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Celexa (Citalopram) for anxiety: What you need to know

Celexa (Citalopram) for anxiety: What you need to know

As an SSRI antidepressant, Celexa (citalopram) is a first-line treatment for depression and anxiety disorders. It can also treat other conditions off-label.

Reviewed by:
Austin Lin, MD
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March 20, 2024
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Key takeaways

If you’ve been diagnosed with an anxiety disorder, medication can be an effective part of your treatment plan. One of those medications is Celexa, an antidepressant drug that’s often prescribed for anxiety, depression, and more. If you’re curious about how it works—or if you’re already on Celexa and want to learn more about it—you’re in the right place. In this article, we'll cover all the basics you need to know, including how long it takes to work, potential side effects,and how it compares to other medications.

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What is Celexa, and how does it work?

Celexa is the brand name for citalopram, was first approved for use in the United States in 1998. Since then, it has been used to treat depression and a variety of other mental health conditions.  

It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs block neurons in your brain from reabsorbing serotonin, the chemical responsible for your mood. This means there’s more serotonin available in your brain to help regulate your mood and carry messages between neurons, which can help you feel better emotionally and help lessen symptoms of anxiety.  

How do you take it?

Celexa comes in tablets, capsules, and as a liquid solution. Dosage starts at 10 mg or 20 mgs per day, but can be increased to 40 mgs once you start taking it. Celexa may not be recommended for children under the age of 18, pregnant people, or adults over the age of 60. However, your doctor will work with you to determine whether it’s the right antidepressant for you and what dose will work best.

What conditions does Celexa treat?

Although citalopram is only FDA-approved to treat depression, mental health professionals prescribe this medication for several other ‘off-label’ uses. Off-label uses are the reasons medicines are prescribed other than their approved purposed, based on scientific studies. Off-label uses are safe and often effective uses of medicines.  

Conditions Celexa treats:

*Indicates an off-label use.

How long does it take for Celexa to work?

Many people start feeling the effects of Celexa in the first 2-4 weeks, but it’s possible for it to take up to 12 weeks to feel the full effects. Consider tracking your mood and symptoms as you start the medication so you can see what progress you’re making. Simply write down how you’re feeling, including a short description of your mood and any side effects  you experience, in a notebook or on your phone each day. Here's more on how long Celexa takes to work.

One of the most important parts of mental health treatment, including medication, is consistency. It can take a few weeks for your brain to adapt to the changes and for you to notice a difference, but that doesn’t mean you should stop taking it.  

If you happen to miss a dose of Celexa, try to take it as soon as possible. However, if it's close to the time of your next scheduled dose, it's generally okay to skip the missed dose and wait until the next one.  

It's worth noting that since Celexa has a moderate half-life of approximately 35 hours, there is a moderate risk of experiencing withdrawal symptoms if doses are missed frequently. The half-life of a medication refers to the time it takes for half of the drug to be eliminated from your system on average.

How long do I have to take it?

Doctors typically recommend staying on an antidepressant for at least six months to a year, and you’ll likely start seeing improvements much sooner. This longer length of time gives you the highest likelihood of entering remission—meaning you’ve returned to feeling like your old self and may be able to taper off the medication slowly. Taping off medication is an individual decision and should be discussed with your doctor. Stopping an antidepressant too soon, or too quickly, may lead to withdrawal symptoms and the drug becoming less effective in the future. Don’t worry; when you’re feeling better you and your doctor can discuss a plan to stop medication safely.

Potential side effects

Like most medications, some people experience side effects while taking Celexa. It’s normal to feel a little nervous when reading about side effects, but don’t worry. Most Many side effects are mild and some go away within a few weeks as you adjust to the medication. Below are the most common side effects, as well as the less common and most severe ones.  

Most common side effects of Celexa:

  • Constipation
  • Diarrhea
  • Drowsiness
  • Dry mouth
  • Headaches
  • Nausea and/or vomiting
  • Sexual dysfunction
  • Sweating
  • Trouble sleeping

Nausea, headache, diarrhea, upset stomach tend to go away within 1-2 weeks. Other symptoms, such as low libido, can be prolonged.

