Sertraline VS Citalopram

April 3, 2024 5:47 PM

I know YMMV but having had bad side effects from Citalopram, is there any chance that Sertraline will be better?

I took Citalopram about 15 years ago when I was really unhappy and I gained weight, couldn't remember anything (ie that morning), passed out on a train, threw up multiple times etc. I was always wanting to sleep and essentially was zombified. It was actually scary and very upsetting in retrospect.

Now, I'm probably less unhappy but still have pretty serious anxiety (but the world is pretty crazy right now, and I live in New York so it's not exactly Shangri-La vibes anyway).

My doctor suggested Sertraline (25mg) and I'm interested in trying it- but I don't want to repeat my past experience or have any other similarly bad experiences. I also think I have mild (anxiety-related) OCD-ish tendencies so if it would help with that too, that would be great.

I know this is a common topic, and differs for everyone but I guess the real question is- are Sertraline and Citalopram similar? Specifically in their potential side effects?

posted by bquarters to Health & Fitness (12 answers total)

Unsure if this helps, but I recently changed from 20+ years on Citralopram to Wellbutrin (weaning off one and onto the other) and am pleased with the change. The Wellbutrin seems to be providing me with better resilience around anxiety and the overall effect is working better for me. Obviously ymmv, but I’m happy to have tried something different that Citralopram - kinda like an upgrade if you will. Good luck and sending you all positive karma.
posted by whatevernot at 5:55 PM on April 3 [1 favorite]

If you are interested in low-side effect antidepressants, I recommend looking into

Brintellix, also called Trintellix - generic name Vortioxetine. This is the only antidepressant where they tested to see if it affected driving, and it didn't affect driving at all - it has no brainfog/sedative qualities.

and Wellbutrin, also called Zyban - generic name Bupropion.

Bupropion is actually associated with weight LOSS for some people who take it.
posted by chariot pulled by cassowaries at 5:58 PM on April 3

Just popping in to say that in my personal experience it is all your body chemistry and any other meds you're taking. I had to work through several different types of anxiety meds before I found one that works for me (in my case, citalopram). I'd have to look through which ones I tried and failed with but my side effects were terrible, like go to bed and not get out terrible.

Good luck finding one that works for you, but if the first one doesn't, try a different one. There are a lot of options out there now and the second one (third, in your case) may do the trick.
posted by gentlyepigrams at 6:26 PM on April 3

IANAD, but yes, my understanding is that it is possible for you to have a different response to sertraline compared to citalopram. They are both SSRIs, but lots of people have to try multiple different SSRIs and have different effects from them before they can find the right one.

Also worth looking into buspirone/buspar, which is not an SSRI (I don't think anyone really knows how it works), but it can help with anxiety. Unfortunately, it did make me massively hungry.

Basically, psych meds are completely YMMV territory for everyone. It's a process.
posted by litera scripta manet at 6:49 PM on April 3 [1 favorite]

Bupropion is actually associated with weight LOSS for some people who take it.

I recall reading a piece in Salon some decades ago about a woman who started on Wellbutrin and soon after experienced an orgasm while shopping. Upon looking for that anecdote online, I did not find the article but I did find this and this. Please enjoy your next trip to the mall.
posted by y2karl at 7:17 PM on April 3

Yes, there is definitely a chance that Sertraline will be better. Both drugs are SSRIs, and each person can react differently to every SSRI.

The SSRI that's reputed to have the mildest side affects is Escitalopram (brand name Lexapro). Despite the similar names, Citalopram and Escitalopram affected me very, very differently.
posted by wryly at 7:40 PM on April 3

My impression is that Escitalopram is a typical first SSRI for depression and Sertraline is a common first for anxiety, though both can be used for both. I've taken both and they affected me similarly, but as others have said, trying different SSRIs is a common thing.
posted by lookoutbelow at 8:12 PM on April 3

Brintellix, also called Trintellix - generic name Vortioxetine.

Came in to recommend this too, there’s no withdrawal period when coming off it either.
posted by ellieBOA at 8:45 PM on April 3

Yes there is a chance, no there is no shortcut to trying it out yourself.
posted by Tell Me No Lies at 6:41 AM on April 4

Although I didn't experience the intensity of the side effects you describe on Citalopram, I did sleep a lot while on it, and almost always needed an afternoon nap to get through the day, so the "zombie" effects were similar. Now I'm on Sertraline, and I don't experience that kind of drowsiness, but I also almost CAN'T nap, even when I'm very tired. I just can't fall asleep.

So, that's a bit of anecdata with some small connection to your experience.
posted by Ms. Toad at 6:47 AM on April 4

Basically, psych meds are completely YMMV territory for everyone. It's a process

Hear, hear!

Maybe also try an SNRI like venlafaxine (effexor). I've been on it for 10+ years and love it, it's now the family anti-anxiety/anti-depressant as it's the one my sister and my mom settled on. Is there anyone you are related to that has a med they like? Pharmacogenetics is still in it's infancy, and drug metabolism is v. complex, so you may have some luck with one that works for a relative.
posted by lizjohn at 10:13 AM on April 4

Sertraline has been very good for me. As an older, more established antidepressant, I think you might find side effects to be few. I tried others, and this one works for me.
posted by Enid Lareg at 3:03 PM on April 4 [2 favorites]