Two medicines, side by side
Citalopram vs escitalopram
Citalopram and escitalopram are both labeled for depression. Drugs@FDA records approvals of citalopram since 1998 and of escitalopram since 2002. Pharmacies paid $0.026 per citalopram hbr 10 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. 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 …”; Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”
Check it at the source: the citalopram FDA label on DailyMed (effective October 9, 2023); the escitalopram FDA label on DailyMed (effective October 1, 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 escitalopram record
Escitalopram (Lexapro) · label of October 1, 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 monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsLexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]
On the market
- Earliest approval on file
- August 14, 2002
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0632 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Source: FDA drug labels via openFDA (Citalopram label of October 9, 2023, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do citalopram and escitalopram differ on the record?
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 …”; Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”
Both are in FDA's class serotonin reuptake inhibitors.
Half-life, in each label's words: Citalopram, “Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours.”; Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: citalopram since 2004; escitalopram since 2007 (Drugs@FDA).
| Citalopram | Escitalopram | |
|---|---|---|
| Labeled for | Depression | Depression, Anxiety |
| Pharmacologic class | Serotonin Reuptake Inhibitor | Serotonin 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 mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS … |
| Half-life (label) | Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours. | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. |
| Earliest approval on file (Drugs@FDA) | July 17, 1998 | August 14, 2002 |
| First generic approved | October 28, 2004 | July 31, 2007 |
| Generic labelers (NDC) | 35 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.026 per tablet (Citalopram hbr 10 mg tablet) | $0.0632 per tablet (Escitalopram 20 mg tablet) |
| 12-month price change | +6% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 136,040 | 139,519 |
| 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)
Do their labels mention each other?
Escitalopram label, contraindicationsStarting Lexapro in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [ see Dosage and Administration ( 2.6 ) and Warnings and Precautions ( 5.2 ) ]. taking pimozide [see Drug Interactions ( 7 ) ]. with a hypersensitivity to escitalopram or citalopram or any of the inactive ingredients in Lexapro.
Escitalopram label, drug interactionsPimozide Clinical Impact: Concomitant use of racemic citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of racemic … Intervention: Lexapro is contraindicated in patients taking pimozide [see Contraindications ()].
Source: FDA drug labels via openFDA
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.
Escitalopram label, drug interactionsConcomitant use of Lexapro 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.
Source: FDA drug labels via openFDA
What next?
- Alternatives to citalopram
- every medicine labeled for the same conditions