Prozac vs. Celexa

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Prozac and Celexa are two of the most common medications used to treat anxiety and depression. Although these medications are similar, there are key differences between the two that should be considered before starting a new medication. 

In this article, we will give a full comparison guide of Prozac and Celexa so that you can have a more informed discussion with a healthcare provider about which medication is right for you. 

When searching for the right medication for you, always consult with a medical professional to discuss your symptoms, potential side effects, and contraindications with other drugs. If you need an affordable, reliable healthcare provider, Klarity can help. We’ll connect you with a licensed provider in your state for online depression or anxiety treatment.

When you work with a provider on Klarity, you can receive an evaluation, diagnosis, and treatment for your symptoms, if applicable, in just 48 hours. Your provider can also help you determine if Prozac, Celexa, or another form of medication is right for you, and send any prescriptions directly to your local pharmacy. To finally experience relief from your symptoms, schedule an appointment today

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately by dialing 988.

CelexaProzac
Drug ClassSelective serotonin reuptake inhibitor (SSRI)Selective serotonin reuptake inhibitor (SSRI)
Brand / Generic StatusBrand name for citalopramBrand name fluoxetine
Form(s) of the Drug• Oval capsules
• Round tablets
• Clear, peppermint-flavored liquid suspension
• Clear, peppermint-flavored liquid suspension
• Half-green, half-white capsules
Standard DosageCapsules:
• 30mg dose

Tablets:
• 10 mg
• 20 mg
• 40 mg

Liquid suspension:
• 10mg of citalopram per dose

Liquid suspension:
• 10mg per dose

Capsules:
• 10mg per dose
Conditions TreatedFDA-approved uses:
• Major depressive disorder (MDD)

Off-label uses:
• Obsessive-compulsive disorder (OCD)
• Binge eating disorder
• Alcohol use disorder
• Generalized anxiety disorder
• Panic disorder or PTSD
• Premenstrual dysphoric disorder
• Postmenopausal flushing
• Premature ejaculation
FDA-approved uses:
• Anxiety and stress
• Major depression
• Bulimia nervosa
• Premenstrual dysphoric disorder (PMDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Postpartum depression
• Schizoaffective disorder

Off-label uses:
• Anorexia nervosa
• Premature ejaculation
• Various anxiety disorders
CostBrand-name:
• $4 for 30-day supply*

*With coupon codes or insurance
Generic form (fluoxetine):
• $3 to $4 for 30-days’ worth of capsules*
• $12 for 30 days’ worth of liquid suspension

*May cost up to $100 for high dosages

Brand-name:
• $460 to $1000 for 30 days’ worth of capsules
Side-EffectsCommon side effects:
• Nausea or GI upset
• Dry mouth
• Changes in appetite
• Drowsiness or fatigue
• Increased sweating
• Blurred vision

Serious side effects:
• Worsening depression
• Suicidal ideation
• Serotonin syndrome
• Rapid heart rate and high blood pressure
• High fever, resulting in increased sweating, shivering, or goosebumps
• Irregular heartbeat or palpitations
• Agitation or restlessness
• Loss of muscle coordination or uncontrollable muscle twitching or rigidity
• Diarrhea
• Headache
• Dilated pupils
• Confusion or altered consciousness

Common side effects:
• Nausea
• Diarrhea or constipation
• Changes in appetite
• Headache and fatigue
• Increased sweating
• Trouble sleeping
• Impotence/sexual dysfunction

Serious side effects include:
• Fever
• High blood pressure
• Rigid muscles
• Seizures
• Kidney or respiratory failure
• Disorientation or delirium
• Serotonin syndrome
Warnings For UseAdverse drug reactions:
• MDMA
• St. John's Wort
• ADHD medications, such as Adderall
• Antipsychotic medications
• Tricyclic antidepressants
• Buspar
• Some migraine medications
• Lithium
• Antiplatelet and anticoagulant medications
• MAOIs
• Drugs that affect heart rhythm

Contraindicated conditions:
• Diabetes
• Liver disease
• Alcohol use disorder
• History of bipolar disorder
• History of suicide attempts
• Low blood sodium or dehydration
• Seizures
• Gastrointestinal ulcers
• Glaucoma

Drug Interactions:
• Monoamine oxidase inhibitors (MAOIs)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Aspirin and other blood thinners
• Antihistamines
• Opioid pain relievers
• St. John’s wort
• Cannabis and MDMA

What is Prozac?

Prozac belongs to the class of medications called selective serotonin reuptake inhibitors (SSRIs), and is one of the most commonly prescribed medications for treating anxiety and depression. SSRIs work by increasing the levels of a neurotransmitter called serotonin. 

Those who suffer from anxiety and depression tend to have lower serotonin levels in the brain, and SSRI medications help restore this neurochemical imbalance.   

