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What Is the Difference Between Citalopram and Escitalopram?

Strong evidence suggests that escitalopram is more effective than citalopram in treating depression.
Doctors appear more likely to prescribe escitalopram than citalopram.
Unlike escitalopram, citalopram is sometimes prescribed for treating menopausal symptoms, such as hot flashes.
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  • Written By: Tricia Ellis-Christensen
  • Edited By: C. Wilborn
  • Last Modified Date: 12 August 2014
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Citalopram and escitalopram, often sold under the names Celexa® and Lexapro®, are two antidepressant medications of the selected serotonin reuptake inhibitor (SSRI) class. They are closely related to each other. The same company, Lundbeck®, created both medications, introducing Celexa® in 1989 and asking for approval of the US Food and Drug Administration (FDA) for Lexapro® in 2001.

Lundbeck® marketed Lexapro® as an improved version of Celexa® with a lower side effect profile. These improvements were considered due to the creation process, where drug makers used an enatiomer or near mirror-image of citalopram's molecule arrangement to develop escitalopram. As such, the drugs have many similarities but also a few differences.

One difference between citalopram and escitalopram are the rates at which both drugs are prescribed. Physicians appear to favor prescription of the newer drug. Presently, Lexapro® is marketed with much greater aggression, building on the company's claims that it is a superior drug. This marketing strategy heavily promotes sales of Lexapro® until its patent expires in 2012. It bridges the gap between the expiration of the patent on Celexa® by less expensively producing another drug very similar to it.

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There is some question of whether there is an appreciable difference between citalopram and escitalopram. Both antidepressants bear similar risk for causing suicidal thoughts in teenagers and young adults. Citalopram has been associated with additional common side effects like nausea, dry mouth, excess perspiration, and sexual dysfunction, among others. Escitalopram's most common side effects are largely the same, though one difference may be their frequency of occurrence in users, with escitalopram potentially having a lower occurrence rate.

There are some slight differences between citalopram and escitalopram that may make a difference in how the medicines work. For example, escitalopram has a shorter half-life and has been more indicated for treating general anxiety disorder. Both drugs may be used to treat depression, but either drug might be of use with anxiety disorders, thought citalopram has shown slightly more efficacy in the treatment of obsessive-compulsive disorder. Citalopram is sometimes used as a non-hormonal treatment for menopause mood shifts or hot flashes. Another difference is price: citalopram can be easily obtained in generic form, but escitalopram doesn't get less expensive until its patent expires.

In terms of citalopram and escitalopram efficacy, there does seem to be strong evidence that in the treatment of depression, escitalopram is more effective. It has been described as increasing the speed at which patients respond, and having more effect on patient symptoms. Clinical studies have compared depressed patients using both drugs and usually conclude that the escitalopram users are more likely to experience a quicker remission of depression.

In the end, the variable rate of response to most antidepressants suggests that individuals making a choice between one of these drugs may not react to them much differently. Finding the right antidepressant can be an arduous process that takes patience and trial and error. It is possible that citalopram and escitalopram are good choices for the individual, but it can be possible that neither is effective and another SSRI, or an antidepressant in a different class, will yield better personal results.

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Discuss this Article

fify
Post 3

The one bad thing about escitalopram is the short half-life. It makes it very difficult while withdrawing from the drug. I had withdrawal symptoms for a month while I quit escitalopram.

fBoyle
Post 2

@ddljohn-- When it comes to escitalopram vs citalopram, I don't think that there is much difference between them. They're both selective serotonin reuptake inhibitors and essentially do the same thing in the brain.

Side effects may vary, but people respond differently to the same medications anyway. I have not had any major side effects from citalopram, so I think this is an individual thing.

Escitalopram is just a way for the drug company to keep making money on their drug after the expiration date of citalopram.

ddljohn
Post 1

I've used both citalopram and escitalopram in the past for anxiety. I was first prescribed citalopram but I used it for a short time -- about three weeks. Citalopram caused many side effects. I had severe fatigue, mood swings, headaches and a weird urge to yawn. When I went back to see my doctor about these side effects, he switched me to escitalopram.

I used escitalopram for three years and I think it's a great drug. I didn't experience any of the side effects I had with citalopram, and it treated my anxiety. I agree with the makers of these drugs that escitalopram is superior to and has less side effects than citalopram. I think if anyone is given the choice of taking citalopram or escitalopram for anxiety, escitalopram is the better choice.

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