Celexa and Lexapro: What is the difference between these two medications? (Citalopram & Escitalopram)

Have you ever been prescribed medication by a doctor for a condition like depression or anxiety? If so, you may have heard of medications called `Celexa` or `Lexapro`. These are two of the most commonly prescribed medications for these conditions around the world and in our country. So, the question that many people have is what is the difference between these two, are they the same, and which one is right for me. Let's talk about this today to clear up all the doubts that you have in your mind.

First, let's see what Celexa and Lexapro are.

Simply put, both of these medications belong to a group called antidepressants . To be precise, they are from a specific group of medications called ``SSRIs`` (Selective Serotonin Reuptake Inhibitors). While the name may sound a bit complicated, the process is very simple.

Imagine that there are messengers inside our brain that carry information back and forth. We call these messengers neurotransmitters. Serotonin is a very important messenger that controls things like our mood, behavior, and memory. In conditions like depression, this level of Serotonin can decrease.

What SSRIs do is stop this messenger serotonin from being reabsorbed quickly after it's done. Then serotonin stays in the brain's nerve cells for longer. That means that "happy" message stays active for longer. This is when our mood starts to improve.

Celexa is the brand name for the drug Citalopram . Lexapro is the brand name for the drug Escitalopram . Both are approved to treat major depressive disorder (MDD) in adults, while Lexapro is also approved to treat generalized anxiety disorder (GAD).

Okay, so what's the biggest difference between the two?

This is a very interesting fact. `Citalopram` (Celexa) and `Escitalopram` (Lexapro) are, chemically speaking, mirror images of the same molecule. Just like our left hand and our right hand. Both are hands, but they are different. In chemistry, these are called `enantiomers`.

• Citalopram (Celexa) is a combination of both the "left-handed" and "right-handed" forms you mentioned.
• Escitalopram (Lexapro) is the more active of the two, meaning it is a drug made from only the main part, like the "right hand".

This is why there are slight differences in the way these two medications work in our bodies.

Let's take a look at some of the main differences:

• Approved uses: While `Citalopram` is only approved for depression in adults, `Escitalopram` is approved for depression in adults and children over 12 years of age, and for anxiety in adults and children over 7 years of age.
• Efficacy: Some studies have shown that Escitalopram is slightly more effective than Citalopram in controlling symptoms of depression.
• Heartbeat risk: Both of these medications can have a small effect on the electrical activity of the heart. This is called `QT prolongation`. This carries a small risk of abnormal heart beats. However, this risk is slightly higher with `Citalopram` than with `Escitalopram`, especially at higher doses.

Side effects and things to be aware of

Since both of these drugs are in the same family, the side effects are largely similar. Not everyone gets them, but they usually go away after a few days as the body gets used to the medication.

'Serotonin Syndrome' is a condition that requires special attention.

This is something you should definitely know . Serotonin Syndrome is a dangerously high level of serotonin in the body. This is most likely to happen when you first start taking the medication, when you increase the dose, or when you take it with other medications that affect serotonin levels (e.g., some migraine medications, other antidepressants).

If you or someone you know experiences these symptoms at the same time, go to a hospital's Emergency Department (ETU) immediately.

• Restlessness, restlessness
• Nausea, vomiting, diarrhea
• Dilated pupils
• Tremors, muscle twitching, stiffness
• Excessive sweating, chills, and shivering
• Severe confusion, loss of consciousness
• Increased heart rate, increased blood pressure
• Fever, seizures, loss of consciousness

Be aware of suicidal thoughts.

This is also very important. The risk of suicidal thoughts may be slightly increased in the first few weeks of starting antidepressants or when changing the dose, especially in young people and children under the age of 24. Be very aware of the following symptoms.

• The depression is getting worse.
• Thinking about ending your life.
• Panic attacks.
• Insomnia.
• Restlessness, aggression, irritability.
• Acting without thinking and becoming unusually excited.

Can you become addicted to this medication?

No. These are not considered addictive medications like narcotics. However, there is a problem . If you suddenly stop taking these medications for more than 6 weeks, you may experience discomfort in your body. This is called `antidepressant discontinuation syndrome`. Symptoms such as mood swings, dizziness, and anxiety may occur.

Therefore, never, for any reason, stop taking this medication suddenly without consulting your doctor. Stopping should be done under your doctor's advice, by gradually reducing the dosage.

Other uses of Celexa and Lexapro (Off-label uses)

"Off-label use" refers to prescribing a drug for a condition that is not officially approved for that condition, but doctors know from experience that the drug is useful for that condition. Both drugs are used for a number of other conditions, including:

• Other situations where Citalopram (Celexa) may be used:
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder
• Social Anxiety Disorder
• Post-traumatic stress disorder (PTSD)
• Premature ejaculation

• Other situations where Escitalopram (Lexapro) may be used:
• Social Anxiety Disorder
• Obsessive-compulsive disorder (OCD)
• Panic Disorder
• Symptoms associated with menopause (e.g. hot flashes)

So, which one to choose between these two?

This is the most important question. This is a decision that your doctor will make after examining you and considering many factors, such as your symptoms, age, and other medical conditions.

• If you have both anxiety and depression, Lexapro may be a better choice.
• If you have a history of heart disease, Lexapro may be a better option because it has lower risks.
• For some people, `Celexa` works well. For others, `Lexapro` is more suitable.