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Lexapro vs Celexa
Introduction
For patients with major depressive disorder (MDD) or other types of depression, certain drugs that alter the levels of compounds in the brain, known as neurotransmitters, can be instrumental in stabilizing mood and managing symptoms. Lexapro and Celexa are two such medications often prescribed for this purpose. Both these drugs work by impacting serotonin—a key neurotransmitter linked to mood—levels in the brain and thereby have mood-stabilizing effects on individuals suffering from depression. Lexapro is an escitalopram oxalate, a selective serotonin-reuptake inhibitor (SSRI), whereas Celexa is a citalopram hydrobromide; both help increase the level of serotonin by preventing its reabsorption into neurons. However, they differ slightly due to their chemical structures and dosing requirements.
What is Lexapro?
Escitalopram (the generic name for Lexapro) is a more modern drug from the SSRI class of antidepressants, which marked an improvement upon citalopram (the generic name for Celexa), another medication in the same category. Escitalopram was first approved by the FDA in 2002. Lexapro aids in increasing levels of free serotonin by preventing its reabsorption, effectively "trapping" it within the brain for longer periods than usual. This medication is prescribed to treat various forms of depression and anxiety disorders. Unlike Celexa, which affects both serotonin transporters equally, Lexapro has a selective influence on serotonin with only minor influence on norepinephrine and dopamine transporters. As such, it results in fewer side effects compared to other antidepressants that have stronger influences on these two neurotransmitters.
What conditions is Lexapro approved to treat?
Lexapro is approved for the treatment of various mental health conditions:
- Major depressive disorder (MDD), also known as unipolar depression
- Generalized anxiety disorder (GAD)
Whereas Celexa is typically used to treat:
- Unipolar depression, also known as major depressive disorder (MDD)
- Panic disorder
How does Lexapro help with these illnesses?
Lexapro, also known as escitalopram, helps to manage depression and generalized anxiety disorder by increasing the amount of serotonin available in the synapses of your brain. It does this by blocking it from being reabsorbed by neurons, which allows for higher levels of serotonin to be maintained over extended periods. Serotonin is a neurotransmitter that acts as a messenger within your brain and throughout your body, playing a crucial role in mood regulation, cognition, memory function, sleep patterns among other things. When individuals experience depression or anxiety disorders they often have lower than normal levels of serotonin. Therefore by increasing these serotonin levels Lexapro can alleviate symptoms associated with these conditions helping patients stabilize their mood.
On the other hand Celexa or citalopram operates on similar principles but contains both left-handed (S-) and right-handed (R-) forms of its active component whilst Lexapro only contains the S- form which can result in fewer side effects and improved efficacy for some people due to reduced influence on additional receptors beyond those intended.
What is Celexa?
Celexa, the brand name for citalopram, is a selective serotonin reuptake inhibitor (SSRI), meaning it works by restoring the balance of serotonin in the brain. It was first approved by the FDA in 1998 and has been used successfully to treat depression and certain anxiety disorders. Unlike some other antidepressants, Celexa does not significantly affect norepinephrine or dopamine levels. Its focus on serotonin means that its side-effect profile might be different from drugs that act on multiple neurotransmitters; it's less likely to cause weight gain or sexual dysfunction, common side effects with some other types of antidepressants like Lexapro. The emphasis on regulating serotonin can be beneficial for treating depression and anxiety symptoms, particularly in patients who don't respond well to other forms of medication such as those affecting multiple neurotransmitters.
What conditions is Celexa approved to treat?
Celexa is a selective serotonin reuptake inhibitor (SSRI) that has been approved by the FDA for treating:
- Major depressive disorder (MDD)
- Panic disorder, with or without agoraphobia.
These conditions can significantly affect everyday life and the ability to function normally, so it's important to manage them effectively.
How does Celexa help with these illnesses?
Serotonin, a neurotransmitter that plays an integral role in regulating mood, sleep and appetite among other things, has been directly linked with depression when its levels are imbalanced. Celexa works by increasing the levels of serotonin available in the brain, thus aiding to alleviate some symptoms of depression. Its action predominantly focuses on serotonin without significantly affecting other neurotransmitters which may also contribute to its efficacy as an antidepressant. Since it affects serotonin concentrations substantially, it is often prescribed when a patient does not respond well to other selective serotonin reuptake inhibitors (SSRIs) like Lexapro or can be combined with them for enhanced effect.
How effective are both Lexapro and Celexa?
