Citalopram (Celexa) vs. Escitalopram (Lexapro)

[jlcb24]

Does anyone know the subtle differences between these SSRI's? I was prescribed Lexapro a few months ago, but immediately switched to Celexa because it was quite a bit less expensive. Did I make a mistake in doing so or do they work in almost identically the same fashion?

[DaneV]

Allthough Lundbeck claims otherwise there is no reason to believe these drugs are any different. The only reason escitalopram was invented, is because the patent citalopram expired and they needed another cash cow.

Citalopram contains both the S-stereoisomer and the R-stereoisomer, where the R-stereoisomer doesn`t seem to have any pharmacological effects.
Escitalopram, as the name implies, is just the S-stereoisomer.

So its 100% the same. Lundbeck implied that the ineffective R-Stereoisomer could contribute to the side effects but this seems to be bullshit. The only difference between these two drugs is that you will need a higher dosage of Citalopram to get the same amount of the active S-Stereoisomer.
It`s all about money...

[Bungalobill]

+1 to what DaneV said. I'm prescribed an SSRI for a somewaht off-label reason. My insurance didn't want to pay for Lexapro and had me ask the doc to switch me to Celexa which has a generic. He did and everything is fine. My dosage on Celexa as DaneV pointed out is higher than on Lexapro.

[jlcb24]

Does anyone know the subtle differences between these SSRI's? I was prescribed Lexapro a few months ago, but immediately switched to Celexa because it was quite a bit less expensive. Did I make a mistake in doing so or do they work in almost identically the same fashion?

Sadly you couldn't be more right. My doctor prescribed Lexapro and Nexium (both incredibly expensive medications) at the same visit when a Celexa and Omeprazole regimen would have likely been just as effective. Someday I hope to find a Dr. who legitimitely cares about my health and not just his paycheck

[dixiewolf]

I was on Celexa years ago, and it never fully helped, it helped some, but I still had a lot of remainining symptoms. I took something else a year later, now I am on Lexapro. My psychiatrist told me Lexapro helps more with anxiety than the Celexa. I have noticed a huge improvement with the Lexapro (I have been taking it a few years now). However, it varies with the person. I have major anxiety and major depression and have to take the highest dose of any anti-d I take. My insurance only pays a small portion of it, so it is around 100 a month for me, but it's worth it. Some people have great success on Celexa as well, it just wasnt the case for me. But yes, they are very similar medications.

[oxygalore]

I have been on both as well but changed over to celexa rather quickly for the cost reason. I do know that if I miss more than a dose of my celexa or go 2 days without and then take my regular dose i have the most lucid nightmares. It is horrible, and I know it has to do with the medication but I deal with it because the positive still outweighs the occasional nightmare. But I have to say, I have woken up screaming more than once from celexa.

[JasonKone6789]

I have heard studies confirmed the R enantiomer actually does contribute to Celexa causing a bit more AEs than its stereo-pure cousin Lexapro. Whether or not that is true, I don't know for sure, but this was accepted practice when I was working in a psychiatric dept. with some very knowledgeable people.

[camjunkie]

I've taken both and Celexa made me incredibly hungry. With Lexapro, no appetite increase. Just my experience.

[deadgecko]

As mentioned above, Lexapro was just an attempt to keep milking a star product when the patent on Celexa expired.

@camjunkie Most of the differences people seem to experience in the split are due to the difference in the fillers and time mechanisms, but as ever YMMV :-)

[curvycutie80]

I've taken several anti-depressants over the years and most recently switched from p axil to c elexa. I have not personally had any experience with increased or disturbing dream activity. My appetite seems to have decreased. The only thing it hasn't helped much with is anxiety. At my local pharm, it is on the discount list for those of us without insurance which makes it very affordable. Hope my experience will help others.

[jholden40]

@curvycutie80
Yep, I remember having the loss of appetite thing with Celexa; I went on to it after being on Remeron (an SNRI), which had the complete opposite effect, i.e. enormous desire for food. Regarding dream activity - I used to find that cutting down or stopping an SSRI invariably led to more intense dream activity - particularly dreams in which I was crying ... Make of that what you will

[camjunkie]

I am always amazed at how each of us respond so differently to these medications. At the moment, I take Cymbalta and Wellbutrin. I used this combination two years ago with great success. Now, after several months, I've had little improvement and ongoing fatigue. Thinking about a move to Effexor.

[Molecular]

I have a prescription at the pharmacy for Lexapro. I am considering trying it out at 20 mg a day for 6 weeks. I have depression from social phobia. Some days I feel better than others. I am concerned about reports of increased anxiety during the adjustment phase. I am currently prescribed 15 mg valium but only take 10 mg. I had a very difficult time trying to taper off of it. Think I did it too quickly plus the other problems in my life. I feel that I should keep taking it until I feel better in general. I have been researching the gamut of antidepressants from agomelatine to zoloft.

[zoniemae]

I am currently on Celexa 40mg daily and throughout past 2 years. Had been on Lexapro but didn't seem to help with obsessive thoughts the way Celexa does.