Common doses and forms of Prozac

Prozac is available in a few different forms, including an oral solution, tablet, and capsule. The dose is typically started around 20 mg and can then be gradually titrated up weekly. The maximum dose should not exceed 80 mg per day. 

Capsules are available as 

  • 10 mg 
  • 20 mg 
  • 40 mg 
  • 90 mg delayed release 

Tablets are available in the following dosage forms: 

  • 10 mg 
  • 20 mg 
  • 60 mg 

The oral solution is the least commonly prescribed form and is typically reserved for use in the pediatric population. It is available in one strength of 20 mg/5 mL. 

Conditions Prozac treats

Prozac is one of the most effective medications for treating several types of anxiety and depressive disorders. 

Prozac is FDA-approved for: 

  • Major depressive disorder (MDD) 
  • Obsessive-compulsive disorder (OCD) 
  • Eating disorders, such as Bulimia nervosa 
  • Panic disorder 
  • Premenstrual dysphoric disorder (PMDD)

In addition, when used in combination with Zyprexa, Prozac is useful in the treatment of: 

  • Acute depressive disorders in patients with bipolar I disorder 
  • Treatment-resistant depression 

Prozac can treat symptoms of Anxiety and Depression

Prozac has been shown to improve mood and increase energy levels, which are commonly seen in people with depression. In addition, Prozac helps stabilize your mood and reduce feelings of helplessness and hopelessness. 

Prozac is also effective in treating anxiety by decreasing the constant feelings of nervousness, restlessness, or worry. With continued long-term use of this medication, feelings of anxiety associated with social situations and ruminating or intrusive thoughts tend to lessen over time. 

Off-label uses for Prozac

The term “off-label” is used to describe any use of the medication that is not FDA-approved. This does not mean that it is ineffective in treating the following conditions, but it simply has not had dedicated clinical trials with the FDA for the specific use. 

Some off-label uses include 

  • Generalized anxiety disorder 
  • Migraine headaches 
  • Fibromyalgia 
  • Neuropathy or nerve pain caused by long-term diabetes 
  • Premature ejaculation 

Prozac Costs

Prozac is available in name brand and generic form, called fluoxetine. Most commercial health insurance plans typically cover both formularies. Without insurance, a 30-day supply of name-brand Prozac can cost anywhere between $500-1000 a month, depending on the dosage. 

With the use of coupon codes and generic formularies, an average monthly supply costs around $10. Coupon codes are available at all major pharmacies for those who do not have health insurance coverage. 

Prozac Side Effects

As with any medication, there is a possibility of experiencing side effects when starting a new medication. Although serious side effects are rare, it is important to take note of changes in your body and discuss them with your healthcare provider. 

As with most SSRI medications, there are a number of potential mild side effects that may occur when initially starting the medication. These effects tend to lessen with long-term use. 

Some of the most common side effects associated with Prozac include 

  • Difficulty falling asleep or insomnia 
  • Drowsiness or fatigue 
  • Changes in bowel movements, including diarrhea or constipation
  • Changes in appetite
  • Headache 
  • Increased anxiety or nervousness 
  • Tremor 
  • Dry mouth 
  • Sexual dysfunction, including lack of desire and orgasm 

Prozac Warnings

There are a few rare but serious side effects associated with taking Prozac, and therefore, the medication should be taken under close supervision when starting and stopping this medication. It is important to take Prozac as prescribed and to contact your healthcare provider if you begin to experience any of the following serious side effects. 

Suicidal thoughts and behaviors

In young adults under the age of 24, there is a risk that Prozac may worsen your depressive symptoms and may even result in new or increased suicidal ideation or behaviors. 

If you begin to experience thoughts of self-harm, contact your healthcare provider immediately or seek urgent medical care at the nearest ER. The Suicide and Crisis Lifeline is available 24/7 at 988. 

Serotonin Syndrome

Serotonin Syndrome is another rare but potentially fatal health condition that results from an overload of serotonin in the body. This is most commonly seen in people who are taking multiple medications that increase the levels of serotonin. 

Common signs and symptoms of serotonin syndrome include: 

  • Fever
  • High blood pressure
  • Increased heart rate or irregular heartbeat 
  • Agitation or restlessness
  • Diarrhea 
  • Dilated pupils 
  • Muscle spasms, stiffness, or loss of muscle coordination
  • Confusion, or even coma 

Withdrawal or Discontinuation Syndrome

If you are considering discontinuing Prozac, it is important to discuss this with your healthcare provider so that you can be titrated off of the medication and avoid unwanted adverse effects from sudden withdrawal or discontinuation of the medication. 

