Celexa (citalopram) and Lexapro (escitalopram) are closely related antidepressants in the selective serotonin reuptake inhibitor (SSRI) class. Lexapro is made from the active form of citalopram, the medicine in Celexa, so the two work the same way. The main differences are their approved uses, typical doses, and how strongly their labels warn about heart rhythm changes at higher doses. If you’ve been prescribed one and are wondering how it compares, this guide walks through what each label says and what research shows.
Key takeaways
- Both medicines are SSRIs, and a large analysis of 522 trials found both were among the better-tolerated antidepressants for adults with depression.
- Lexapro is FDA-approved for depression and generalized anxiety disorder, while Celexa is approved for depression in adults.
- Never switch between them, change your dose, or stop on your own, since that decision belongs with your prescriber.
What are Celexa and Lexapro?
Both are prescription antidepressants that increase the activity of serotonin, a chemical messenger in the brain, by blocking its reabsorption. SSRIs as a class include several other common medicines, such as sertraline and fluoxetine.
Here’s how the two relate:
- Celexa is the brand name for citalopram, which is a mix of two mirror-image forms of the same molecule.
- Lexapro is the brand name for escitalopram. Its label describes it as the pure S-enantiomer, a single, active form of the citalopram molecule.
Because they’re so closely related, you shouldn’t take them together. The Lexapro label lists a known allergy to either escitalopram or citalopram as a reason not to use it.
Celexa vs. Lexapro: side-by-side comparison
The clearest differences show up in the official prescribing information for each medicine.
- FDA-approved uses: Celexa is approved to treat major depressive disorder in adults. Lexapro is approved for major depressive disorder in adults and adolescents 12 and older, and for generalized anxiety disorder in adults and children 7 and older.
- Usual starting dose: Celexa usually starts at 20 mg once daily. Lexapro usually starts at 10 mg once daily.
- Maximum dose: Celexa’s maximum is 40 mg a day, or 20 mg for some people. Lexapro’s maximum is 20 mg a day.
- Tablet strengths: Celexa comes in 10, 20, and 40 mg tablets. Lexapro comes in 5, 10, and 20 mg tablets.
- Heart rhythm warning: Celexa’s label includes a detailed warning about dose-related QT prolongation. Lexapro’s label lists QT prolongation among reports received after approval.
Both are taken once a day, with or without food, and both carry the same boxed warning about suicidal thoughts in young people.
Is Lexapro stronger than Celexa?
Lexapro isn’t “stronger” in the sense that matters to patients. Its milligram doses are lower because it contains only the active form of the molecule, so the numbers on the two labels can’t be compared directly.
Research comparing effectiveness has found some differences. A network meta-analysis of 522 trials involving about 116,000 adults found that all 21 antidepressants studied worked better than placebo for depression. In head-to-head trials, escitalopram was among the more effective options, and both citalopram and escitalopram were among the better tolerated, meaning fewer people stopped taking them.
An earlier systematic review of escitalopram found it was more effective than citalopram for early response and remission in depression. These results describe averages across many people. How you respond to either medicine depends on your symptoms, health history, and other factors your prescriber weighs.
Dosing and heart rhythm safety
The biggest safety difference involves the heart’s electrical rhythm. Citalopram can lengthen the QT interval, a measurement on an electrocardiogram (ECG), and this effect increases with dose.
In 2012, the FDA revised its recommendations for citalopram after studies showed a dose-related risk of abnormal heart rhythms:
- Doses above 40 mg a day are not recommended, and studies found no added benefit for depression above that dose.
- The maximum is 20 mg a day for people over 60, people with liver problems, people whose bodies process the drug slowly (CYP2C19 poor metabolizers), and people taking cimetidine or certain other medicines.
- Citalopram is not recommended for people with certain heart conditions, such as congenital long QT syndrome, a slow heart rate, a recent heart attack, or uncompensated heart failure, or with low potassium or magnesium levels.
For Lexapro, the usual dose for older adults and people with liver problems is 10 mg a day. Some other medicines can also affect heart rhythm or interact with SSRIs, so tell your prescriber and pharmacist about everything you take.
Side effects of Celexa and Lexapro
Because they’re so similar, Celexa and Lexapro share most of the same side effects. Common SSRI side effects include upset stomach, sleep changes, sexual problems, and appetite changes.
According to their labels, the most common side effects include:
- Celexa: nausea, sleepiness, dry mouth, trouble sleeping, and delayed ejaculation
- Lexapro: trouble sleeping, nausea, sweating, fatigue, sleepiness, and sexual side effects such as delayed ejaculation or decreased sex drive
Less common but serious risks for both include serotonin syndrome (a reaction from too much serotonin, with symptoms such as confusion, fever, fast heart rate, or stiff muscles), higher bleeding risk when combined with NSAIDs or blood thinners, and the boxed warning about suicidal thoughts. That warning applies to children, adolescents, and young adults, and the FDA advises close monitoring for worsening symptoms or unusual behavior changes, especially early in treatment.
Neither medicine should be taken with monoamine oxidase inhibitors (MAOIs) or pimozide.
Can you switch from Celexa to Lexapro?
Switching between these medicines is a decision for your prescriber, not something to do on your own. Because their doses aren’t the same milligram for milligram, a provider needs to choose the right dose and timing.
