Two medicines, side by side
Citalopram vs mirtazapine
Citalopram and mirtazapine are both labeled for depression. Drugs@FDA records approvals of citalopram since 1998 and of mirtazapine since 1996. Pharmacies paid $0.026 per citalopram hbr 10 mg tablet and $0.063 per mirtazapine 15 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the citalopram FDA label on DailyMed (effective October 9, 2023); the mirtazapine FDA label on DailyMed (effective August 6, 2025).
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 mirtazapine record
Mirtazapine (Remeron) · label of August 6, 2025
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) ]. REMERON/REMERONSolTab is not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsREMERON/REMERONSolTab are indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies (14) ]. REMERON/REMERONSolTab is indicated for the treatment of major depressive disorder (MDD) in adults.
On the market
- Earliest approval on file
- June 14, 1996
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.063 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Citalopram label of October 9, 2023, Mirtazapine label of August 6, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do citalopram and mirtazapine 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 …”; Mirtazapine, “The mechanism of action of mirtazapine for the treatment of major depressive disorder, is unclear.”
Half-life, in each label's words: Citalopram, “Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours.”; Mirtazapine, “Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or …”
Both labels carry a boxed warning; the records quote them.
Generics: citalopram since 2004; mirtazapine since 2003 (Drugs@FDA).
| Citalopram | Mirtazapine | |
|---|---|---|
| Labeled for | Depression | Depression |
| Pharmacologic class | Serotonin Reuptake Inhibitor | n/a |
| 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 action of mirtazapine for the treatment of major depressive disorder, is unclear. |
| Half-life (label) | Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours. | Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or REMERONSolTab. |
| Earliest approval on file (Drugs@FDA) | July 17, 1998 | June 14, 1996 |
| First generic approved | October 28, 2004 | January 24, 2003 |
| Generic labelers (NDC) | 35 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.026 per tablet (Citalopram hbr 10 mg tablet) | $0.063 per tablet (Mirtazapine 15 mg tablet) |
| 12-month price change | +6% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 136,040 | 91,057 |
| 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.
Mirtazapine label, warnings and precautionsIncreased risk when co-administered with other serotonergic drugs (e.g., SSRI, SNRI, triptans), but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to citalopram
- every medicine labeled for the same conditions