Celexa vs. Remeron
See how Celexa and Remeron compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Celexa is an SSRI often chosen for depression and anxiety, while Remeron's strong sedative effect makes it a common pick when insomnia is also a problem.
Remeron causes drowsiness in more than half of patients, compared to about 18% with Celexa, so the two drugs suit very different daily routines.
Both carry a boxed warning for suicidal thinking in children and young adults and are not approved for use in children.
Celexa vs. Remeron Drug Summary
Celexa
Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder in adults. It's taken once daily as a tablet or oral solution, typically starting at 20 mg and increasing to 40 mg after one week.
Remeron
Remeron (mirtazapine) is a tetracyclic antidepressant approved for major depressive disorder in adults. It's taken once daily, usually at bedtime, starting at 15 mg and titrating up to a maintenance dose of 45 mg.
Celexa vs. Remeron Side Effects
Celexa
Remeron
Celexa vs. Remeron Dosage
Celexa
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 1 |
| Maximum dose | 40 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Celexa
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 1 |
| Maximum dose | 40 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Celexa vs. Remeron Indications
Celexa
Celexa is FDA-approved to treat major depressive disorder in adults. Doctors also prescribe it off-label for generalized anxiety disorder, panic disorder, and OCD, given its predictable dosing and long track record.
Major depressive disorder (MDD) in adults
Off-label: generalized anxiety disorder
Off-label: panic disorder
Off-label: obsessive-compulsive disorder (OCD)
Remeron
Remeron is FDA-approved to treat major depressive disorder in adults. Its sedating and appetite-stimulating effects lead doctors to prescribe it off-label for insomnia, anxiety, and appetite loss in cancer or elderly patients.
Major depressive disorder (MDD) in adults
Off-label: insomnia
Off-label: anxiety disorders
Off-label: appetite stimulation
Celexa vs. Remeron Pros and Cons
Celexa
Celexa has a long safety record as one of the most widely prescribed SSRIs, with less sedation than Remeron for people who need to stay alert during the day. Its main clinical caution is dose-dependent QT prolongation, which caps the dose at 40 mg and lowers it further in older adults.
Pros
Long-established safety record as a widely used SSRI
Lower sedation, easier to take during the day
Available as tablet or oral solution for flexible dosing
Simple two-step titration schedule
Cons
Dose capped at 40 mg/day due to QT prolongation risk
Lower starting dose required in patients over 60
Not particularly helpful for insomnia or low appetite
Can cause insomnia and increased sweating in some patients
Remeron
Remeron's strong sedative and appetite-stimulating effects make it useful for depressed patients who also have insomnia or poor appetite. The tradeoff is significant weight gain and daytime drowsiness, plus a rare risk of severe neutropenia that requires monitoring.
Pros
Strong sedative effect can improve sleep quickly
Stimulates appetite, useful for underweight patients
Available as an orally disintegrating tablet (SolTab)
Sedation often lessens as the dose is increased
Cons
Significant weight gain is common with long-term use
More than half of patients experience daytime drowsiness
Rare but serious risk of severe neutropenia/agranulocytosis
Not ideal for patients needing daytime alertness
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.