# Citalopram (Celexa) vs. Escitalopram (Lexapro)



## rawiswaruk (Jun 18, 2012)

Hi guys, so just been to my docs to try out Escitalopram (Lexapro). Straight away my doc says I should try Citalopram (Celexa) instead.

First I thought maybe my docs putting my interests first, but it seems it maybe because Citalopram (Celexa) is a lot cheaper than Escitalopram (Lexapro).

Whats your thoughts on the two drugs?

Thank you


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## istayhome (Apr 4, 2012)

I noticed absolutely no difference between the two. Escitalopram is the S- isomer of citalopram. citalopram being the racemic mixture of equal parts s- and r- isomer. If Citalopram is cheaper for you than Escitalopram, then try Citalopram first.


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## rawiswaruk (Jun 18, 2012)

Hi, thanks for replying. I live in the UK where we have the NHS so price is not a concern for me, however it is a concern for the doctors it seems lol.


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## istayhome (Apr 4, 2012)

rawiswaruk said:


> Hi, thanks for replying. I live in the UK where we have the NHS so price is not a concern for me, however it is a concern for the doctors it seems lol.


got it. Both were exactly the same to me. So maybe read some reviews of others and if you still can't decide which to try first then flip a coin


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## rawiswaruk (Jun 18, 2012)

My docs already gave me citalopram. I have read a few reviews, its as all ssri's though. They effect people differently. Fingers crossed they work for me


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## RockiNToM (Jun 15, 2009)

There is quite a big difference actually, despite Lexapro basically being the cleaner version. 

The action on Serotonin is slightly different, Lexapro is actually stronger than Celexa. 10mg Lexapro vs 10mg Celexa is very different. Lexapro 10mg is comparable to 20-30mg of Paxil, and 50mg of Zoloft. There is some info out there that shows the potency of Lexapro, but I don't have it to hand right now. No doubt someone else will confirm this.

Celexa is actually one of the weaker SSRIs. You may need a larger dose of Celexa 20-40mg to have comparable effects to 10mg of Lexapro.


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## UltraShy (Nov 8, 2003)

They're the same thing.

It has far more to do with finance than pharmacology. Every time a patent is about to expire a drug company comes up with a way to keep milking their cash cow. Right before Celexa went generic the company that made it magically came out with Lexapro, the active isomer of Celexa. A "new" drug that was substantially the same as the old drug.

I've used both. They both do nothing except produce sexual side effects. In that regard, they're just like all the other SSRIs I've been forced to try.


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## pati (Aug 15, 2012)

I was on Lexapro a few years before someone gave me Celexa. I noticed no difference.


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## istayhome (Apr 4, 2012)

RockiNToM said:


> There is quite a big difference actually, despite Lexapro basically being the cleaner version.
> 
> The action on Serotonin is slightly different, Lexapro is actually stronger than Celexa. 10mg Lexapro vs 10mg Celexa is very different. Lexapro 10mg is comparable to 20-30mg of Paxil, and 50mg of Zoloft. There is some info out there that shows the potency of Lexapro, but I don't have it to hand right now. No doubt someone else will confirm this.
> 
> Celexa is actually one of the weaker SSRIs. You may need a larger dose of Celexa 20-40mg to have comparable effects to 10mg of Lexapro.


This is very bizarre jargon. We can't discuss the relative potency's of different SSRI's because they all have their own different binding affinities at the various 5-ht receptor sites. SSRI's are not like benzos or opiods which all have basically the same effect just with a varying potency. SSRI's are an entirely different beast. You can not say "SSRI X is more potent than SSRI Y" they have a different profile.

The notable exception being Citalopram and Escitalopram in which essentially half of Citalopram is Escitalopram and the other half is R- Citalopram. Escitalopram is not a cleaner drug than Citalpram; they are both essentially equal when it comes to their binding affinities.


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## jonny neurotic (Jan 20, 2011)

My thoughts? 

Give me methamphetamine over either of them any day.


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## RockiNToM (Jun 15, 2009)

istayhome said:


> This is very bizarre jargon. We can't discuss the relative potency's of different SSRI's because they all have their own different binding affinities at the various 5-ht receptor sites. SSRI's are not like benzos or opiods which all have basically the same effect just with a varying potency. SSRI's are an entirely different beast. You can not say "SSRI X is more potent than SSRI Y" they have a different profile.
> 
> The notable exception being Citalopram and Escitalopram in which essentially half of Citalopram is Escitalopram and the other half is R- Citalopram. Escitalopram is not a cleaner drug than Citalpram; they are both essentially equal when it comes to their binding affinities.


I know the difference of Celexa and Lexapro thanks.

