Citalopram vs. Fluoxetine — What's the Difference?
By Tayyaba Rehman & Maham Liaqat — Updated on March 13, 2024
Citalopram is an SSRI used primarily for depression, focusing on mood improvement, while Fluoxetine treats a broader range of conditions including OCD and anxiety, with a longer half-life.
Difference Between Citalopram and Fluoxetine
Table of Contents
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Key Differences
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.
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Comparison Chart
Primary Use
Major depressive disorder
Depression, OCD, bulimia, panic disorder
Half-life
Shorter (about 35 hours)
Longer (4 to 6 days)
Dosing Frequency
May require daily dosing
Allows for more flexible dosing schedules
Common Side Effects
Nausea, drowsiness, gender dysfunction
Insomnia, anxiety, gender dysfunction
Special Considerations
Lower risk of QT prolongation
More stimulating, may affect sleep
Compare with Definitions
Citalopram
Primarily used for depression.
Citalopram effectively improves mood and energy levels.
Fluoxetine
Less frequent dosing needed.
Fluoxetine can sometimes be taken as a once-weekly dose.
Citalopram
Boosts serotonin in the brain.
Citalopram's action on serotonin helps alleviate depressive symptoms.
Fluoxetine
Also treats OCD, bulimia.
Fluoxetine is prescribed for both depression and obsessive-compulsive behaviors.
Citalopram
Metabolized quicker.
Citalopram may require consistent daily dosing for effectiveness.
Fluoxetine
Insomnia, anxiety.
The stimulating effect of Fluoxetine can lead to increased anxiety in some patients.
Citalopram
Less risk of QT prolongation.
Citalopram is often chosen for patients with cardiac concerns.
Fluoxetine
Stays in the system longer.
Fluoxetine's long half-life allows for flexible dosing options.
Citalopram
Nausea, drowsiness.
Some users of Citalopram experience drowsiness as a side effect.
Fluoxetine
Can cause insomnia.
Patients taking Fluoxetine may experience more energy but also insomnia.
Citalopram
Citalopram, sold under the brand name Celexa among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, and social phobia.
Fluoxetine
Fluoxetine, sold under the brand names Prozac and Sarafem among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used for the treatment of major depressive disorder, obsessive–compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder.
Citalopram
A drug of the SSRI class, C20H21FN2O, used in its hydrobromide form to treat depression.
Fluoxetine
A drug of the SSRI class, C17H18F3NO, used in its hydrochloride form to treat depression, obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, and certain eating disorders.
Citalopram
(pharmaceutical drug) A drug that functions as a SSRI and is administered orally in the form of its hydrobromide C20H21FN2O·HBr to treat depression and anxiety. It is marketed under the trademark Celexa.
Fluoxetine
(pharmaceutical drug) A synthetic compound which inhibits the uptake of serotonin in the brain and is taken to treat depression.
Fluoxetine
A selective-serotonin reuptake inhibitor commonly prescribed as an antidepressant (trade name Prozac)
Common Curiosities
What is Citalopram used for?
Citalopram is primarily used to treat depression, helping to improve mood and energy levels.
Is Fluoxetine stimulating or sedating?
Fluoxetine is more stimulating, which can lead to insomnia in some patients.
How often do you need to take Citalopram versus Fluoxetine?
Citalopram typically requires daily dosing, while Fluoxetine's longer half-life allows for more flexible dosing schedules, including once-weekly options.
Which SSRI has fewer side effects?
Side effect profiles vary by individual; one is not universally better than the other. Personal experience and medical guidance are key in finding the most suitable medication.
Can Citalopram cause heart problems?
Citalopram can prolong the QT interval, but it is generally considered to have a lower risk compared to other medications.
Can you switch from Citalopram to Fluoxetine?
Switching between SSRIs, including Citalopram and Fluoxetine, should be done under medical supervision to manage dosing and potential withdrawal or side effects.
How does Fluoxetine differ from Citalopram?
Fluoxetine treats a broader range of conditions, including OCD and bulimia, and has a longer half-life, affecting dosing frequency.
Do Citalopram and Fluoxetine have the same side effects?
They share common SSRI side effects like nausea and gender dysfunction, but differ in their likelihood to cause insomnia or affect heart rhythms.
Are Citalopram and Fluoxetine effective for OCD?
Fluoxetine is specifically approved for the treatment of OCD, while Citalopram may be used off-label for similar purposes.
Which is better for anxiety, Citalopram or Fluoxetine?
Both can be effective for anxiety, but the choice depends on individual patient needs, other conditions, and potential side effects.
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Written by
Tayyaba RehmanTayyaba Rehman is a distinguished writer, currently serving as a primary contributor to askdifference.com. As a researcher in semantics and etymology, Tayyaba's passion for the complexity of languages and their distinctions has found a perfect home on the platform. Tayyaba delves into the intricacies of language, distinguishing between commonly confused words and phrases, thereby providing clarity for readers worldwide.
Co-written by
Maham Liaqat
