved for the treatment of both conditions.

Does Citalopram Cause 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 explaining that 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 appear to be rare side effects of citalopram.

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.

This suggests a "real" suicidality risk of 3.5% (total % - placebo %). 

A YouTube creator named "Search For Sunshine" has a video documenting side effects she experienced during her first week on citalopram:

Is Citalopram Better 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 in 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 currently approved by the FDA to treat sleep disorders, so using the medication for that purpose alone is potentially unsafe.

This should instead 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 People Try Citalopram

A YouTube creator named Amanda DiPrato has a video describing citalopram's effect on her anxiety:

A TikTok creator named "daynemicah" suggests that citalopram was effective against anxiety:

@daynemicah @Hunter #fyp #billieeilish #anxiety #CheetosReaperReactions #xyzbca ♬ maybe i was just crazy - ♱

Is the Brand-Name Version Better?

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 drugs and some taking generic versions of the same drugs.

We would recommend that patients speak with their doctor about citalopram rather than Celexa (the brand name version) if they’re interested in taking this medication

At the time of updating this article, Celexa currently costs around $290 according to GoodRx.

Citalopram currently costs under $6 at Cost Plus Drugs.

Can I Drink Alcohol on Citalopram?

Citalopram’s FDA label indicates that use of alcohol while taking the medication is not advised.

This drug 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 would be beneficial for patients with alcoholism or substance abuse disorders to speak with their doctor about alternatives that don't have a negative interaction with alcohol.

It's important in this case for patients to be honest with their doctor about their alcohol use, because this consideration not only affects the patient's safety, but also the safety of their community.

Does Citalopram Cause Withdrawals?

We can't identify conclusive evidence about whether or not citalopram causes withdrawal symptoms.

Citalopram’s FDA label does not currently have a warning about withdrawals, and a medical review on 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:

Patients Rate Citalopram

Drugs.com is a website that allows prescription medication patients to rate and review the drugs they're taking.

We cannot verify the accuracy or authenticity of any reviews on this site.

Citalopram has been reviewed over 2,000 times on Drugs.com, and currently has an average rating of 7.4 out of 10 for anxiety, and 7.2 out of 10 for depression.

A top positive review of citalopram for depression is written by a user named “Lefty” who gives the drug a 10/10 rating, and claims it successfully treated both 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.”

A top negative review of citalopram for depression comes from a user named “Yikes” who gives the drug a 2/10 rating, and claims it caused 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.”

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 citalopram and Lexapro.

One comparative study in patients with 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 in elderly patients with depression. 

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

A 2011 meta-analysis analyzed results from eight clinical trials on citalopram and 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

Brightside Health is our top online therapy pick, as this platform 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. 

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 at the time of updating this article.

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

Citalopram Dosage

Citalopram may be prescribed at a wide range of doses and in various formats.

A 2023 medical review documents that citalopram is available in both tablet and liquid form, and available at dosages of 10 mg, 20 mg and 40 mg.

The above-linked medical review 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 may reduce the risk of side effects.

If a patient can experience relief at the lowest possible dose, this can be a benefit (and a cost savings) to both the patient and provider.

Stay up-to-date on our research reviews

Conclusion

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

Citalopram is clinically shown to improve sleep quality, so it may be a good option for patients with both a sleep disorder and depression to discuss with their doctor.

We would recommend that patients speak with their doctor about Lexapro over citalopram, as the former appears to be more effective based on clinical studies that we came across while researching this article.

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 has a lower retail price.

Citalopram has a higher average rating on Drugs.com than most antidepressants we've reviewed to date.