Your experiences with Celexa/Lexapro

July 22, 2010 9:30 AM

You're taken both Celexa and Lexapro. In your experience, is there a difference? Did you have fewer side effects with Lexapro?

The question is pretty well right there in the short version, but for folks who enjoy the hand-wringy details:

A few years ago, a doctor put me on Celexa for some severe anxiety I was having related to a scary life situation. It really helped with the anxiety, but over the next 18+ months it pretty much ruined my life in other ways: I experienced debilitating fatigue (which nobody I consulted about it told me could be a Celexa side effect...I figured it out from somebody else's AskMetafilter question last fall), I lost my appetite, yet I gained 40+ pounds in under a year despite not being able to eat.

I tapered off the Celexa last fall, and the withdrawal was also hellish. Because of the fatigue, I lost a lot of my fitness and I've had trouble getting it back; my appetite has not returned. I feel like it broke me in a way I don't know whether I'll be able to fix.

So, fast-forward to now: I'm having a lot of anxiety, and just recently, some depression. This seems to be related to some underlying hormonal weirdness that is making my mid-40s a hellish time, and I'm working with an ob to try to deal with that aspect of things. But in the meantime, the hormones are driving this anxiety and depression and I wonder if I need meds again.

I saw my doctor yesterday, and she wants me to try Lexapro. She says that in her experience, it's much "cleaner" than Celexa and people tolerate it better, with fewer side effects.

A friend of mind who is a PA says that medical types she knows are divided on Lexapro. Some think it's pretty much Celexa changed just enough to get a new patent and wring out some profits; others think it really is dramatically different. Clearly my doctor is in the latter group.

She rejected Wellbutrin because it can rev people up and be bad for people with anxiety, and offered Seroquel as an alternative, but she says it's so sedating when people are first on it they call her up and complain that she put them in a coma; after 18 months of not being able to stay awake for a whole day, the idea of being heavily sedated, even temporarily, freaks me out.

So: I took my first Lexapro last night (1/2 of a 10 mg tablet), and woke in the middle of the night with a screaming headache, nausea, and electric-shock sensations like I had when I was tapering off the Celexa. Now I'm freaked out. I don't know whether to stick with it or ask for something else or give up on it.

I don't want to give up on something because of temporary effects that will pass in a few weeks, but I don't want a clusterfuck like I had with Celexa, either. I would prefer to stay off psych meds altogether for awhile but I may well need them at least until we deal with my hormonal bs. I've been visiting some of the mental health forums, but don't have the patience to wade through a lot of threads about Celexa/Lexapro that wander off-topic or never answer the original question.

So here I am. Tell me what you know.

posted by not that girl to health & fitness (25 answers total)

All I know is that my ex-doctor tried to put me on Lexapro, and didn't really give me any reason why. As I was walking out of the office with my big bag o' samples and coupons (that I later disposed of), the Lexapro rep was there chatting up the office staff. She had been there since before I got there, during my hour delay, and was still there when I left.

Just sayin'.
posted by Geckwoistmeinauto at 9:35 AM on July 22, 2010

Haven't taken either - though I take both Welbutrin and Seroquel every day with very few to no side effects. That being said - your mileage may vary with *any* medication. Just because Depakote was the DRUG FROM HELL for me >_<>
Also, try this forum for questions about crazy meds. They're very helpful.
posted by patheral at 9:37 AM on July 22, 2010

Damn, half my message disappeared. I meant to say, " just because Depakote was the drug from hell for me doesn't mean that other people don't use it with spectacular success every day. Because they do.
posted by patheral at 9:38 AM on July 22, 2010

Patheral, thanks for the crazymeds link. That is very helpful. Their article on Lexapro says it tends to work fast if it's going to, and that it's easier to discontinue than other SSRIs. Both are reassuring.
posted by not that girl at 9:45 AM on July 22, 2010

I was on lexapro twice. Once when I was Super Depressed and a year later when I was only a little bit depressed.

The first time I was on it, it worked a bit and I had no side effects. I even went off it cold turkey with no ill effects.

This second round? No way. It made me MORE depressed then I already was, including a slew of side effects (headaches and insomnia, aside from the depression).