Both escitalopram (Lexapro) and citalopram (Celexa) are selective serotonin reuptake inhibitors (SSRIs), used primarily to treat depression and anxiety disorders. They were approved by the FDA within a few years of each other; Celexa in 1998, followed by Lexapro in 2002.
While both medications function similarly by increasing levels of serotonin in the brain, they differ slightly chemically. Citalopram is a racemic mixture, meaning it contains equal parts of two different types of molecules: S-citalopram and R-citalopram. Escitalopram, on the other hand, contains only S-citalopram which is thought to be responsible for the therapeutic effects.
Clinical trials comparing these two drugs have found that Lexapro may be more effective than Celexa at treating major depressive disorder with fewer side effects at lower doses.[1] However, this does not necessarily mean that Lexapro will work better for every individual since everyone responds differently to medication.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013225/
In terms of safety profiles, both drugs are generally well tolerated but can cause similar side effects such as nausea or upset stomachs initially which usually improve over time. Like all SSRIs though they carry an increased risk for suicidal thoughts especially in young adults under age 24 when first starting treatment or when changing doses.
More recent reviews indicate that while Lexapro may hold some advantage over Celexa due its potency and tolerability at lower doses — like most antidepressants — ultimately patient response varies greatly so what works best will depend on the individual's unique circumstances including their specific symptoms and how they react to medication.
At what dose is Lexapro typically prescribed?
Oral dosages of Lexapro range from 10-20 mg/day, with most people finding relief at the lower end of this range for treating major depressive disorder or generalized anxiety disorder. Adolescents aged 12 to 17 and elderly patients may be started on a dosage as low as 5 mg/day. In these populations, the dosage can be increased after a few weeks if there is no response. The maximum daily dose that should not be exceeded in any case is 20 mg/day.
On the other hand, oral doses of Celexa start from a minimum of 20mg per day and can go upto a maximum of 40mg per day for adults dealing with depression or anxiety. For elderly patients or those with liver issues, it’s recommended to initiate treatment at half this dose (10mg per day), which might then be increased up to a max limit of 20mg per day based on individual patient response.
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At what dose is Celexa typically prescribed?
Celexa treatment is typically initiated at a dosage of 20 mg/day. After about one week, the dose can then be increased to 40 mg/day, taken in a single dose or divided into two doses spaced 12 hours apart. The maximum recommended dosage is 60 mg/day divided into two doses of 30 mg and spaced evenly throughout the day. This higher dosage may be considered if there's no significant improvement in symptoms after several weeks on the standard dose.
What are the most common side effects for Lexapro?
Common side effects shared by both Lexapro and Celexa include:
- Nausea
- Dry mouth
- Insomnia or sleepiness/drowsiness
- Increased sweating
- Diarrhea, constipation, changes in appetite
- Fatigue and dizziness (general weakness)
- Decreased libido (sex drive)
- Difficulty with ejaculation/orgasm
In rare cases, they can also cause tremors (unintentional trembling or shaking), anxiety, nervousness, abnormal dreams and yawning. Always consult a medical professional if you experience any of these symptoms persistently.
Are there any potential serious side effects for Lexapro?
When comparing Lexapro to Celexa, it's important to be aware of the serious side effects that could potentially occur:
- Increased suicidal thoughts or tendencies
- Signs of allergic reaction, such as hives, difficulty breathing, swelling in your face or throat
- Severe skin reactions: fever, sore throat, burning eyes and skin pain accompanied by a red or purple rash that blisters and peels
- Vision disturbances including blurred vision, tunnel vision and eye pain or swelling possibly paired with seeing halos around lights
- Cardiovascular issues like fast or pounding heartbeats; fluttering in your chest; shortness of breath; sudden dizziness as if you might faint
- Symptoms indicating low sodium levels in the body like headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady
- Indications of severe nervous system reaction include very rigid muscles high fever sweating confusion fast uneven heartbeat tremors feeling like you might pass out -Symptoms suggestive of serotonin syndrome: agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss coordination nausea vomiting diarrhea.
If any signs listed above become apparent when taking either medication it is crucial that medical attention is sought immediately.
What are the most common side effects for Celexa?
Celexa, also known as citalopram, may produce a certain set of side effects. These include:
- Dry mouth or increased saliva production
- Nausea, upset stomach and possible loss of appetite
- Sweating excessively or experiencing hot flashes
- Feeling tired or drowsy during the day
- Sleep disturbances such as insomnia
- Frequent urination
- Blurred vision occasionally
- Mild headache or light-headedness -Increased heart rate (tachycardia) -Muscle pain or weakness. While less common than other symptoms, some patients may experience a skin rash. In rare cases, Celexa can cause weight changes and confusion. It's important to note that everyone reacts differently to medication so not all individuals will experience these effects when taking Celexa.