Less common, serious side effects of Celexa:

  • Heart attack
  • Hemorrhage
  • Hyponatremia—low sodium levels
  • Irregular heart rhythm
  • Mania
  • Serotonin syndrome—mild to severe symptoms caused by too much serotonin; your doctor will help you minimize the risk  
  • Stroke
  • Suicidal thoughts

If you have any concerns, speak with your doctor for medical advice. They’ll be able to help you weigh the benefits and risks of taking antidepressants. If you experience any of these side effects or a worsening of your condition, also make sure to let them know as they may adjust your dose or change your medication.  

Other considerations

It’s up to you and your doctor to determine whether antidepressants, including Celexa, are right for you. Based on your age and other medical factors, your doctor may determine it isn’t right for you or adjust your dose accordingly. For example, Celexa isn’t typically recommended for children and young adults under 18, and smaller doses are recommended for those over 60. Your doctor may also adjust your medication if you’re pregnant or breastfeeding.  

Celexa also has negative drug interactions with several medications, including urokinase, pimozide, methylene blue, linezolid, and dapoxetine. The bottom line is that it’s important to disclose your medical history, which medications you take, and any medical conditions you have when speaking to your doctor about Celexa.  

Celexa vs other medications

While Celexa may be a great treatment option for anxiety or depression, it’s certainly not the only one. Alongside working with a therapist or psychiatrist, there are many types of medications out there that may improve your mental health.  

Here are a few medications you should know about and how they differ from Celexa.  

  • Other antidepressants may be a good option. Celexa isn’t the only SSRI (selective serotonin reuptake inhibitor) or SNRI (serotonin-norepinephrine reuptake inhibitor) that’s effective in treating anxiety and depression. Other common antidepressants include Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline). Each of these medications has a similar effect because they increase serotonin levels in your brain. However, each comes with slightly different possible side effects. The most effective medicine varies from person to person, so work with your doctor to find the right one for you.
  • Anti-anxiety medications like benzodiazepines work by making your nervous system less active. They do this by signaling your brain to produce more of the neurotransmitter GABA (gamma-aminobutyric acid), which slows down your nervous system. Benzodiazepines, like Xanax (alprazolam), may be used to treat panic disorder, social anxiety disorder, seizures, and muscle spasms. Benzodiazepines are faster-acting than SSRIs like Celexa, but they aren’t always recommended for long-term use because they can carry a risk for addiction.  
  • Beta-blockers block adrenaline and lower your blood pressure. For this reason, they are typically used to treat heart conditions, including irregular heart rhythms, chest pain, and heart attacks. However, anxiety treatment is an off-label use for beta blockers because this type of medicine does a good job of relieving physical anxiety symptoms.

Is Celexa good for depression and anxiety?

Celexa helps reduce symptoms of anxiety by increasing the availability of serotonin in your brain. It’s an effective, FDA-approved medication for treating depression, and some studies show that it’s also effective at relieving anxiety symptoms.  

Regardless of which medication is right for you, the first step in anxiety and depression treatment is working with your doctor to get a diagnosis and treatment plan. A psychiatrist can help you talk about what you’re struggling with, reach a diagnosis, and determine which medication is a good fit.  

The good news is that finding a psychiatrist is easier than ever. Enter: Talkiatry. We’re a national psychiatry practice that provides in-network100%  virtual care. To get started, fill out a short online assessment.  We treat, diagnose, and prescribe medication to patients with anxiety, depression, ADHD, and more.


Here’s more answers to all your questions about Celexa.

How does Celexa make you feel?

The effects of Celexa (citalopram) can vary from person to person, but generally this antidepressant medication can help improve your mood, increase your energy levels, and reduce your anxiety by restoring the balance of certain chemicals in your brain.

Does Celexa help anxiety immediately?

While Celexa can provide relief from anxiety and depression, it's not an instant fix. It usually takes a few weeks for the medication to kick in and start reducing your symptoms. So, be patient and keep taking it as prescribed. If you have any concerns about its effectiveness or if your anxiety worsens, reach out to your healthcare provider.

What is the best SSRI for anxiety?

When it comes to finding the best anxiety medication, it's not a one-size-fits-all situation, and one SSRI is not necessarily superior than the other. Different people have different needs and responses. To figure out which one is right for you, it's essential to work closely with your psychiatrist. They'll consider your unique situation, potential side effects, and help determine the most suitable medication to tackle your anxiety symptoms.  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Does Talkiatry take my insurance?

We're in network with major insurers, including:

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Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.

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