Common withdrawal symptoms include:

  • Dizziness or vertigo
  • Headache 
  • Fatigue  
  • Tremor or visual disturbances 
  • Nausea, vomiting, diarrhea 
  • Increased anxiety or agitation 
  • Confusion or irritability 
  • Insomnia 

Caution in Use with Elderly Patients

SSRI medications, including Prozac, should be used with caution in the older population due to additional potential health complications, including low blood pressure and electrolyte imbalances, which could result in increased falls.

Prozac drug interactions

SSRI medications are relatively safe medications but are known to have potential interactions with other medications or over-the-counter supplements. Before starting any new medication, it is important to disclose all medications you are taking with your healthcare provider. 

Some common medications to avoid while taking Prozac include: 

  • Monoamines oxidase inhibitors
  • NSAIDs
  • Blood thinning medications, including Warfarin and aspirin
  • Opioids 
  • Anti-nausea medications, including Zofran 
  • Thiazide diuretics 
  • Medications that increase serotonin levels: ADHD medications including Adderall, TCAs, Buspar, antipsychotics, Lithium, migraine medications, over-the-counter supplements such as St. John’s Wort and recreational drugs like MDMA 

What is Celexa?

Similar to Prozac, Celexa is an SSRI medication that works by increasing serotonin levels in the brain. Celexa is commonly prescribed for depression and anxiety. Of note, Celexa is likely not the best treatment option for those who have chronic heart or liver problems. 

Common doses and forms of Celexa

Celexa is available in capsule, tablet, and oral solution forms. The tablet form is most commonly used in the adult population due to the various forms of dosing available. Celexa is typically started at 10 mg by mouth daily and can be titrated up by 10 mg weekly, as needed. 

The maximum dose is 40 mg per day, and in patients over 60 years of age, the maximum dose is 20 mg per day due to cardiac concerns in this population. 

Celexa is available in tablet form in the following doses: 

  • 10 mg 
  • 20 mg 
  • 40 mg 

Celexa capsules are available in 30 mg doses only. 

Like Prozac, the oral solution of Celexa is available in one dose of  10 mg/5 mL and is typically reserved for the pediatric population. 

Conditions Celexa treats

Celexa is used in the treatment of several different depressive and anxiety disorders. The FDA has only formally approved the medication to treat major depressive disorder (MDD), but there are a number of off-label uses for this SSRI medication listed below.  

Celexa can treat symptoms of Anxiety and Depression

Celexa is used to treat depression by improving mood and increasing the patient’s ability to enjoy everyday life activities that they once enjoyed. 

Additionally, Celexa can improve sleep disturbances and improve appetite, as well as calm the thought process, including anxious, restless, or intrusive thoughts associated with various anxiety disorders. 

Off-label uses for Celexa

As previously stated, the term “off-label” is used for any use of a medication that is not FDA approved for the medication. There are a number of “off-label” uses for Celexa, including:

  • Obsessive-Compulsive Disorder (OCD)
  • Binge eating disorder 
  • Alcohol use disorder 
  • Generalized anxiety disorder 
  • Panic disorder or PTSD
  • Premenstrual dysphoric disorder 
  • Postmenopausal flushing 
  • Premature ejaculation 

Celexa Costs

When compared to Prozac, Celexa is less expensive, with the average cost of a 30-day supply being roughly around $300-500 for name-brand Celexa without insurance. But when using a generic formulary and coupon codes, a 30-day supply is affordable at around $4. Most insurance plans typically cover Celexa, and prescription coupon codes are widely available at any major pharmacy. 

Celexa side effects

Prozac and Celexa have similar side effects because they belong to the same class of drugs and have the same mechanism of action on serotonin receptors in the brain. 

Some common side effects seen with Celexa include: 

  • Nausea or GI upset
  • Dry mouth 
  • Changes in appetite 
  • Drowsiness or fatigue 
  • Increased sweating 
  • Blurred vision 

Celexa warnings

As with Prozac, there are a few rare but serious warnings to keep in mind when starting Celexa, including increased incidences of worsening depression and increased suicidal ideation. If you are having thoughts of suicide or self-harm behaviors, contact your healthcare provider immediately or go to the nearest emergency department. 

The national suicide hotline can be reached by dialing 988 and is available 24/7.

Serotonin syndrome is an uncommon but serious condition caused by elevated levels of serotonin in the brain. This is most commonly seen in patients who are taking multiple medications that work by increasing serotonin. 

It is important to contact your healthcare provider or seek medical care if you begin to experience the following side effects: 

  • Rapid heart rate and high blood pressure 
  • High fever, resulting in increased sweating, shivering, or goosebumps 
  • Irregular heartbeat or palpitations 
  • Agitation or restlessness
  • Loss of muscle coordination or uncontrollable muscle twitching or rigidity 
  • Diarrhea 
  • Headache 
  • Dilated pupils 
  • Confusion or altered consciousness

Another important consideration with any SSRI is the potential for withdrawal syndrome. When considering discontinuing or decreasing the dose of your medication, it is important to discuss this plan with your healthcare provider so that they can guide the process and slowly titrate the medication. 

