Drugs Q & A

Citalopram vs. Sertraline: Differences, Similarities, Which Is Better?

What is Citalopram?

Citalopram (Celexa) is used to treat depression. It is an antidepressant that belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of a chemical called serotonin in the brain.

Citalopram is used to treat depression but may also be helpful when prescribed “off-label” for obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, social phobia (also known as social anxiety disorder), posttraumatic stress disorder, eating disorders such as binge eating disorder, and premenstrual dysphoric disorder (PMDD). “Off-label” means that it hasn’t been approved by the Food and Drug Administration for this condition. Citalopram is not a controlled substance.

What is Sertraline?

Sertraline is a type of antidepressant sold under the brand name Zoloft among others. Sertraline is a selective serotonin reuptake inhibitor class of medication and affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Sertraline is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). It usually takes 4 to 6 weeks for sertraline to work. Sertraline may also be used for purposes not listed in this medication safety guide.

Sertraline has not been designated as a controlled substance by the Drug Enforcement Administration (DEA). It is not considered to have any serious risk of abuse or addiction.

Similarities between Citalopram and Sertraline

Citalopram and Sertraline are each Food and Drug Administration (FDA) approved to treat major depressive disorders. They also each have some unique indications for use. Sertraline is approved by the FDA in the treatment of social anxiety disorder and obsessive-compulsive disorder (OCD). Both Citalopram and Sertraline are used off-label in generalized anxiety disorder (GAD), panic disorder, and premature ejaculation.

Differences between Citalopram and Sertraline

  • Mechanism of action: Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs) and is available generically as citalopram. Neurotransmitters like serotonin move between neurons via selective pumps. Citalopram blocks the reuptake of serotonin by the pump. By blocking serotonin reuptake by the transport pump, the drug is effectively leaving more free serotonin in the neuron synapse. Higher levels of serotonin are associated with improved mood and energy levels. Sertraline on the other hand also works by blocking the reuptake of only serotonin at the neuronal synapse. Other SSRIs you may be familiar with include Prozac (fluoxetine), and Paxil (paroxetine).
  • Dosage forms: Citalopram is available in an oral tablet formulation in strengths of 10 mg, 20 mg, and 40 mg. It is also available in an oral liquid solution in concentrations of 10 mg/5 ml and 20 mg/5 ml. Sertraline is available as an oral tablet in strengths of 25 mg, 50 mg, and 100mg. It is also available in an oral concentrated solution that is 20 mg/ ml.
  • Side Effects: Citalopram and Sertraline also differ in terms of side effects. Side effects of Citalopram that are different from Sertraline include increased sweating or urination, and cold symptoms such as stuffy nose, sneezing, sore throat, or cough. Side effects of Sertraline that are different from Citalopram include nervousness, skin rash, headache, changes in appetite, and weight loss.
  • Drug interactions: Another area these two drugs differ is the type of medication they interact with. Both Sertraline and Citalopram may interact with other medicines that make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, narcotics, sleeping pills, muscle relaxers, and medicines for seizures or anxiety), nonsteroidal anti-inflammatory drugs (NSAIDs), other antidepressants, lithium, St. John’s wort, tramadol, L-tryptophan, blood thinners, heart rhythm medications, migraine.

Citalopram vs Sertraline which is better?

Studies have shown that Citalopram (Celexa) is better than Sertraline (Zoloft) in the treatment of depression because it provides a quicker relief and improvement from depressive symptoms as compared to Sertraline (Zoloft) even though they are both well tolerated.

The earlier onset of relief as provided by Citalopram can be a significant contributing factor to medication compliance. The delay in symptom relief can be a factor in the early discontinuation of therapy because patients don’t realize a benefit fast enough. Your psychiatry professional will help decide what is right for you.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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