Fluoxetine vs Citalopram(A comprehensive guide)

Fluoxetine vs Citalopram

In this blog post, we will discuss the effectiveness of fluoxetine vs citalopram. Additionally, we will understand what Citalopram is, side effects, overdose and when to seek medical assistance.

Fluoxetine vs Citalopram?

Fluoxetine and Citalopram belong to the Selective Serotonin Reuptake Inhibitors (SSRIs) group of antidepressants, and both are considered very effective when treating depression. However, citalopram seems to act faster than fluoxetine when seeing the results. 

Unlike Citalopram, Fluoxetine is also used when treating other disorders such as bulimia, obsessive-compulsive disorder (OCD), panic disorder and premenstrual dysphoric disorder (PMDD).

Antidepressants are drugs prescribed to treat mental disorders. Some of the most common are:

  • Anxiety disorders
  • Phobias
  • Bulimia
  • Some medical conditions

How do Antidepressants work?

Antidepressants act in your body by prolonging or boosting the activity of neurochemicals such as noradrenaline and serotonin, which are thought to be involved in mood regulation. 

There are several different types of antidepressants, and they are:

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin and noradrenaline reuptake inhibitors (SNRIs)
  • tricyclics and tricyclic-related drugs
  • monoamine oxidase inhibitors (MAOIs) 
  • other antidepressants

How should I take Fluoxetine?

You can take it with or without food. Oral tablets are available at 10 mg, 20 mg or 40 mg. It is available  in capsules, tablets, capsules with delayed-release and oral solution

Also, it can take 4-6 days for you to start seeing some improvement long term and 1-3 days short term.

Remember, You should always follow your doctor’s instructions at all times.  

Fluoxetine: Side effects

Some of the most common and known side effects of fluoxetine are according to RxList are:

  • Nausea,
  • Upset stomach,
  • Constipation,
  • Headaches,
  • Anxiety,
  • Sleep problems (insomnia),
  • Drowsiness,
  • Dizziness,
  • Nervousness,
  • Heart palpitations,
  • Loss of appetite or increase in appetite,
  • Weight changes
  • Cold symptoms (stuffy nose, sneezing, sore throat),
  • Dry mouth,
  • Decreased sex drive,
  • Impotence
  • Difficulty having an orgasm

Fluoxetine Drug interactions

Fluoxetine may interact with medicines meant for cold or allergies, sedatives, narcotics, pain killers, sleeping pills, muscle relaxers, medicine for seizures or anti-anxiety medication, monoamine oxidase inhibitors (MAOIs), nonsteroidal anti-inflammatory drugs (NSAIDs), other antidepressants or medicine for migraine. 

Other drugs 

  • Alprazolam
  • Clopidrogel
  • Clozapine
  • Flecainide
  • Haloperidol
  • Nebivolol
  • Vinblastine
  • Seizure medications

Fluoxetine Overdose

If you think you or someone else has taken a fluoxetine overdose you should get in contact with medical emergency services. 

Some of the most common symptoms of a Fluoxetine overdose are:

  • Feeling confused
  • Being unresponsive
  • Shaking uncontrollably
  • Feeling dizzy
  • Irregular or very fast heartbeat
  • Hallucinations
  • Restlessness
  • Having fever
  • Fainting
  • Losing consciousness

What is Citalopram supposed to do?

Citalopram is a type of antidepressant (Selective Serotonin Reuptake Inhibitor or SSRI), as we discussed previously, often used to treat depression and also sometimes it is prescribed to treat panic attacks. 

Research has suggested its effectiveness in helping people recover from depression and has been shown fewer side effects compared to other antidepressants. However, it is only available on prescription, in the form of tablets or liquid drops for faster intake.

It usually takes between 4 to 6 weeks for Citalopram to start working and as with any other drug, it poses the risk of experiencing side effects. Some of the common side effects include but are not limited to tiredness, dry mouth, and sweating excessively.

How and when to take it?

You need to take it once a day (at any time of the day but it is recommended to take it in the morning if you have trouble sleeping) and it won’t make a difference if you take it with or without having food.

How much do I have to take?

Citalopram tablets come in different doses ranging from 10mg to 40mg and the usual recommended dose for adults is 20mg a day (max dose of 40mg a day). In children, the usual dose is 10mg a day, but it may get increased to 40mg a day as in it is the case for adults. 

If you take too much by accident or get to experience symptoms such as the following, contact your doctor straight away:

  • Being sick (vomiting)
  • Shaking
  • Feeling sleepy
  • Fast heart rate
  • Seizures

Be aware that your body needs to gradually get used to the medicine, as soon as this happens, some of the side effects might disappear. However, if they are persistent in time or get worse, you need to seek medical assistance. 

Some of the serious effects are listed as follows:

  • Chest pain or pressure or shortness of breath
  • Severe dizziness or passing out
  • Painful erections that last longer than 4 hours – this may happen even when you’re not having sex
  • Any bleeding that’s very bad or you can’t stop, such as cuts or nosebleeds that won’t stop within 10 minutes

Citalopram Overdose: How?

Citalopram overdoses tend to have mild to moderate symptoms, particularly when ingesting doses under 600 mg in adults. However, with higher doses, severe symptoms like QTc prolongation, torsade de pointes or TdP, and seizures may manifest. 

  • Hypotension
  •   Cardiac arrest
  • Nausea
  • Serotonin syndrome
  • Agitation or restlessness 
  • Bradycardia or having a very low heart rate
  • Feeling dizzy
  • Hypertension
  • Sweating excessively
  • Hyperventilation 

Can I die from a Citalopram Overdose?

