Citalopram vs. Fluoxetine — What's the Difference?

Citalopram is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for major depressive disorder. It works by increasing serotonin levels in the brain, which can improve mood and reduce symptoms of depression. Fluoxetine, also an SSRI, is used not only for depression but also for the treatment of obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder. Its ability to treat a wider range of conditions differentiates it from Citalopram.

One of the main differences between Citalopram and Fluoxetine is their half-life. Citalopram has a shorter half-life, meaning it is metabolized and exits the body quicker than Fluoxetine, which has a longer half-life. This makes Fluoxetine suitable for less frequent dosing schedules. Consequently, the choice between them can depend on patient convenience and the need for steady medication levels.

Side effect profiles of Citalopram and Fluoxetine share commonalities typical of SSRIs, such as nausea, drowsiness, and gender dysfunction, but there are differences in their likelihood to cause certain side effects. For instance, Fluoxetine is more commonly associated with insomnia and has a stimulating effect, whereas Citalopram is less likely to cause insomnia and might be preferred in patients who experience anxiety or sleep disturbances.

Citalopram is generally considered to have a more favorable cardiac safety profile, especially concerning the risk of QT interval prolongation, a measure of heart rhythm regularity. Fluoxetine, while also safe for most patients, requires more caution in individuals with pre-existing heart conditions or those on medications that can affect the heart's rhythm.

The decision between Citalopram and Fluoxetine often comes down to the specific needs of the patient, including the conditions being treated, potential side effects, and the patient's overall health profile. A healthcare provider will consider these factors to determine the most appropriate medication for each individual.