Two medicines, side by side
Citalopram vs sertraline
Citalopram and sertraline are both labeled for depression. Drugs@FDA records approvals of citalopram since 1998 and of sertraline since 1991. Pharmacies paid $0.026 per citalopram hbr 10 mg tablet and $0.0507 per sertraline HCl 100 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 …”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”
Check it at the source: the citalopram FDA label on DailyMed (effective October 9, 2023); the sertraline FDA label on DailyMed (effective August 8, 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 sertraline record
Sertraline (Zoloft) · label of August 8, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior 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) ]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZOLOFT is indicated for the treatment of the following [See Clinical Studies (14) ]: • Major depressive disorder (MDD) • Obsessive-compulsive disorder (OCD) • Panic disorder (PD) • Posttraumatic stress disorder (PTSD) • Social anxiety disorder (SAD) • Premenstrual dysphoric disorder (PMDD) ZOLOFT is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of ( 1 ): • Major depressive disorder […]
On the market
- Earliest approval on file
- December 30, 1991
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0507 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Citalopram label of October 9, 2023, Sertraline label of August 8, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do citalopram and sertraline 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 …”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”
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.”; Sertraline, “The average terminal elimination half-life of plasma sertraline is about 26 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: citalopram since 2004; sertraline since 2006 (Drugs@FDA).
| Citalopram | Sertraline | |
|---|---|---|
| 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). | Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT). |
| Half-life (label) | Biotransformation of citalopram is mainly hepatic, with a mean terminal half-life of about 35 hours. | The average terminal elimination half-life of plasma sertraline is about 26 hours. |
| Earliest approval on file (Drugs@FDA) | July 17, 1998 | December 30, 1991 |
| First generic approved | October 28, 2004 | June 30, 2006 |
| Generic labelers (NDC) | 35 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.026 per tablet (Citalopram hbr 10 mg tablet) | $0.0507 per tablet (Sertraline HCl 100 mg tablet) |
| 12-month price change | +6% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 136,040 | 218,311 |
| 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.
Sertraline label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to citalopram
- every medicine labeled for the same conditions