So maybe, anecdotally, the type of medication Lexapro/Celexa is.. doesn't work well after you've taken it and gone off it.. and tried to take it again.
posted by royalsong at 9:46 AM on July 22, 2010

If you don't mind a referral -- the first place I'd go to find tons of stories about Celexa vs Lexapro is the Celexa/Lexapro board at Crazymeds. There's one thread on the subject on the first page, and probably lots more buried in the archive.
posted by mendel at 10:00 AM on July 22, 2010

is this a GP that's prescribing for you? I've never had a GP handle my 'mind meds.' At the most, they have given me a script for a suggested med along with a referral to see a psychiatrist. In my experience, psychiatrists are much more knowledgeable about the caveats and benefits of each med and at comparing them for your situation. in my case, i saw a shrink regularly after the GP appt, but i also have a friend who just went for an isolated "med" appointment. an hour to talk all this over may much more helpful than what you're getting. i know this isn't answering your question -- i had no troubles with celexa myself so I don't think i can relate to your situation very well -- but i do think a psychiatrist is where you'll find the help you need with meds, even if you don't want to enter a 'talk'-therapy regime...
posted by Tandem Affinity at 10:14 AM on July 22, 2010

I have a close friend who took Lexapro for about a year and a half, for situational depression (lost his job and a parent at about the same time). He did not have the anxiety you describe, just depression. I asked him for his experiences with it and here's what he told me:

"It helped the depression a lot. However I gained about 35 pounds and slept too much. I went to bed early and slept late which has never been my way. It also dulled my feelings and I feel like they haven't really recovered even though I've been off it for 4 years. I just don't feel highs and lows anymore and I wonder if it permanently changed my brain chemistry. I switched to Welbutrin after 18 months and I think I felt better with that. But pretty soon my situation in life changed enough that the depression improved a lot and I went off all meds. "

Clearly this is one person's experience (male, late 30's) and doesn't mean you'll go through what he did. I wish you good health and good luck whatever you decide.
posted by Kangaroo at 10:40 AM on July 22, 2010

Tandem, I'm in talk-therapy (CBT) already. There is a psychiatrist shortage in our area. If they're taking referrals at all, they're scheduling weeks or even months out. My doctor and I discussed a referral, and may go that route, but it's not a short-term solution.
posted by not that girl at 10:42 AM on July 22, 2010

FYI, citalopram is the drug that is Celexa. It's patent expired in 2003, allowing generics to be created. Celexa is the original tradename brand, but you can buy generics of it.

Lexapro is merely an "updated" version of citalopram (the molecule is essentially a mirror image), which allows its maker, Lundbeck, to market it under a new patent, which will itself expire in 2012.

What I'm saying is ... Lexapro and Celexa are just expensive versions of what you could be getting with generic citalopram.

Lexapro worked wonders for me. My new doctor pointed out citalopram, and there was zero noticeable difference.

Except for, you know, the $50 I was now saving each month. That certainly put a little extra spring in my step.
posted by Cool Papa Bell at 10:46 AM on July 22, 2010

So your problem is mostly anxiety? Have they tried any meds that aren't SSRIs? Anxiolytics like buspirone (Buspar) or a beta blocker?
posted by elsietheeel at 10:56 AM on July 22, 2010

Tapering on lexapro was hell for me. But once it got to stable levels in my system, I've had mostly positive results. The short half life will make it a bitch if you miss a pill though.
posted by Candide at 10:57 AM on July 22, 2010

Lexapro is merely an "updated" version of citalopram (the molecule is essentially a mirror image), which allows its maker, Lundbeck, to market it under a new patent, which will itself expire in 2012.

Our bodies do not deal with "mirror image" molecules the same way. Think of left-handed scissors: If you try to hold them normally with your right hand, they don't work right. The original drug, citalopram/Celexa, is an equal mix of both "mirror images" (a "racemic mixture" in chem-speak); escitalopram/Lexapro is only one of the mirror images (the "S-enantiomer" in chem-speak.) As a result, they don't behave identically. Some people get better results from one than for the other, and some people, (like Cool Papa Bell) have similar results from both.

What I'm saying is ... Lexapro and Celexa are just expensive versions of what you could be getting with generic citalopram.

This is true for Celexa, but not true for Lexapro. Lexapro is escitalopram, which is only one of the mirror-images. If Lexapro works better than Celexa for you, generic citalopram is not the correct replacement.

However. The drugs are similar enough that they often have similar side effects in a given patient. If Celexa had awful side effects for you, Lexapro might not be best thing to try next. (Or there may be other reasons to think Lexapro would be better for you - I am not your doctor!) This is why you need to be working with a psychiatrist, not a GP. I know you say that local psychiatrists are busy, with appointments weeks away, but if you have the time to wait through weeks of awful side effects to see if they'll go away, you have the time to wait for an appointment with a psychiatrist, a doctor who - unlike your GP, and unlike other patients who may react to things differently than you - does nothing but work with cases like yours. Your experience with Celexa sounds highly unpleasant, and you owe it to yourself to see a specialist who may be able to help you avoid similar experiences in the future.
posted by ubersturm at 11:47 AM on July 22, 2010 [2 favorites]

