Celexa vs Lexapro: Differences, Similarities and Which One Is Right For You?

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
December 13, 2021

Nearly one in five adults in the United States live with a mental illness.

But just because mental health conditions like major depressive disorder, anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder are common doesn’t mean that they’re easy to live with.

These and other mental health conditions can also cause significant distress.

If your symptoms are ongoing or interfering with your daily functioning, a healthcare professional may recommend antidepressant or anti-anxiety medication to help you.

Luckily, there are many effective and safe prescription medications that can help lift a person’s mood.

For example, selective serotonin reuptake inhibitors (SSRIs) such as Celexa and Lexapro can help depression and anxiety by increasing the amount of serotonin available in the brain.

Increasing the amount of this neurotransmitter can help improve mood and increase energy. 

While both Celexa and Lexapro can be effective, there are some important differences.

To learn more about which one is right for you, talk to your primary care provider, a psychiatrist, or a K provider.

In this article, I’ll cover the differences between Celexa and Lexapro, including the conditions treated by both, how each should be taken, the side effects of each medication, as well as other drugs that may interact with each of these SSRI antidepressants.

I’ll also discuss the costs and insurance coverage for each drug.

I’ll explain what withdrawal symptoms from each drug can be like, when you should seek medical attention, and talk about ways for you to determine which of these medications could work best for your mental health.

Finally, I’ll help you understand when to talk to a provider about Celexa or Lexapro.

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Difference Between Celexa and Lexapro 

Both Celexa and Lexapro are prescription SSRI medications that are often used as first-line treatments for mental conditions including major depressive disorder (MDD) and generalized anxiety disorder (GAD).

SSRIs work by changing how the brain uses and recycles a neurotransmitter called serotonin, increasing the amount available. 

Under normal circumstances, serotonin carries messages within the brain, and between the brain and body.

When it’s done transmitting its message (that is, “neurotransmitting”), the serotonin is reabsorbed. SSRIs prevent this reabsorption, or “reuptake,” increasing the amount of serotonin available in your brain and body.

Serotonin impacts mood and well-being, so more serotonin availability can improve your mood and decrease symptoms of anxiety and depression.

Both Celexa and Lexapro work to inhibit this reuptake process.

And while they do so similarly, there are a couple of key differences. Celexa, or citalopram, has two components, called R-citalopram and S-citalopram.

Lexapro, known as escitalopram, only contains S-citalopram.

It works the same way as Celexa––by blocking serotonin reuptake in the brain to increase serotonin levels.

While the two drugs are very similar, and are both used to treat major depressive disorder and generalized anxiety disorder, they come with different possible side effects, and are used to treat slightly different conditions.  

Here are some of the primary differences between Celexa and Lexapro:

Drug class

Generic name

Form

Typical dosage

Typical treatment course

Typical patient

Celexa

Selective serotonin reuptake inhibitor (SSRI)

Citalopram

Tablet and oral suspension

20 mg daily

Long-term

Adolescents and adults

Lexapro

Selective serotonin reuptake inhibitor (SSRI)

Escitalopram

Tablet and oral suspension

10 mg daily

Long-term

Adolescents and adults

Conditions Treated By Both

Both Lexapro and Celexa work by changing how the brain uses the neurotransmitter serotonin.

Currently, the Food and Drug Administration (FDA) has approved each medication for its own, unique uses based on clinical trials.

Occasionally, a provider may prescribe Lexapro or Celexa for off-label purposes, which means the potential benefits of the drug’s use for a certain condition may outweigh the risks.

Here are the most common conditions treated by Celexa and Lexapro: 

Condition

Major depression (MDD)

Generalized anxiety disorder (GAD)

Obsessive compulsive disorder (OCD)

Panic disorder

Social anxiety disorder (SAD)

Post-traumatic stress disorder

Binge-eating disorder

Body dysmorphic disorder

Bulimia nervosa

Premenstrual dysphoric disorder (PMDD)

Premature ejaculation

Aggression disorder (associated with dementia)

Celexa

Yes

Off-label

Off-label

Off-label

Off-label

Off-label

Off-label

No

No

Off-label

Off-label

Off-label

Lexapro

Yes

Yes

Off-label

No

No

Off-label

Off-label

Off-label

Off-label

Off-label

Off-label

No

If you’ve been diagnosed with or think you may have any of the above conditions, your healthcare provider or a K provider can help you determine whether Lexapro or Celexa is right for you.

How Should They Be Taken?

SSRI medications such as Celexa and Lexapro are typically taken orally, in tablet form, once a day.

Celexa and Lexapro are also both available as a liquid suspension. 

Depending on your condition and your provider’s recommendation, you may take Celexa or Lexapro in the morning or before bed, either with or without food.