There are conflicting facts about dying from citalopram overdose. Most of the studies suggest that you are not actually able to die from a citalopram overdose but from the interaction of citalopram with other substances like alcohol or other drugs.

Fluoxetine vs Citalopram(A comprehensive guide)

What are the symptoms related to Citalopram Overdose?

These are some of the symptoms that have been reported in cases of citalopram overdose:

  • Convulsion or seizures
  • Tachycardia or an accelerated heart rate
  • Somnolence (feeling sleepy)
  • QT prolongation 
  • Coma
  • Vomiting
  • Tremors

Antidepressants: Suicidal Risk

Some studies have shown that taking antidepressants is associated with a higher risk of suicidal behavior (suicidal thinking or attempts) when compared to placebo drugs. This risk has been associated with age in the case in children, adolescents, and adults with major depressive disorder (MDD) or related psychiatric disorders. 

One study conducted by the Centre for Suicide Research in Oxford, England attempted to identify which antidepressant drugs were more closely related to suicides or suicide attempts using coroner reports and hospital admissions from six hospitals across the United Kingdom and Wales (between 2000 and 2006). 

They found that Tricyclic antidepressants or TCAs had the highest toxicity and rate of fatality compared to other classes of antidepressants. Additionally from the SSRIs group, Citalopram indicated to be the one with the highest toxicity and fatality rates. 

Besides being a treatment often used for depression, it can also be prescribed for the treatment of other major psychiatric disorders such as Obsessive-compulsive disorder (ODD), Panic disorder, premenstrual dysphoric syndrome (PMDD), anxiety disorders, post-traumatic stress disorder (PTSD) and eating disorders. 

People under antidepressant medication should always be monitored and observed closely to help reduce or prevent suicidal behavior.  

Reviews from users after taking Citalopram (from drugs.com):

Here are some helpful reviews based on the experience of real users of Citalopram. Let’s take a look at how was their experience with the drug and if you are taking it or planning to, then it will let you make a decision about whether you should start taking it or stop (always under medical supervision.

Jd

Taken for 1 to 6 months

November 27, 2019

“I have battled against depression all my adult life and finally caved in a few months ago. Went to the doctor and asked for help. This drug has made me realise just how bad I have been and wish I hadn’t waited till I was 53 to take something. Now on citalopram I feel great and positive and looking forward to the rest of my life. Still have a bad day every now and then but am now able to understand and except the bad day and not want to run away and hide. Would tell anyone who feels they are struggling with life to see a doctor and let them help.”

7.0

Anonymous

November 20, 2019

Celexa (citalopram): “This drug made me sleepwalk three nights in a row, talk about scary,!…the final night, I took a giant swig of paint thinner, in my sleep. I immediately discontinued the drug, and all sleepwalking stopped, I was only taking it for about 5 weeks. I can still taste the turpentine”

1.0

Pipes

·

Taken for less than 1 month

November 19, 2019

“Started on these 3 weeks ago after my mam passing away then a fall out with a family member I just felt so emotional all the time after realising I needed. My GP he put me on 20mg I can honestly say I feel loads better + not so emotional I’ve been off work for 5 months but know I’m ready to return now Good luck all.”

Why is this blog about Fluoxetine vs Citalopram important?

It is important because it helps understand the similarities and differences between Fluoxetine and Citalopram. 

As we now know, they are both antidepressants and do have some minor differences as it is the case of citalopram just being prescribed for anxiety and stress, depression and postpartum depression while fluoxetine can be prescribed, in addition to the disorders we just mentioned, it also helps with MDD, bulimia, OCD and related conditions. 

Please feel free to comment in the comments section below. 

Frequently Asked Questions (FAQ’s) about Fluoxetine vs Citalopram

Is fluoxetine the same as citalopram?

Fluoxetine and Citalopram are not the same. They are both drugs classified as selective serotonin reuptake (SSRIs) however there are some differences in the conditions they can treat, side effects and the time of reaction.

Is fluoxetine a strong antidepressant?

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and is prescribed for treating depression, anxiety, obsessive-compulsive disorder (OCD), and bulimia. One of the side effects includes the risk of suicidal behavior in adolescents. 

Is citalopram a strong antidepressant?

Citalopram is very effective in treating depression. Studies have even reported the effectivity when comparing to groups of patients taking placebos.

Which SSRI is the best?

Some of the most commonly prescribed SSRIs are:

  • Fluoxetine: one of the most popular selective serotonin reuptake inhibitors (SSRIs).
  • Citalopram: Studies show Celexa has similar side effects as other SSRIs. 
  • Sertraline. 

What’s the strongest antidepressant?

There are many antidepressants considered as “strong” or effective and the NIHR mention them as:

  • escitalopram.
  • paroxetine.
  • sertraline.
  • agomelatine.
  • mirtazapine.

Recommended books

  1. A Parent’s Guide to Depression and Anxiety (Axis Parent’s Guide)
  2. Citalopram Hydrobromide; A Clear and Concise Reference
  3. Citalopram 598 Questions to Ask that Matter to You
  4. Fluoxetine Hydrochloride; Third Edition
  5. Fluoxetine 603 Questions to Ask that Matter to You

References 

RxList

Mind.org.uk

Drugs.com

Fluoxetine vs Citalopram(A comprehensive guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.

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