Drug Comparison

Escitalopram vs. Citalopram: A Comparison for Depression and Anxiety

Escitalopram and citalopram are both antidepressant medications known as SSRIs, commonly prescribed for mood disorders. Patients often compare them because escitalopram is a purified version of citalopram, leading to similar effects but with some key differences in indications and dosing.

Side-by-Side Comparison

CategoryEscitalopram OxalateCitalopram Hydrobromide
Drug ClassSelective Serotonin Reuptake Inhibitor (SSRI)Selective Serotonin Reuptake Inhibitor (SSRI)
Primary UseMajor Depressive Disorder (MDD) in adults and pediatric patients (12+), Generalized Anxiety Disorder (GAD) in adults.Major Depressive Disorder (MDD) in adults.
Mechanism of ActionPotentiates serotonergic activity in the central nervous system; it is the S-enantiomer of citalopram, meaning it's the 'active' part of the citalopram molecule.Potentiates serotonergic activity in the central nervous system; it is a racemic mixture containing both the S-enantiomer (active) and R-enantiomer (less active) forms.
Onset of ActionTypically 1-4 weeks for noticeable improvement, with full effects potentially taking 4-6 weeks.Typically 1-4 weeks for noticeable improvement, with full effects potentially taking 4-6 weeks.
DurationTaken once daily due to its half-life, providing sustained effect over 24 hours.Taken once daily due to its half-life, providing sustained effect over 24 hours.
Common Side EffectsNausea, insomnia, ejaculation disorder, fatigue, sweating, decreased libido. Generally well-tolerated.Nausea, dry mouth, insomnia, somnolence, sweating, tremor, diarrhea, ejaculation disorder. Generally well-tolerated.
Drug InteractionsSimilar to other SSRIs; caution with other serotonergic drugs (e.g., triptans, other antidepressants), blood thinners, and drugs that prolong QT interval.Similar to other SSRIs; caution with other serotonergic drugs, blood thinners, and drugs that prolong QT interval (especially with higher doses).
Cost (Generic)Generally affordable as a generic.Generally affordable as a generic, often slightly less expensive than escitalopram.
When to ChooseOften preferred for GAD or if a lower dose is desired for similar efficacy, or if citalopram causes intolerable side effects at effective doses.Often a first-line choice for MDD, especially if cost is a primary concern or if escitalopram is not tolerated.

Bottom Line

Escitalopram is essentially a purified, more potent version of citalopram, meaning a lower dose of escitalopram can achieve similar effects to a higher dose of citalopram. While both are effective SSRIs for depression, escitalopram has an additional indication for GAD and may have a slightly better tolerability profile regarding cardiac effects at equivalent therapeutic doses. Your doctor will help determine which is best for your specific needs.

Escitalopram Oxalate Overview

Escitalopram is a type of antidepressant medication called a selective serotonin reuptake inhibitor (SSRI). It is used to treat major depressive disorder and generalized anxiety disorder by helping to restore the balance of a natural substance called serotonin in the brain.

Full Escitalopram Oxalate guide →

Citalopram Hydrobromide Overview

Citalopram is an antidepressant medication belonging to a class called SSRIs (selective serotonin reuptake inhibitors). It is prescribed to adults to help treat major depressive disorder by increasing the levels of a natural substance called serotonin in the brain, which can improve mood.

Full Citalopram Hydrobromide guide →

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