No matter what time you take an SSRI medication, aim to take it at the same time every day so you don’t experience unwanted side effects or withdrawal symptoms.  

Always follow your provider’s instructions for Celexa or Lexapro.

Don’t take more or less than your prescribed dose unless you consult with your healthcare provider.

If you can’t remember whether you took your medicine, it’s OK to take the dose again unless you’re close to the time of the next dose.

If you’re concerned, consult with a medical provider.

If you drink alcohol, consume it in moderation or avoid it altogether.

The effects of alcohol, like confusion or drowsiness, may be more intense if you take Celexa or Lexapro, and all alcohol use can make anxiety and depression symptoms worse. 

Side Effects

As with all medications, both Celexa and Lexapro can cause side effects––some rare, and some of them a bit more common.

Which medication your doctor prescribes may depend on which side effects you can tolerate.

Here are some of the most common side effects of both Celexa and Lexapro:

Side effect

Agitation

Constipation

Decreased appetite

Decreased sex drive

Diarrhea

Dizziness

Dry mouth

Heartburn

Nausea

Sleepiness

Sweating

Vomiting

Weakness

Celexa

Yes

No

No

Yes (males only)

Yes

Yes

Yes

No

Yes

Yes

No

Yes

Yes

Lexapro

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

If any of these side effects are becoming severe or difficult to tolerate, make sure to talk to your doctor.

You may need to alter your dose or try out a different medication with fewer or different side effects.

Larger doses of citalopram have also been associated with changes in the electrical activity in the heart, which can lead to an abnormal heart rhythm—which could be fatal.

This side effect has only been found for patients taking doses of Celexa larger than 40 mg per day.

For this reason, doctors no longer prescribe daily amounts in excess of 40 mg per day.

Drug Interactions

Both Celexa and Lexapro can interact with medications used to treat other conditions, potentially causing serious side effects.

That’s why, before prescribing either drug, your provider will ask about your health history and whether you’re on any other medications.

Make sure you tell your medical provider about any prescription or over-the-counter medicines you take, as well as any herbal supplements or illicit drugs.

Because they can cause side effects, it’s especially important to tell your doctor if you take any of these prescription medicines:

Drug

Almotriptan Eletriptan Oxitriptan

Bemiparin Enoxaparin Heparin

Acalabrutinib Dabrafenib Erdafitinib Gilteritinib Ibrutinib

Dexmethylphenidate Methylphenidate

Aripiprazole

Aspirin Ibuprofen Naproxen Diclofenac

Bupropion

Buspirone

Esomeprazole Omeprazole

Fluoxetine (Prozac) Duloxetine (Cymbalta) Paroxetine (Paxil) Sertraline (Zoloft)

Hydroxychloroquine

Tramadol

Venlafaxine (Effexor)

Amitriptyline Clomipramine Doxepin Nortriptyline

Linezolid

Hydrochlorothiazide Chlorthalidone Metolazone

Cyclobenzaprine Metaxalone

St. John’s Wort

Selegiline Phenelzine Rasagiline

Drug Class

5HT Agonists/Triptans (antimigraine)

Anticoagulants

Antineoplastics (chemotherapy)

Amphetamines

Antipsychotics

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Dopamine/norepinephrine reuptake inhibitor

Anti-anxiety

Proton pump inhibitor

SSRIs

Antimalarial

Opioid

Selective norepinephrine reuptake inhibitor (SNRI)

Tricyclic antidepressants

Antibiotic

Thiazide diuretics

Muscle relaxers

Herbal supplement

Monoamine oxidase inhibitors (MAOI)

Celexa

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Lexapro

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Cost and Insurance Information 

Celexa and Lexapro come in generic forms known, respectively, as citalopram and escitalopram.

Generic versions of medications are typically cheaper than brand-name versions, so if cost is a concern, ask your provider to prescribe the generic pills if possible.

Your insurance may cover all or part of your prescription if you take citalopram or escitalopram.

Before you pick up your prescription, contact your insurance provider or pharmacy to find out if you have a copay.

The generic versions are relatively affordable with a discount programs, though the cost varies based on your pharmacy and where you live. 

Buying your medications online can also keep your drug costs down, as online pharmacies often offer lower prices.

If you have a prescription for Lexapro or Celexa from your healthcare provider, you may be able to purchase the drugs through an online retailer.

Buying your medications online also has them shipped straight to your door. 

Warnings of Celexa and Lexapro 

While some people notice improvement right away when taking Celexa or Lexapro, for some it could take up to two weeks to notice even a small change, and up to eight weeks to start feeling significantly better. 

If you have major depressive disorder, you may be at risk for suicidal thoughts.

SSRI medications can increase suicidal thoughts in children and young adults, though they have not been linked to increased risk of attempting suicide.