I've only taken Lexapro. And I only lasted a week because it made me dead tired, i threw up every morning, and according to witnesses, farted all night in my sleep.
posted by WeekendJen at 12:24 PM on July 22, 2010 [1 favorite]

My brother, who is a biochemist for a pharmaceutical company, found (much to his surprise!) that he did much better on Lexapro than Celexa, side-effects-wise. But, yes, this is one of those things where individual reactions are Very different, so ymmvTremendously.
posted by ldthomps at 12:36 PM on July 22, 2010

I've taken Lexapro twice for about 6 months, and had good results both times. Quick happyboost and no side effects/withdrawal. That being said, I've had friends who had good mood effects, but harsh withdrawal. I guess it really just depends upon your personal reaction to the drug. It's probably worth a shot though. ::shrug::
posted by amileighs at 12:58 PM on July 22, 2010

Oh, posted too quick. Yeah the electroshock thing is what I meant by "harsh withdrawal effects." My friend called them "brain zaps." If that is happening already, even if you get use to it now, it may happen again when you tapper off the meds. So if you stick with it, be prepared for that possibility in the future.
posted by amileighs at 1:03 PM on July 22, 2010

I tried Lexapro as a sample from my GP. I couldn't even handle a week on it -- it gave me an anxiety attack the first day (which is not a normal behavior for me), and even with a half dosage I didn't give a shit about anything and had no interest in sex.

When I started reading up on personal experiences with it, the stories of horrible side effects when getting off of Lexapro made me decide to keep calm and carry on without it and try psychotherapy.

It's not for me.
posted by hanoixan at 2:25 PM on July 22, 2010

My partner's been on both Lexapro and Celexa for anxiety and depression. Celexa made him gain a ton of weight and sleep all the time; Lexapro makes him a normal human being. The difference between them--at least for him--are like night and day.

Also, I'll just reiterate what your doctor said about Seroquel. I was on it (first the original, then the XR) at various doses for about two years, and finally had to go off because I was literally a zombie all the time. I'd take it two hours before bedtime like you're supposed to, and then I'd fall asleep, and then I'd sit at my desk all morning trying desperately to stay awake. I'd get about ten hours of alertness, and I felt great for those ten hours, but everything else was shot to hell. I don't know anyone who's been on it without becoming a zombie, at least for a while.
posted by MeghanC at 3:45 PM on July 22, 2010

Lexapro is merely an "updated" version of citalopram

This is exactly what my doctor told me, including the information about the expiring patent. Like Cool Papa Bell, I found the only difference to be the weight of my wallet.
posted by Houstonian at 5:46 PM on July 22, 2010

Also, I'll just reiterate what your doctor said about Seroquel. *snip* I don't know anyone who's been on it without becoming a zombie, at least for a while

erm... after the first week, the sleepy, hangover effect that's so common with Seroquel disappeared, and I've been on it for about five years. I also have not gained weigh (once I found out what was making me crave carbs I stopped shoving my face with cookies every twenty minutes). I've actually lost nearly 100 pounds. Those are the two most common side effects of Seroquel. The good thing is, I don't get manic, and all the racing thoughts that used to keep me up at night are gone, gone, gone.

This is why I always say. Your mileage may vary. It doesn't matter what the drug does to someone else - even if it does it to the majority. No one knows what effect - good, bad or otherwise - it will have on them until they try it. That's the only way to find out. It's good to be informed about what *might* happen, but don't let that information keep you from taking something that could potentially help.
posted by patheral at 7:16 PM on July 22, 2010

I took Lexapro starting about 6 years ago for anxiety. It was before it was "officially" approved for anxiety. It worked wonders for me. I have also heard anecdotally that Lexapro is "cleaner" than Celexa, and my Dr told me this too.
posted by radioamy at 7:34 PM on July 22, 2010

Lexapro made me a zombie, when it wasn't revving up the suicidal thoughts. And I second the gas comment. Not a fan.
posted by naoko at 4:39 PM on July 23, 2010

I've taken both. Lexapro has barely any side effects, and is twice as effective per mg as Lexapro (because Celexa contains both Lexapro, and the "other" chiral version that is apparently responsible for the side effects, but not the good effects). Celexa cut into my sex life, and loosened bowel movements.

Lexapro (escitalopram) for the win.
posted by IAmBroom at 7:33 PM on July 23, 2010

I want to thank people for chiming in... I was so overwhelmed earlier this week when I posted this. It's possible the Lexapro is already making me a bit more normal, brain-wise, but I had very good anxiety-reduction effects with Celexa, too, so we'll see. My doctor is monitoring very closely, and I think I'll be getting on a shrink's waiting list just to be on the safe side.
posted by not that girl at 8:54 PM on July 24, 2010