Depression and anxiety disorders are very common in the United States.
Anxiety disorders are the most common mental illness in the US, affecting roughly 40 million adults every year.
Fortunately, there are many options for treatment, including talk therapy and medication.
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medication often considered the first-line treatment for depression by healthcare providers.
Fluoxetine (Prozac) and citalopram (Celexa) are two popular SSRI medications that can be prescribed to treat clinical depression, anxiety, and other conditions.
Finding the right antidepressant for you and your symptoms can take some trial and error.
When talking with your doctor to help find the right antidepressant, it’s important to consider the unique uses and possible side effects for each, as well as your medical history and more.
Speaking with a provider is the best way to start your search for an effective antidepressant medication.
In this article, I’ll help you learn more about Prozac and Celexa.
I’ll talk about the different conditions treated by the two medications, the side effects of each, and some key differences between them. I’ll also provide some warnings, and some guidance on when to talk to your doctor.
Celexa vs. Prozac
Both are SSRIs, which work by increasing the levels of serotonin in your brain.
Conditions treated by both
Both Celexa and Prozac can be prescribed to treat:
- Major depressive disorder (MDD): Also referred to as clinical depression, MDD can significantly affect quality of life. Symptoms include fatigue, constantly feeling sad, hopeless, empty, or tearful, and loss of interest in normal activities or hobbies. People with MDD may also find it difficult to manage daily responsibilities, including working, caretaking for family, and socializing.
- Obsessive compulsive disorder (OCD): OCD is a common disorder marked by obsessions that either cause distress or anxiety, and/or compulsive behaviors that a person feels they must perform in order to suppress or ease anxious thoughts and feelings. These compulsions and obsessions can concern topics like cleanliness, contamination, or the need for symmetry.
- Premenstrual dysphoric disorder (PMDD): PMDD is a more severe form of premenstrual syndrome (PMS) in which symptoms appear during the week before menstruation and can continue up until a few days after your period begins. Symptoms of PMDD can be both psychological and physical, including irritability, nervousness, insomnia, anxiety, forgetfulness, difficulty concentrating, abdominal cramps, bloating, constipation, nausea, backache, acne, vision changes, food cravings, and diminished sex drive.
- Bulimia nervosa: Bulimia is an eating disorder marked by periods of binge-eating and periods of compensatory behaviors like forced vomiting, abusing laxatives or other diuretics, and fasting. Symptoms can include chronically sore throat, swollen salivary glands, acid reflux, worn tooth enamel, dehydration, intestinal distress, and electrolyte imbalance. Many people with bulimia nervosa also suffer from anorexia nervosa.
Which is more effective?
Both medications have been shown to be effective at treating the above conditions.
In fact, one study of 357 patients found no significant difference between Celexa and Prozac in the treatment of depression.
However, the study did find more reports of back pain in people treated with Celexa.
Another, small study found both medications equally efficient at improving sleep quality in patients with MDD.
In most cases, the effectiveness of an antidepressant medication will vary depending on the individual, which is why it can take some trial and error to find the right medication for you.
How is each taken?
Though the right dosage will vary depending on several factors, including your age and medical history, the therapeutic dosage for Celexa is between 20-40 mg per day.
For Prozac, a typical daily dose can range from 20-80 mg.
Depending on the condition being treated, you may also be prescribed one of the medications in a 10 mg dose.
Celexa comes in tablets and liquids that are taken by mouth while Prozac comes in tablet, capsule, and liquid forms.
Both can be taken with or without food.
As with any prescription antidepressant, it’s essential that you take either medication at the same time every day and only as directed by your provider.
If you miss a dose, take the missed dose as soon as you can, unless it’s time for your next dose.
In those cases, skip the missed dose. Never double up on a dose of Celexa or Prozac.
To avoid symptoms of withdrawal (including headache, dizziness, anxiety, and irritability), never stop taking Celexa or Prozac suddenly or without the guidance of a healthcare professional.
If you’re considering stopping or switching your medication, talk to your provider about the right strategy for tapering off your prescription.
By reducing the amount you’re taking over time, you’ll be less likely to suffer severe withdrawal symptoms.
Celexa vs. Prozac Side Effects
All antidepressants, including Prozac and Celexa, can cause side effects.
Usually, these side effects resolve on their own in a few weeks as your body adjusts to the medication.
But if any of these side effects persist, you should reach out to your provider to see if an adjustment in dosage or medication type is needed.
Side effects of Celexa
Common side effects reported with Celexa use include:
- Hot flashes
- Stomach aches
- Diarrhea or constipation
- Sleepiness or fatigue
- Joint or muscle aches (including back pain)
- Changes in appetite
- Changes in weight
- Dry mouth
- Painful periods
- Changes in sexual behavior (including a decrease in sex drive, impotence, or difficulty ejaculating)
Side effects of Prozac
Common side effects of Prozac include:
- Insomnia or strange dreams
- Vision changes
- Tremors or shaking
- Worsened feelings of anxiety or nervousness
- Dry mouth
- Sweating or hot flashes
- Changes in appetite
- Changes in weight (weight loss is especially common in children)
- Stuffy nose or other flu-like symptoms
- Sexual side effects, including decreased sex drive, impotence, or trouble reaching orgasm
Major Differences Between the Two SSRIs
Though there are many similarities between Celexa and Prozac, there are some differences that are important to note.
These major differences include:
- Treatment in children: Celexa is not FDA-approved to treat children with depression or anxiety. Prozac is FDA-approved for treatment of depression and anxiety disorders in both children and adolescents.
- Cost: Both Celexa and Prozac are available in generic versions (citalopram and fluoxetine, respectively), which are much cheaper than the brand name versions of these medications. If you are purchasing the brand name versions, though, Prozac can be more expensive than Celexa.
- Uses: In addition to their shared uses, Celexa can treat additional conditions including irritable bowel syndrome, post-traumatic stress disorder, and dementia.
Precautions and Warnings Before Taking Either
Before taking Prozac or Celexa, it’s important to talk with your provider about your health history and any other medications or supplements you’re currently taking.
Both Prozac and Celexa can interact with other medications and supplements to cause adverse side effects.
Tell your doctor if you’re pregnant or plan to become pregnant.
Additionally, most providers suggest taking extra precautions when drinking alcohol and taking SSRIs like Celexa and Prozac, since excessive alcohol drinking can cause drowsiness.
When to See a Doctor
If the medication you’re taking isn’t working to resolve your symptoms, or if you’re experiencing unwanted side effects (including suicidal thoughts), talk to your provider or a healthcare professional immediately to discuss your options.
Both medications can also cause rare, but serious side effects.
Watch out for:
- Severe dizziness
- Hives, or a red or purple rash with blistering or peeling
- Itching or swelling, particularly of the mouth, face, or throat
- Difficulty breathing
- Abnormal bleeding or bruising
If you experience any of these severe side effects, seek medical attention immediately.
Additionally, speak to your provider as soon as possible if you experience any of the following signs of an overdose:
- Uncontrollable shaking
- Rapid, pounding, or irregular heartbeat
How K Health Can Help
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Frequently Asked Questions
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.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Citalopram versus fluoxetine: a double-blind, controlled, multicentre, phase III trial in patients with unipolar major depression treated in general practice. (1996).
Comparing effects of citalopram with fluoxetine on sleep quality in patients with major depressive disorder. (2013).
Eating Disorders. (2021).
Facts & Statistics. (2021).
Fluoxetine (Prozac). (2020).
Obsessive-Compulsive Disorder (OCD). (2021).