Switching From Celexa® to Lexapro®: A Guide

Every year, tens of millions of American adults are affected by mental health conditions such as major depression and anxiety disorders. Many of these people depend on antidepressants, like Celexa®, to manage their symptoms.

However, not all antidepressants are effective for every person. If you’re prescribed Celexa and find that it doesn’t produce improvements in your symptoms of depression or anxiety, or if you’re prone to side effects, your healthcare provider may suggest switching to Lexapro®.

Celexa and Lexapro are both widely-used antidepressants, and switching is generally a simple, stress-free process. However, there are a few things that you should be aware of before making the switch, including potential side effects, interactions and withdrawal symptoms.

Below, we’ve explained what Celexa and Lexapro are, as well as how they work to treat clinical depression, anxiety disorders and related conditions. 

We’ve also covered everything you need to know about switching from Celexa to Lexapro, from gradually tapering your dosage to avoiding antidepressant medication withdrawal symptoms.

Celexa is an antidepressant that contains the active ingredient citalopram. It belongs to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.

SSRIs like Celexa work by increasing the amount of serotonin — a natural chemical referred to as a neurotransmitter — that’s active in your brain and throughout your body.

Serotonin helps to regulate your moods and promote mental stability. It’s involved in managing feelings of anxiety and happiness, as well as allowing you to stay emotionally stable, calm and focused.

Low levels of serotonin are linked to several mood and emotional disorders, including anxiety, obsessive-compulsive disorder (OCD) and major depressive disorders (MDD). 

By increasing serotonin levels, Celexa and other SSRIs may help to reduce the severity of the symptoms of depression. 

Celexa is a prescription medication. It was first approved by the FDA in 1998, and is currently approved as a treatment for major depressive disorder (MDD). It’s also used off-label to treat the following conditions:

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Obsessive-compulsive disorder

• Premenstrual dysphoric disorder (PMDD)

• Post-traumatic stress disorder (PTSD)

• Separation anxiety disorder

• Binge eating disorder

• Panic disorder

We offer citalopram online as part of our range of depression and anxiety medications, following a consultation with a psychiatry provider who will determine if a prescription is appropriate.

Lexapro is also an antidepressant. Like Celexa, it’s an SSRI that works by increasing serotonin levels and reducing the severity of depression symptoms.

The active ingredient in Lexapro is escitalopram. You may have noticed that this sounds similar to the citalopram in Celexa. This is because citalopram is composed of two enantiomers (mirror-image forms of the same molecule): R-citalopram and S-citalopram.

Escitalopram, on the other hand, contains S-citalopram, without the R-citalopram that’s found in generic citalopram and Celexa.

Lexapro is currently approved by the FDA as a treatment for major depression and generalized anxiety disorder. It’s also used off label to treat the following conditions: 

• Social anxiety disorder

• Obsessive-compulsive disorder

• Post-traumatic stress disorder

• Premenstrual dysphoric disorder

• Menopause symptoms

• Panic disorder

We offer escitalopram online as part of our range of medications for depression and anxiety. You can also learn more about how Lexapro and generic escitalopram work in our complete guide to Lexapro. And if you need more information on the difference between Celexa vs Lexapro, we have a guide for you, too.

Switching antidepressants is a common, normal part of treating depression. In fact, it’s common for people with depression to try several antidepressants before finding a medication that works well while providing tolerable side effects.

There are several reasons why your healthcare provider may suggest switching from Celexa to Lexapro, including the following:

• You have side effects from Celexa. Celexa and Lexapro can both produce side effects, but the specific side effects caused by each medication — as well as their frequency and severity — can differ from person to person.
  Your healthcare provider may suggest switching medications if Celexa causes severe or persistent side effects.
  

• Celexa doesn’t treat your depression or anxiety symptoms. Antidepressants tend to be effective, but not every medication works for every person. Sometimes, you may find that one antidepressant is better suited to your needs than another.
  Your healthcare provider may recommend switching medications if Celexa doesn’t seem to help with your symptoms, even after you’ve used it for several weeks.
  

• You have a condition that Celexa isn’t approved to treat. Celexa is approved by the FDA as a treatment for major depressive disorder. It has not been approved to treat any forms of anxiety, even though it’s commonly used for these conditions off-label.
  Your healthcare might suggest changing from Celexa to another medication if you have an anxiety disorder that’s better treated by a different type of drug. 

Because Celexa and Lexapro are both SSRIs with similar half-lives, switching medications isn’t a complicated process. 