Are there any potential serious side effects for Celexa?
While Celexa is generally well-tolerated, there are instances where it can cause serious side effects. If you experience any of the following symptoms while taking Celexa, please seek immediate medical attention:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Changes in behavior or mood swings including increased feelings of depression and suicidal thoughts (especially for people under 25 years old)
- Unusual bleeding or bruising
- Blurred vision, tunnel vision, eye pain or swelling
- Fast heartbeats accompanied by headache and chest pain
- High levels of serotonin in the body: agitation, hallucinations (seeing things that aren't there), fever, sweating excessively.
Ensure to always contact a healthcare professional before making changes to your medication regimen.
Contraindications for Lexapro and Celexa?
Both Lexapro and Celexa, along with most other antidepressant medications, may worsen symptoms of depression in some people. If you notice your depression worsening, or an increase in suicidal ideation, thoughts, or behavior, please seek immediate medical attention.
Neither Lexapro nor Celexa can be taken if you are taking monoamine oxidase (MAO) inhibitors (MAOIs), due to the risk of serotonin syndrome - a potentially fatal condition caused by excessive levels of serotonin in the brain. Always inform your physician about all medications you are taking; MAOIs will require a period of approximately 2 weeks to clear from your system before it is safe to start on either Lexapro or Celexa to prevent dangerous interactions.
How much do Lexapro and Celexa cost?
For the brand name versions of these drugs:
The price for 30 tablets of Lexapro (10 mg) averages around $356, which works out to about $12/day. On the other hand, the price for 30 tablets of Celexa (20 mg) is approximately $308, equating roughly to $10/day.
Thus, if you are prescribed a higher dosage range for Lexapro (i.e., 20mg/day or more), then brand-name Celexa may be less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which of these drugs suits your needs best.
As far as generic versions go:
Escitalopram oxalate (generic version of Lexapro) costs roughly between $0.30 and $2 per tablet depending on dosage and pack size. So daily treatment cost would run from as low as $.60 to about $4 if you're taking typical dosages like 10 or 20mg a day.
Citalopram hydrobromide (generic version of Celexa), on the other hand, might typically cost between $.15 and $.50 per tablet resulting in an estimated daily cost ranging from just under $.50 up to about a dollar and half with normal doses.
Popularity of Lexapro and Celexa
Escitalopram, known by the brand name Lexapro among others, was estimated to have been prescribed to about 25.7 million people in the US in 2020. Escitalopram accounted for just over 26% of SSRI prescriptions and nearly 15% of overall antidepressant prescriptions during that year.
On the other hand, Citalopram or Celexa was prescribed to approximately 19.4 million people in the United States in the same period. In terms of market share, citalopram represents nearly 20% of SSRI prescriptions and roughly accounts for around 11% of total antidepressant prescriptions across the nation.
Both drugs belong to a class called selective serotonin reuptake inhibitors (SSRIs) which are commonly used as first-line treatments for depression and anxiety disorders. While both medications come with similar side effect profiles and efficacy levels, some studies suggest that escitalopram might be slightly more effective than citalopram at managing major depressive disorder.
Conclusion
Both Lexapro (escitalopram) and Celexa (citalopram) are widely used in the management of depression and anxiety disorders, supported by numerous clinical trials showing their superiority over placebo treatments. In some instances, these drugs may be used together, but this should be carefully evaluated by a healthcare provider due to potential interactions. Both belong to the selective serotonin reuptake inhibitors (SSRIs) class of medication with similar mechanisms of action; they work primarily on increasing levels of serotonin in the brain.
Lexapro is considered slightly more effective than Celexa for treating major depressive disorder and generalized anxiety disorder, while Celexa might be preferred for use in geriatric patients due to its longer track record and extensive safety data.
Both Lexapro and Celexa can be found as generic medications which offer significant cost savings especially for self-paying patients. An adjustment period may also apply when therapy begins with either drug, meaning effects may not always be immediately noticeable.
The side effect profile is very similar between both drugs; common side effects include nausea, dry mouth, sweating or sexual dysfunction. However, these tend to diminish over time as your body adjusts to the medication. For both Lexapro and Celexa users it's crucially important that they closely monitor their mood changes during treatment initiation or dosage adjustments - if there's any worsening depression or emerging suicidal thoughts immediate medical help must be sought.