Celexa vs. Sertraline
See how Celexa and Sertraline compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Celexa reaches its full dose in one titration step, while sertraline usually needs up to three dose increases to reach 200 mg.
Sertraline is FDA-approved for six conditions, including OCD, PTSD, and PMDD, while Celexa is FDA-approved only for major depressive disorder.
Celexa carries a dose-dependent QT prolongation warning that caps its maximum dose, a limit sertraline's label does not have.
Celexa vs. Sertraline Drug Summary
Celexa
Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI) FDA-approved to treat major depressive disorder in adults. It is taken once daily as a tablet or oral solution, starting at 20 mg and moving to a 40 mg maintenance dose after one week.
Sertraline
Sertraline is a selective serotonin reuptake inhibitor (SSRI) FDA-approved for major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It is taken once daily, starting at 50 mg and increasing in steps up to a 200 mg maximum.
Celexa vs. Sertraline Side Effects
Celexa
Sertraline
Celexa vs. Sertraline Dosage
Celexa
Sertraline
| 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 | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 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 |
Sertraline
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Celexa vs. Sertraline Indications
Celexa
Celexa is FDA-approved only for major depressive disorder in adults. Doctors sometimes prescribe it off-label for anxiety-related conditions, though the FDA has not reviewed it for these uses.
Major depressive disorder (FDA-approved)
Generalized anxiety disorder (off-label)
Panic disorder (off-label)
Obsessive-compulsive disorder (off-label)
Sertraline
Sertraline carries FDA approval for six separate conditions, giving doctors more on-label options beyond depression. It is also the only SSRI in this comparison approved for pediatric OCD in children age 6 and older.
Major depressive disorder (FDA-approved)
Obsessive-compulsive disorder (FDA-approved)
Panic disorder (FDA-approved)
Post-traumatic stress disorder (FDA-approved)
Celexa vs. Sertraline Pros and Cons
Celexa
Celexa's simple one-step titration reaches an effective dose in about a week, backed by decades of real-world use. Its main tradeoff is a dose-dependent QT prolongation risk, which caps the dose at 40 mg and limits it further for some patients.
Pros
Reaches its full maintenance dose in one titration step, typically within a week
One of the most widely prescribed SSRIs, with a well-established long-term safety record
Effective at a much lower milligram dose than sertraline (40 mg max vs. 200 mg)
Cons
FDA-approved only for depression, so anxiety, OCD, and PTSD uses are off-label
Carries a dose-dependent QT prolongation warning that caps the dose at 40 mg/day
Capped further at 20 mg/day for people over 60, with liver problems, or certain metabolizer types
Sertraline
Sertraline's broad label lets prescribers use it on-label for depression, OCD, panic disorder, PTSD, social anxiety, and PMDD. Reaching an effective dose usually means several step-by-step increases from 50 mg up to a 200 mg maximum over weeks.
Pros
FDA-approved for six conditions, including OCD, PTSD, panic disorder, and PMDD
Only SSRI here approved for pediatric OCD in children age 6 and older
No dose-dependent QT prolongation warning capping its maximum dose
Cons
Titration takes multiple weekly step-ups to reach an effective dose
Sexual side effects such as ejaculation failure are explicitly listed on the label
Diarrhea affects up to 20% of patients
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