Lexapro vs. Celexa

See how Lexapro and Celexa compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lexapro and Celexa are both SSRIs, but Lexapro has FDA approval for adolescent depression and generalized anxiety disorder, while Celexa is approved only for adult depression.

  • Celexa carries a boxed warning for dose-dependent QT prolongation and caps its maximum dose at 40 mg daily, a risk profile Lexapro's labeling doesn't share.

  • Celexa typically costs less than Lexapro without insurance, though both are available as low-cost generics.

Lexapro vs. Celexa Drug Summary

Lexapro

Lexapro (escitalopram) is an SSRI antidepressant FDA-approved to treat major depressive disorder in adults and adolescents ages 12-17, and generalized anxiety disorder in adults. It's taken as a tablet or oral solution once daily, usually starting at 10 mg.

Celexa

Celexa (citalopram) is an SSRI antidepressant FDA-approved to treat major depressive disorder in adults. It's taken once daily as a tablet or oral solution, starting at 20 mg for one week before increasing to a 40 mg maintenance dose.

Lexapro vs. Celexa Side Effects

Lexapro

Most common
nausea (up to 15%)
insomnia (up to 9%)
somnolence (up to 6%)
increased sweating (up to 5%)

Celexa

Most common
nausea (up to 21%)
insomnia (up to 15%)
somnolence (up to 18%)
increased sweating (up to 11%)

Lexapro vs. Celexa Dosage

Lexapro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily Week 1
Maximum dose 20 mg once daily Week 2 onward
Dose changes 1 increase Every week

Celexa

Dosage
Dosage Table
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

Lexapro vs. Celexa Indications

Lexapro

Lexapro is FDA-approved to treat major depressive disorder in adults and adolescents ages 12 to 17, as well as generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety disorders in pediatric patients.

  • Major depressive disorder in adults

  • Major depressive disorder in adolescents (12-17 years)

  • Generalized anxiety disorder in adults

Celexa

Celexa is FDA-approved only for major depressive disorder in adults. It is frequently prescribed off-label for generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, though these uses aren't part of its FDA labeling.

  • Major depressive disorder in adults

  • Off-label: generalized anxiety disorder

  • Off-label: panic disorder

Lexapro vs. Celexa Pros and Cons

Lexapro

Lexapro is FDA-approved for both major depression and generalized anxiety disorder, including use in adolescents, giving it a broader label than Celexa. It carries a higher typical list price and, like other SSRIs, can cause sexual side effects in some patients.

Pros

  • FDA-approved for depression in adolescents ages 12-17, not just adults

  • FDA-approved for generalized anxiety disorder, an on-label option Celexa lacks

  • No dose-dependent QT-prolongation warning, unlike Celexa's boxed caution

  • Simple once-daily maintenance dosing without a separate titration week

Cons

  • Costs roughly $440 to $603 per month without insurance, more than Celexa's typical range

  • Sexual side effects, including ejaculation disorder, reported in up to 9% of men

  • Fewer years of real-world prescribing history than citalopram, used since 1998

Celexa

Celexa is FDA-approved only for major depression in adults, though it's widely prescribed off-label for anxiety-spectrum conditions. It carries a distinct boxed warning for dose-dependent heart rhythm changes and is generally the less expensive option.

Pros

  • Typically costs $15 to $300 per month without insurance, often less than Lexapro

  • Long, well-established safety record as one of the most prescribed SSRIs since 1998

  • Widely available as a low-cost generic, easing access for many patients

  • Off-label use is common and well-documented for anxiety, panic, and OCD

Cons

  • Boxed warning for dose-dependent QT prolongation and sudden death risk, not shared by Lexapro's label

  • Maximum dose capped at 40 mg/day, and just 20 mg/day for people over 60 or poor metabolizers

  • Not FDA-approved for anxiety disorders, adolescents, or any pediatric use

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