And yes, they do have various strengths or potency at certain receptor sites. Like I said, Zoloft 50mg will be about the same strength as 10mg of Lexapro, but 10mg Celexa will be weaker than both. I've tried them all and I know the difference. And I never said they were like Benzos or Opiates...


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## istayhome (Apr 4, 2012)

RockiNToM said:


> I know the difference of Celexa and Lexapro thanks.
> 
> And yes, *they do have various strengths or potency at certain receptor sites*. Like I said, Zoloft 50mg will be about the same strength as 10mg of Lexapro, but 10mg Celexa will be weaker than both. I've tried them all and I know the difference. And I never said they were like Benzos or Opiates...


you're welcome :boogie

I too have had the pleasure of trying them all... like pokemon...

They have different binding _affinities_ at various receptor sites. Meaning that different SSRI's can have very different effects. Not just that a low dose of Celexa is 10 mg while a low dose of Zoloft is 50 mg. You can not say that Celexa is weaker/stronger than zoloft because they have _different_ effects. A given individual might respond better to Celexa (which you say is relatively weak) than they would to a comparable dose of Zoloft (which you say is relatively strong) This is because they are _Selective_ Serotonin Reuptake Inhibitors. Selective being the key word there. The different SSRI's have been designed to selectively affect different 5-ht receptor sites. Again, you can not simply say one is stronger than the other because they have different effects.

Once again the exception being the whole Citalopram/Escitalopram which are both essentially the same drug with Escitalpram being more potent than Citalopram. That doesn't even matter though because you can just take twice as much Citalopram as you would Escitalopram and both would likely provide the same results.


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## RockiNToM (Jun 15, 2009)

istayhome said:


> you're welcome :boogie
> 
> I too have had the pleasure of trying them all... like pokemon...
> 
> ...


Look, I really can't be bothered to get in a debate over the differences of something being Selective (which I already knew) and having different affinities at certain receptors. You said so yourself that Lexapro is more potent than Citalopram - that's all I was trying to say. Instead, you made it your mission to actively pick holes in what I said - for what purpose? I don't know. Just look at the other thread where it asks about addiction in the title, yet you singled me out and claimed it didn't...

Can't be bothered arguing with you. I grew out of arguing on message boards with little boys a long time ago.


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## istayhome (Apr 4, 2012)

RockiNToM said:


> Look, I really can't be bothered to get in a debate over the differences of something being Selective (which I already knew)


Again, I commend you on your knowledge! :clap I'm sorry that you can't be bothered to discuss the misinformation that you post in a reasonable manner, you must have a very busy and important life.



RockiNToM said:


> and having different affinities at certain receptors. *You said so yourself that Lexapro is more potent than Citalopram - that's all I was trying to say*. Instead, you made it your mission to actively pick holes in what I said - for what purpose? I don't know. Just look at the other thread where it asks about addiction in the title, yet you singled me out and claimed it didn't...
> 
> Can't be bothered arguing with you. I grew out of arguing on message boards with little boys a long time ago.


I am merely asking questions about the ideas you have posted, Much of what you said I think is very incorrect so It is reasonable to discuss the accuracy of your claims. I'm sorry you see it as a personal attack and believe that the only why to appropriate and intelligent conversation is to argue.

Also if you read both of my posts I discussed to death the fact the Citalopram and Escitalopram are the ONLY SSRI's for which it is even reasonable to directly discuss relative potency of the two. If you would kinfly remember, you stated that "zoloft and paxil are stronger than equivalent doses of celexa." I'll say again that this can not possibly be said because all three drugs work quite _differently._ You seem to suggests that if celexa doesn't help any given person, hey take Lexapro, it's "stronger," hey if that doesn't work then take Paxil, it's even "stronger," and if that doesn't work well then take Zoloft, it's even "stronger."

We can all agree that that is not how SSRI's work.

Again, I am unsure as to why you feel personally attacked by this conversation and I apologize that you feel so negatively towards discussion. Maybe it is you're admitted history of spending much time "arguing on forums." I personally avoid arguments, especially on internet forums because logical conversation always prevails over being a loud screamer 

Also I'll have you know that despite my own wishes I am far from being a "little boy," so don't get any ideas buddy. :blank


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## RockiNToM (Jun 15, 2009)

istayhome said:


> Again, I commend you on your knowledge! :clap I'm sorry that you can't be bothered to discuss the misinformation that you post in a reasonable manner, you must have a very busy and important life.
> 
> I am merely asking questions about the ideas you have posted, Much of what you said I think is very incorrect so It is reasonable to discuss the accuracy of your claims. I'm sorry you see it as a personal attack and believe that the only why to appropriate and intelligent conversation is to argue.
> 
> ...


I have no hard feelings about this, I'm just not in the mood for debating due to a lot of reasons, many of which prevent me from more than just not being able to debate, but that's another topic.

