Two medicines, side by side
Citalopram vs desvenlafaxine
Citalopram and desvenlafaxine are both labeled for depression. Drugs@FDA records approvals of citalopram since 1998 and of desvenlafaxine since 2008. Pharmacies paid $0.026 per citalopram hbr 10 mg tablet and $0.396 per unit (Desvenlafaxine succnt ER 50 mg) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, citalopram is a serotonin reuptake inhibitor and desvenlafaxine a serotonin and norepinephrine reuptake inhibitor.
Check it at the source: the citalopram FDA label on DailyMed (effective October 9, 2023); the desvenlafaxine FDA label on DailyMed (effective January 27, 2023).
Highlights of the citalopram record
Citalopram (Celexa) · label of October 9, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short -term studies. Closely m onitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. CELEXA is not approved for use in pediatric patients [see Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsCELEXA is indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies ( 14 )]. CELEXA is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of major depressive disorder (MDD) in adults ( 1 ).
On the market
- Earliest approval on file
- July 17, 1998
- Generic labelers
- 35 labelers
- Pharmacy cost
- $0.026 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Highlights of the desvenlafaxine record
Desvenlafaxine (Pristiq) · label of January 27, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older [see Warnings and Precautions (5.1)].
Used for
From the label: indicationsDesvenlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is indicated for the treatment of major depressive disorder (MDD) [see Clinical Studies (14) and Dosage and Administration (2.1)]. The efficacy of desvenlafaxine has been established in four short-term (8-week, placebo-controlled studies) of outpatients who met DSM-IV criteria for major depressive disorder. […]
On the market
- Earliest approval on file
- February 29, 2008
- Generic labelers
- 20 labelers
- Pharmacy cost
- $0.396 per unit
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Source: FDA drug labels via openFDA (Citalopram label of October 9, 2023, Desvenlafaxine label of January 27, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do citalopram and desvenlafaxine differ on the record?
In FDA's classes, citalopram is a serotonin reuptake inhibitor and desvenlafaxine a serotonin and norepinephrine reuptake inhibitor.
How each works, in its label's words: Citalopram, “The mechanism of action of citalopram is unclear, but is presumed to be related to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS …”; Desvenlafaxine, “The exact mechanism of the antidepressant action of desvenlafaxine is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through …”
Half-life, in each label's words: Citalopram, “Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours.”; Desvenlafaxine, “The mean terminal half-life (t 1/2 ) was prolonged from 11.1 hours in the control subjects to approximately 13.5, 15.5 …”
Both labels carry a boxed warning; the records quote them.
Generics: citalopram since 2004; desvenlafaxine since 2015 (Drugs@FDA).
| Citalopram | Desvenlafaxine | |
|---|---|---|
| Labeled for | Depression | Depression |
| Pharmacologic class | Serotonin Reuptake Inhibitor | Serotonin and Norepinephrine Reuptake Inhibitor |
| How it works (label) | The mechanism of action of citalopram is unclear, but is presumed to be related to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT). | The exact mechanism of the antidepressant action of desvenlafaxine is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through inhibition of their reuptake. |
| Half-life (label) | Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours. | The mean terminal half-life (t 1/2 ) was prolonged from 11.1 hours in the control subjects to approximately 13.5, 15.5, 17.6, and 22.8 hours in mild, moderate, severe renal impairment and ESRD subjects, respectively. |
| Earliest approval on file (Drugs@FDA) | July 17, 1998 | February 29, 2008 |
| First generic approved | October 28, 2004 | June 29, 2015 |
| Generic labelers (NDC) | 35 labelers | 20 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.026 per tablet (Citalopram hbr 10 mg tablet) | $0.396 per unit (Desvenlafaxine succnt ER 50 mg) |
| 12-month price change | +6% | -6% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 136,040 | 26,842 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Citalopram label, drug interactionsConcomitant use of CELEXA and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Desvenlafaxine label, warnings and precautionsSerotonin syndrome has been reported with SSRIs and SNRIs, including with desvenlafaxine extended-release tablets, both when taken alone, but especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John's Wort).
Source: FDA drug labels via openFDA
What next?
- Alternatives to citalopram
- every medicine labeled for the same conditions