citalopram vs paroxetine
Side-by-side comparison of citalopram and paroxetine Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Celexa
Paxil
Citalopram is a medicine used to treat depression in adults. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).
Paroxetine (Paxil) is a medicine that can help treat depression and anxiety disorders. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).
Citalopram is used to treat major depressive disorder (MDD) in adults. Depression can cause feelings of sadness, loss of interest, and difficulty functioning in daily life. This medicine can help improve your mood and overall well-being.
Paroxetine is used to treat several conditions in adults. These include major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). It helps to improve mood and reduce anxiety and panic feelings.
Citalopram works by increasing the amount of serotonin in the brain. Serotonin is a chemical messenger that helps regulate mood. By blocking the reabsorption of serotonin, citalopram helps to improve communication between nerve cells and stabilize mood.
Paroxetine works by increasing the amount of serotonin in your brain. Serotonin is a natural substance that helps regulate mood. By increasing serotonin levels, paroxetine can help improve symptoms of depression and anxiety.
- • Ejaculation disorder (mostly delayed ejaculation)
- • Abnormal ejaculation
- • Weakness or fatigue
- • Constipation
- • Decreased appetite
- • Diarrhea
- Tiredness 8,930
- Feeling sick to your stomach 8,204
- Medicine not working 7,287
- Head pain 6,654
- Loose stools 6,214
- Medicine not working 2,032
- Reaction with another medicine 1,825
- Tiredness 1,821
- Feeling sick to your stomach 1,738
- Harmful effect from different substances 1,579
Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor will monitor you closely for worsening depression or suicidal thoughts. Citalopram is not approved for use in children.
Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor will monitor you closely for worsening depression or suicidal thoughts. Paroxetine is not approved for use in children.
Taking citalopram late in pregnancy may cause problems for the newborn. Talk to your doctor about the risks and benefits of taking this medicine while pregnant. There is a pregnancy registry to monitor outcomes, call 1-844-405-6185 to register.
Paroxetine may cause harm to your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Taking paroxetine later in pregnancy may cause problems for the newborn.
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How to Read This citalopram vs paroxetine Comparison
citalopram is classified in the Selective Serotonin Reuptake Inhibitor (SSRI) drug class, while paroxetine sits within the Selective Serotonin Reuptake Inhibitor (SSRI) class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, citalopram has 37,289 submissions while paroxetine has 8,995. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between citalopram and paroxetine — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.