Maybe I was unclear about what I meant. I wasn't saying to take a different SSRI because one is stronger than the other. I was trying to say that Celexa and Lexapro both give different results. Lexapro gives very little side-effects in my experience (since it's the cleaner drug) but if a person was to switch from 40mg of Celexa they might need to go up a dose higher than 10mg of Lexapro to get the same therapeutic effect, that's all I was getting at - that's why there are vary doses for each drug in the first place. In practice, most physicians try to put you on a similar therapeutic level in terms of efficacy on the new drug by modifying the doses. I was merely suggesting equivalency from experience.

I have no intention to argue and get into all the 'jargon' as you call it, about how these drugs work. I am well versed on how they work, so I don't need someone to explain to me in simple terms how they work. I've used them for a number of years, and for my own personal reasons have had to research into how each of them work. Like I said, it's not that I don't know how they work - it's that I really can't be bothered to get into a debate about how each of them work to prove to you that I do know what they do. More or less, most people here have a grasp on what each of them do, and if you've been on a few, you tend to become more knowledgeable on what they do, so you don't need to try and educate me.

I'm going to leave it here, because otherwise it's just going to go on and on, and yes I do have far more important things in my life than to debate this. I'm glad you realise this.


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## istayhome (Apr 4, 2012)

RockiNToM said:


> I have no hard feelings about this, I'm just not in the mood for debating due to a lot of reasons, many of which prevent me from more than just not being able to debate, but that's another topic.
> 
> Maybe I was unclear about what I meant. I wasn't saying to take a different SSRI because one is stronger than the other. I was trying to say that Celexa and Lexapro both give different results. Lexapro gives very little side-effects in my experience (since it's the cleaner drug) but if a person was to switch from 40mg of Celexa they might need to go up a dose higher than 10mg of Lexapro to get the same therapeutic effect, that's all I was getting at - that's why there are vary doses for each drug in the first place. In practice, most physicians try to put you on a similar therapeutic level in terms of efficacy on the new drug by modifying the doses. I was merely suggesting equivalency from experience.
> 
> ...


Again, not even about a debate. (Of which you should know I am a Master-debater <---haha get it?)

I've been on SSRI's, you've been on SSRI's, we've all been on SSRI's. For the sake of the original poster and those who are reading I would like to dispel your misinformation which you so stubbornly hold onto for some reason. Why? You say yourself how you have more important things to do, can't be bothered, aren't in the mood and are well educated in the matter. Oh well enough about you.

Having been on both myself and noting that they are exactly the same I hadn't researched much how the R-enantiomer and S-enantiomer differ. Guess what, the R-enantiomer has not been shown to do anything.

http://www.cipralex.co.il/sitecontent/ExternalFiles/217.pdf

From the manufacturer's own research, they have not been able to find that R-citalporam does ANYTHING or that there is any difference between the affects of Celexa (Racemic-citalopram) and Lexapro (S-Citalporam).
If not even the manufacturer of Escitalopram can find any difference or benefit of it over good old Celexa, you know that there is no difference.

So Escitalopram is not any "cleaner," than Citalopram. They are exactly the same besides the fact that you must take twice the amount of racemic Citalopram because half of it is R-citalopram which is what? Totally inactive!

Well, RockiNToM I hope you simply were misinformed and not well-researched about these drugs; deliberately spreading misinformation for some reason. Giving you the benefit of the doubt now you know the truth and as they say, knowing is half the battle.

To rawiswaruk: I hope this clears it up for you, Celxa or Lexapro - there is no difference whatsoever in how each drug will affect you.

Escitalopram was clearly put on the market to obtain a new patent and an additional revenue stream.


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## Redefine (Jan 11, 2005)

In other words because Celexa is exactly 50% s-citalopram (Lexapro) and 50% r-citalopram (does nothing) essentially 20mg of citalopram IS 10mg of lexapro. In terms of price however 20mg of Celexa (generic) is much cheaper than 10mg Lexapro. Your doctor is correctly recommending the right thing.


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## rockyraccoon (Dec 13, 2010)

I've been on both and neither worked. I was on Celexa at 80 mg for 3 months and it didn't do anything. I didn't help with my depression, but I also did not get any sexual side effects, which usually plague me. I tried Lexapro but I can't remember the dose. Again I experienced nothing from this drug, nothing positive, nothing negative.


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## yourfavestoner (Jan 14, 2010)

I've never taken Lexapro, but I feel like the guy's have covered this well.

Celexa is a total waste of time. Absolutely 100% a sugar pill. I didn't get any benefit from it nor did I have any sexual side effects or any other side effects.

I guess that makes it better than Paxil and Prozac which also did nothing positive but gave me sexual dysfunction.


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