Most of the time, switching from Celexa to Lexapro involves gradually tapering your dosage of Celexa, then beginning treatment with Lexapro at a low to moderate dosage. Your healthcare provider may adjust your dosage of Lexapro over time based on your symptoms and needs. 

Gradually decreasing your dosage of Celexa can help to reduce your risk of experiencing side effects while switching antidepressants. 

It can also reduce your risk of developing antidepressant discontinuation syndrome — a variety of issues, including flu-like symptoms, insomnia, nausea, balance issues, sensory disturbances and hyperarousal — that can occur when you abruptly stop taking an antidepressant.

Make sure to closely follow your healthcare provider’s instructions while switching medications, and let them know if you notice any side effects or withdrawal symptoms.

As SSRIs, Celexa and Lexapro are less likely to cause side effects and drug interactions than older classes of antidepressants, such as monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).

However, Celexa and Lexapro can both potentially cause adverse effects, including some that may be bothersome or persistent. 

Common side effects of Celexa include:

• Nausea

• Dry mouth

• Insomnia

• Somnolence (drowsiness)

• Diarrhea

• Tremor

• Dyspepsia (indigestion)

• Increased sweating

• Fatigue

• Rhinitis (nasal congestion)

• Anxiety

• Anorexia

Celexa can also cause sexual side effects, including a reduced sex drive and difficulty reaching orgasm. In men, Celexa may cause erectile dysfunction and ejaculation issues.

Common side effects of Lexapro include:

• Fatigue

• Increased sweating

• Insomnia

• Nausea

• Somnolence (drowsiness)

Like Celexa, Lexapro may affect your sexual function and contribute to a weak sex drive, issues related to orgasm and other side effects that affect your sexual health.

It’s important to inform your healthcare provider if you develop side effects while taking Celexa or Lexapro. They may suggest adjusting your dosage, using your medication at a different time of day or making other changes to reduce the severity of your side effects. 

Celexa and Lexapro can potentially interact with other medications and supplements, including common prescription medications for mental health and pain. 

When Celexa or Lexapro are used with other medications that also increase levels of serotonin, they may cause a potentially serious interaction called serotonin syndrome.

Serotonin syndrome occurs when your serotonin levels are too high. It can cause a large range of symptoms, including the following:

• Hypertension (high blood pressure)

• Tachycardia (rapid heart rate)

• Elevated body temperature

• Dilated pupils

• Excessive sweating

• Shivering

• Tremors

• Involuntary muscle jerking

• Overly responsive reflexes

• Hyperactive bowel sounds

• Uncontrolled eye movement

• Increased alertness

• Pressured speech

When severe, serotonin syndrome can cause life-threatening issues, including temperatures in excess of 106°F, delirium, seizures, increased muscle rigidity, renal failure, respiratory distress, blood clots, coma and even death.

Medications and supplements that may cause serotonin syndrome when used with Celexa or Lexapro include:

• Tricyclic antidepressants

• Monoamine oxidase inhibitors

• Other medications for depression

• Tramadol, fentanyl and other opioid painkillers

• Buspirone and other anxiety medications

• Amphetamines

• Tryptophan

• Lithium

• St John’s wort

Celexa and Lexapro may also interact with other medications, including medications that affect hemostasis and CYP2C19 inhibitors.

To reduce your risk of experiencing serotonin syndrome or other drug interactions, it’s important to inform your healthcare provider about any medications and supplements you currently use or have used in the past 14 days.

If you notice any early signs of serotonin syndrome or have any other concerns while switching from Celexa to Lexapro, let your healthcare provider know as soon as you can. 

To learn about a different kind of potential interaction, read our blog on Celexa and alcohol.

Switching from Celexa to Lexapro is usually a straightforward process, although it’s important to closely follow your mental health provider’s instructions and let them know if you notice any side effects or withdrawal symptoms.

Your healthcare provider will likely instruct you to taper your dosage of Celexa, then start taking Lexapro at a low to moderate dosage. Over time, you may be instructed to adjust your Lexapro dosage based on your symptoms and needs.

It’s normal to change antidepressants. In addition to Celexa and Lexapro, other medications are also prescribed to treat depression, including some that may be more effective for certain forms of depressive illness. 

Interested in taking action to treat depression? We offer a range of medications for depression and anxiety online following a consultation with a psychiatry provider, including citalopram (the active ingredient in Celexa) and generic escitalopram (Lexapro).

We also offer a complete range of online mental health services, including online therapy and anonymous support groups. 

Finally, you can learn more about dealing with depression, anxiety disorders, stress and other common mental health concerns using our free mental health resources and content.