Lexapro, or escitalopram oxalate, and Celexa, or citalopram hydrobromide, are prescription selective serotonin reuptake inhibitors. Although both medications are licensed to treat depression and have chemical similarities, they are different medications and are not interchangeable.
As of 2010, only Celexa is available as a generic drug. Lexapro, which will not be sold in generic form until after 2012, must be purchased under the brand name until then. Lexapro is a more expensive option than the citalopram, the generic version of Celexa.
Both Lexapro and Celexa contain enantiomers, molecules that are almost identical but are actually opposites. Like right and left hands, enantiomers are mirror images of each other. Celexa is a mixture of ‘R’ and ‘S’ enantiomers, and Lexapro has only the ‘S’ enantiomer.
According to author and doctor of pharmacology Kristi Monson, who oversees drug and supplement information on eMedTV.com, research comparing Lexapro with Celexa suggests that the ‘S’ enantiomer is a more active antidepressant than the ‘R’ enantiomer, which is one reason Lexapro was developed.
History and Patent Status
Celexa was introduced in 1989. When the trade name patent expired in 2003, other manufacturers could produce the generic form of citalopram. Lexapro is the trade name for the generic medication escitalopram, an updated citalopram formula. Lexapro was developed and produced in 2002. The patent is effective until 2012.
Uses and Efficacy
Lexapro is approved to treat anxiety disorders, whereas Celexa is not. This does not mean Celexa cannot help with anxiety, just that Celexa has not been adequately researched or approved by the U.S. Food and Drug Administration for anxiety treatment.
Some studies suggest Lexapro may be more effective than Celexa for depression treatment, while others have not found significant differences between these medications. In a 2008 article about escitalopram from Expert Review of Neurotherapeutics, Drs. Cyril Höschl† and Jaromír Švestka of the Prague Psychiatric Centre in the Czech Republic explain that escitalopram is effective as the first option for managing patients with major depression and various anxiety disorders.
Celexa and its generic drug, citalopram, are approved by the Food and Drug Administration to treat major depression, mood disorders, panic disorders and social anxiety. Celexa is prescribed commonly for elderly patients and people with dual diagnoses, but Lexapro may be more beneficial for patients who experience panic attacks.
Researchers from the University of Catania in Italy looked at the safety and efficacy of escitalopram at half dosage compared with citalopram and concluded that escitalopram may be the better drug for elderly patients with panic attacks because of its safety, more rapid action and reduced total dose necessary. Their finding were published in "The Journal of Clinical Psychopharmacology" in 2006.
Lexapro and Celexa come with identical warnings about serious side effects, such as rigid muscles, high fever, uneven heartbeat, sweating, tremors, nausea, diarrhea, weakness, appetite loss, unsteadiness, headaches, confusion, trouble concentrating or remembering, fainting, seizures, shallow breathing or hallucinations.
The less-serious side effects are somewhat different between the two, according to Drugs.com. Celexa may cause gastrointestinal upset, insomnia, drowsiness, dry mouth, ejaculation disorder, bleeding abnormalities, weight changes, increased urination, decreased sex drive, impotence, difficulty having an orgasm, dry or watery mouth and yawning; or cold symptoms such as sneezing, sore throat or a stuffy nose.
Lexapro’s less-serious side effects include insomnia, drowsiness, dry mouth, gastrointestinal upset, dizziness, sweating, fatigue, decreased libido, gas, heartburn, constipation, weight changes, dry mouth, yawning, ringing in the ears, decreased sex drive and impotence or difficulty achieving orgasm.