Your provider will discuss these risks with you when prescribing, and make sure the benefits of the medication for you or your child outweigh the risks.

If you notice any suicidal thoughts or feelings, let your healthcare provider know, call a suicide hotline (1-800-273-8255), call 9-1-1, or visit your nearest emergency department.

In rare cases, Celexa can cause a heart problem called QT prolongation, an abnormality in an EKG reading, when taken at higher doses.

Most providers prescribe less than 40 mg of Celexa daily to avoid this risk.

Make sure to tell your prescriber if you have congenital long QT syndrome, or any personal or family history of heart rhythm problems. 

Another condition called serotonin syndrome can occur with any SSRI, including Celexa and Lexapro.

This rare condition happens when a person’s body has too much serotonin, whether from SSRIs, anti-migraine medications, or recreational drugs.

Common symptoms include agitation, fast heart rate, high fever, muscle rigidity, hallucinations, confusion, and dizziness.

Seek medical care immediately if you think you may have serotonin syndrome. This is very rare, and generally only occurs at high doses or if medications are mixed.

If you take Celexa or Lexapro, never stop taking it or decrease your dose without speaking to your provider.

Withdrawal symptoms such as headache, vomiting, dizziness, and increased anxiety and depression may occur if you do.

You may also experience a relapse of the condition your medication is treating.

Withdrawal Symptoms 

Because Celexa and Lexapro impact how your brain uses serotonin, you may experience withdrawal symptoms if you don’t take your medication.

These symptoms may be more severe if you abruptly stop your medication or forget a dose, and are more common if you are prescribed higher doses.

Some possible symptoms of SSRI discontinuation may include: 

  • Dizziness
  • Lightheadedness
  • Difficulty walking
  • Vertigo
  • Nausea
  • Vomiting
  • Fatigue
  • Headaches
  • Irritability
  • Increased anxiety or depression
  • Flu-like symptoms

It’s never a good idea to stop your medication without talking to a provider.

If you want to stop taking Lexapro or Celexa, speak with a medical provider, who can help you safely taper off the medication, and monitor you in the process. 

When to Seek Medical Attention

Anyone experiencing symptoms of anxiety or depression should consult with a healthcare professional or mental health specialist who can make a diagnosis and potentially prescribe an antidepressant or anti-anxiety medication

If you’re already taking Celexa or Lexapro, talk to your medical provider if your symptoms aren’t improving after a few weeks, if you’re feeling worse, or if your side effects are difficult to manage.

If you are having suicidal thoughts, call 9-1-1, 1-800-273-8255, or go to the ER right away. 

Which One Is Better?

Both Celexa and Lexapro can be effective, but studies have found that certain patients may benefit more from one medication or the other. 

One 2004 study suggests Lexapro is more effective for the treatment of severe major depressive disorder (MDD).

A double-blind study from 2005 confirmed these findings, showing that Lexapro may be better for treatment of MDD. A meta-analysis from 2010 found similar results.

Lexapro may also be more effective in treating anxiety, because it’s indicated by the FDA to do so.

In some cases, doctors may prescribe Celexa off-label for anxiety-related conditions. 

Despite these findings, the medication that will work best for you depends on factors like side effects and genetics.

Your provider will work with you to find the best and safest method for treating your mental health condition.

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When to Talk to a Healthcare Professional

It’s never too soon to ask for help. If you suffer from symptoms of depression or anxiety, talk to a healthcare provider.

While both Lexapro and Celexa have similar psychopharmacology, your medical provider can help you determine which medication is best to treat the anxiety or depression symptoms you’re experiencing. 

Talk to your provider if your current medication isn’t helping, if you’re experiencing unwanted side effects, and especially if you’re having suicidal thoughts.

How K Health Can Help

Anxiety and depression are among the most under-reported and under-treated diseases in America.

Nearly 20% of adults in the US suffer from mental health illness and fewer than half receive treatment.

Our mission is to increase access to treatment for those suffering in silence.

You can start controlling your anxiety and depression and get access to the treatment you need with K Health.

Starting at $29/month get prescriptions for mental health medications plus unlimited provider visits through the K Health app.

Start your free assessment today!

Frequently Asked Questions

Can I use Celexa or Lexapro with alcohol?
There’s no major interaction between either of these medications and alcohol, but it’s wise to monitor your alcohol use and consume in moderation. Drinking while on either drug can increase alcohol-related symptoms like sleepiness. Also, any alcohol use can make anxiety and depression worse.
Does Celexa or Lexapro cause weight gain?
Neither medication directly causes weight gain. But since Lexapro can decrease appetite, people may be more likely to experience weight change than while taking Celexa.
Does Celexa or Lexapro treat social anxiety?
Doctors sometimes prescribe Celexa off-label for social anxiety.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.