[dixiewolf]

I am always amazed at how each of us respond so differently to these medications. At the moment, I take Cymbalta and Wellbutrin. I used this combination two years ago with great success. Now, after several months, I've had little improvement and ongoing fatigue. Thinking about a move to Effexor.

Yeah I wish it wasnt trial and error. I have been on several meds, and Zoloft and Lexapro were the best for me (especially Lexapro, I feel like myself). Never tried Cymbalta, but took Wellbutrin and it changed my personality, I was angry and would yell, I am usually the most laid-back and calm person, it just didnt work, so I had to get off. I found out later it wasnt good for people with anxiety disorder, b/c it is more stimulating, but may help other people with depression. Others I took didnt make a dent in my major depression. Someone mentioned Remeron in this thread, I used that for awhile (I had lost way too much weight from depression so it was supposed to help with appetite). I gained to a healhier weight, but I felt zombie-like and I would fall asleep in mid-sentence when I was talking to people sometimes. It is good there are a lot of brands, since everyone responds differently, I dread when my meds dont work anymore, then I have to try something else and hope it works for me.

[GoingBananas]

Trial and error. Boy, you said it @Dixiewofl.
I have tried so many anit-depressants and the biggest lesson I have learned in all the time was that i now honestly believe i often did not give the medication enough time to work and enough dosage adjustment to see if increasing would work.


No, I wanted someting to work in a couple weeks.
30 days was the limit.
Well, that does not happen very often that we feel 180 difference in 30 days or at least not for me.

So, when i got a new psych last year he made it clear that he considered 60 days the minimum unless side effects were intolerable and that meant REALLY intolerable not unpleasant.

I of course rallied against this but low and behold if he was not right. After 60 days on the same med I started to see SOME improvement. Adjusted the dosage and another 60 days and it was like a whole new world.

I wish this could happen overnight.

But, I now know it is close to a miracle it can happen at all.

keep on keeping on my friends....

[Kat0711]

I am currently on celexa and have been for 12 days. I have not seen or felt an improvement with my depressive disorder. I KNOW, it can take anywhere from 1-6 weeks for me to get the full benefit of this medication. I have a follow up with my shrink this friday and I will continue as she prescribes as she is my doc. I have noticed a decrease in my appetite and increased dream activity, which I gather is both side effects of this med. I just hope it hurrys up and helps my depressive disorder.

Have a good day everyone!
Kat

[scorpigoh]

@GoingBananas....if you don't mind, what meds did your Dr. put you on? I am having a high level of anxiety and I am prescribed Prozac whic seems to have lost it's mojo for me and Monday I go to see my Dr. and plan on discussing this with him. Thanks.
@GoingBananas....if you don't mind, what meds did your Dr. put you on? I am having a high level of anxiety and I am prescribed Prozac whic seems to have lost it's mojo for me and Monday I go to see my Dr. and plan on discussing this with him. Thanks.

[Starscream_]

I am currently on celexa and have been for 12 days. I have not seen or felt an improvement with my depressive disorder. I KNOW, it can take anywhere from 1-6 weeks for me to get the full benefit of this medication. I have a follow up with my shrink this friday and I will continue as she prescribes as she is my doc. I have noticed a decrease in my appetite and increased dream activity, which I gather is both side effects of this med. I just hope it hurrys up and helps my depressive disorder.

Have a good day everyone!
Kat

I /hope/ Celexa doesn't decrease my appetite...I'm far too thin as it is and have a difficult time, at times, eating enough to keep my weight up.

If so I am definitely going to have to try a different med. I was just prescribed this by my new GP for bipolar disorder...she says that I shouldn't be taking the antipsychotics that my previous doctor was feeding me.

I tend to agree but I am hesitant to take this alongside tramadol due to their similarity in profiles....yet my own doctor prescribed them both in the same visit.

Hopefully I won't keel over from serotonin syndrome.

[Kat0711]

I /hope/ Celexa doesn't decrease my appetite...I'm far too thin as it is and have a difficult time, at times, eating enough to keep my weight up.

If so I am definitely going to have to try a different med. I was just prescribed this by my new GP for bipolar disorder...she says that I shouldn't be taking the antipsychotics that my previous doctor was feeding me.

I tend to agree but I am hesitant to take this alongside tramadol due to their similarity in profiles....yet my own doctor prescribed them both in the same visit.
.
Hopefully I won't keel over from serotonin syndrome.

@starscream

Did your doc ask that you decrease you Tramadol? Mine did. I take that as well and mine asked that to begin with I decrease my dosage of Tramadol, which I did then gradually went back to my regular dosage over a few days. For my follow up visit, I had actually lost weight but for me that's a good thing as I am too heavy, she increased my dosage by half so now I take 1 1/2 tablets a day and I have noticed a definite difference. I am more up beat, I don't have feelings of dread when I wake up and a general good feeling about life now. I would ask your doc about this side effect if it is affecting your appetite and most certainly bring it to his/her attention. Dont just go along with this if it affecting your health.

Wishing you well!

Kat