Several factors usually guide the choice of an antidepressant:
- Your symptoms, including whether anxiety is a main concern
- Side effects you’ve had or want to avoid
- How well a medicine worked for you or a close relative in the past
- Other medicines and health conditions, including heart rhythm problems
- Pregnancy or breastfeeding
- Cost and insurance coverage
Both medicines take time to reach full effect. Antidepressants usually take 4 to 8 weeks to work, and sleep, appetite, and energy often improve before mood does.
Don’t stop suddenly
Both labels recommend lowering the dose gradually rather than stopping abruptly. Stopping escitalopram or citalopram suddenly can cause withdrawal symptoms such as mood changes, irritability, dizziness, nausea, anxiety, and trouble sleeping, so talk with your prescriber before making any change. Our article on staying consistent with escitalopram explains why steady use matters for long-term recovery.
Refilling Celexa or Lexapro online
If you’re stable on citalopram or escitalopram and about to run out before you can see your regular provider, an online refill can help you avoid a gap. A board-certified physician can review your refill request without an appointment and send it to your pharmacy. See our escitalopram medication page for more on that medicine.
A refill service continues a medicine that’s already working for you. It doesn’t start new medicines, switch you between Celexa and Lexapro, or change your dose. If your symptoms have changed or you’re thinking about switching, a virtual primary care visit is the better route. Keep up with regular follow-up care with your own provider, too.
When to seek medical attention
Contact your prescriber if your depression or anxiety gets worse, you notice unusual changes in mood or behavior, or side effects are hard to manage. Seek care right away for a fast or irregular heartbeat, fainting, dizziness, or shortness of breath, or for signs of serotonin syndrome such as confusion, fever, or muscle stiffness.
This is not an emergency service. In an emergency, call 911 or go to the nearest emergency room. If you’re having thoughts of suicide or are in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day.
Frequently asked questions
Is escitalopram the same as citalopram?
Not exactly. Escitalopram is the active form of citalopram, separated out on its own. They work the same way, but doses differ, and they shouldn’t be taken together.
Is Lexapro or Celexa better for anxiety?
Lexapro is FDA-approved for generalized anxiety disorder, while Celexa’s label covers depression in adults. Our page on anxiety covers ongoing treatment and refills. Your prescriber can explain which fits your situation based on your symptoms and history.
Does Celexa cause more heart problems than Lexapro?
Celexa’s label has a detailed warning about dose-related QT prolongation, and the FDA limited its maximum dose for that reason. Lexapro’s label lists QT prolongation among post-approval reports. Your prescriber may check an ECG if you have heart risk factors.
Can I get Celexa or Lexapro refilled online?
Yes, if you’re already stable on the medicine and a physician determines a refill is appropriate after reviewing your request. A refill continues your current dose and doesn’t replace ongoing care with your own provider.
How long do Celexa and Lexapro take to work?
Antidepressants usually take 4 to 8 weeks to work, and some symptoms may improve before others. Keep taking your medicine as prescribed while you wait, and talk with your prescriber if you don’t see improvement.
Get your prescription refill
If you’re stable on citalopram or escitalopram and can’t get a timely appointment, My Med Refills can help. Complete a short online form, and a board-certified physician will review your request, typically within a few hours. If approved, your prescription is sent to your preferred pharmacy. Get your prescription refill; current pricing is shown on the booking page.
Sources
- U.S. National Library of Medicine, DailyMed. Revised October 2023. CELEXA (citalopram) tablets, prescribing information. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4259d9b1-de34-43a4-85a8-41dd214e9177
- U.S. National Library of Medicine, DailyMed. Revised October 2023. LEXAPRO (escitalopram) tablets, prescribing information. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13bb8267-1cab-43e5-acae-55a4d957630a
- U.S. Food and Drug Administration. Published March 28, 2012. FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-revised-recommendations-celexa-citalopram-hydrobromide-related
- U.S. Food and Drug Administration. Accessed October 24, 2026. Suicidality in Children and Adolescents Being Treated With Antidepressant Medications. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/suicidality-children-and-adolescents-being-treated-antidepressant-medications
- Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357-1366. doi:10.1016/S0140-6736(17)32802-7. https://doi.org/10.1016/S0140-6736(17)32802-7
- Cipriani A, Santilli C, Furukawa TA, et al. Escitalopram versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2009. doi:10.1002/14651858.CD006532.pub2. https://doi.org/10.1002/14651858.CD006532.pub2
- Cleveland Clinic. Last reviewed September 26, 2025. Selective Serotonin Reuptake Inhibitors: Uses & Side Effects. https://my.clevelandclinic.org/health/treatments/24795-ssri
- Mayo Clinic. Accessed October 24, 2026. Selective serotonin reuptake inhibitors (SSRIs). https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
- Mayo Clinic. Accessed October 24, 2026. Antidepressants: Selecting one that’s right for you. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
- MedlinePlus, U.S. National Library of Medicine. Revised October 15, 2025. Escitalopram. https://medlineplus.gov/druginfo/meds/a603005.html
- MedlinePlus, U.S. National Library of Medicine. Revised November 15, 2025. Citalopram. https://medlineplus.gov/druginfo/meds/a699001.html
- National Institute of Mental Health. Last reviewed December 2023. Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
- 988 Suicide & Crisis Lifeline. Accessed October 24, 2026. 988 Suicide & Crisis Lifeline. https://988lifeline.org/
This article is for informational purposes only and is not a substitute for professional medical advice.
This is not an emergency service. In an emergency, call 911 or go to the nearest emergency room.