Celexa drug interactions

As with any medication, there are a number of associated drug interactions that may occur. It is important to discuss all current medications you are currently taking, including over-the-counter medications and supplements. 

Some medications that are known to interact with Celexa include 

  • Medications that increase the risk for serotonin syndrome:
    • Recreational drugs like MDMA or ecstasy 
    • St. John’s Wort 
    • ADHD medications, such as Adderall 
    • Antipsychotic medications 
    • Tricyclic antidepressants
    • Buspar 
    • Some migraine medications, including sumatriptan, rizatriptan, tramadol 
    • Lithium 
  • Antiplatelet and anticoagulant medications will increase the risk of bleeding
  • MAO inhibitors include linezolid, metaxalone, and methylene blue, to name a few. These medications should be discontinued two weeks before starting an SSRI.

Licensed providers on Klarity provide personalized treatment. Find a provider that matches your needs and preferences.

Get Anxiety and Depression Treatment with Help From Klarity

If you are struggling with anxiety or depression, medications like Prozac or Celexa could help you find relief from your symptoms. However, you should never attempt to self-medicate your symptoms, and should always speak to a psychiatric professional to receive a safe and effective prescription. 

At Klarity, we help you access quality anxiety or depression treatment right from the comfort of your own home. We’ll connect you with a licensed healthcare provider who will work with you to develop an individualized treatment plan based on your symptoms, including prescription medication like Prozac or Celexa, if necessary. 

Schedule an appointment on Klarity today and be seen by a medical professional for your first private telehealth appointment in as little as 48 hours. 

Frequently Asked Questions About Prozac and Celexa

Does Prozac Make You Gain Weight? Does Celexa?

Nearly all SSRI medications have the potential side effect of causing weight gain, although the actual amount of weight gain is around 1-10 lbs. When comparing Prozac and Celexa, Prozac is less likely to cause weight gain. 

Is Prozac or Celexa Better for Anxiety?

Prozac is FDA-approved for treating anxiety, while Celexa is not, but both medications are equally effective for treating anxiety. Some studies showed that those taking Celexa experienced an improvement in their symptoms faster than those taking Prozac. It is important to remember that everyone reacts to medications differently, and your healthcare provider will help determine which medication is best for you. 

Can I Replace Prozac with Celexa?

Both medications are SSRIs and technically can be interchangeable, but only under the close supervision of your healthcare provider. Since these medications have different dosing, your dose will need to be adjusted when switching to a different medication. 

Is Prozac Energizing or Sedating? What About Celexa?

Prozac is known to be more energizing than most antidepressants, which makes this medication a good choice for someone who experiences low energy levels associated with depression. Celexa is not as energizing but is not sedating when compared to other antidepressants. 

Can I Drink Alcohol On Celexa? On Prozac?

Due to the enhanced effects of alcohol while on an SSRI and the increased risk of side effects, it is generally advised not to drink alcohol while taking either medication. 

Can I Drink Caffeine When I’m on Celexa? How About Prozac?

Drinking caffeine with either Celexa or Prozac is considered to be relatively safe. Remember that caffeine is a drug in itself and causes undesirable side effects when taken in large quantities. 

What Is Better For Depression—Celexa or Prozac?

Celexa and Prozac are known to be well-tolerated and effective medications for the treatment of depression. While they are considered equally effective overall, some studies have shown that those taking Celexa may see improvement in their symptoms sooner than Prozac. 

It’s important to remember everyone reacts to medications differently, and your healthcare provider will help determine which medication is best for you. 

Sources: 

“Citalopram: Drug Information.” UpToDate. https://www.uptodate.com/contents/citalopram-drug-information

“Compare Celexa Vs. Prozac”. Iodine. https://www.iodine.com/compare/celexa-vs-prozac 

“Fluoxetine: Drug Information.” UpToDate. https://www.uptodate.com/contents/fluoxetine-drug-information 

“”Fluoxetine” Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/fluoxetine-oral-route/proper-use/drg-20063952

Karen Berger. “Celexa vs. Prozac: Differences, similarities, and which is better for you”. SingleCare. https://www.singlecare.com/blog/celexa-vs-prozac

Megan Huang. “How much is citalopram without insurance?” Singlecare. https://www.singlecare.com/blog/citalopram-without-insurance

Author

Dr. Zoe Russell

Dr. Zoe Russell received a dual bachelor’s degree in biology and psychology from the University of Michigan-Dearborn, pursued a master’s degree in public health from Michigan State University, and received her doctorate in osteopathic medicine from Michigan State’s College of Osteopathic Medicine in 2021. Currently, Dr. Russell is completing her residency training in family medicine and hopes to specialize in female reproductive and mental health.

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