Sertraline vs Citalopram (Differences and Similarities)

In this brief guide, we will look at differences and similarities of sertraline vs citalopram, or as they are known by their brand names, Zoloft vs celexa. We will also look at the side effects of both medications and what they are commonly used for.

Sertraline vs Citalopram

The comparison of sertraline vs citalopram reveals that while both have side effects such as weight gain or dizziness, they also have key differences in how long they stay in the system, and it may be seen that citalopram is slightly stronger because it stays in the system slightly longer.

Sertraline has a half life of about 26 hours or so, and that means that it reached the peak potential till about that time, and after that it tends to get removed from the system, which is not the case for citalopram, whose half life is about 35 hours which means that it is not eliminated from the body that quickly.

This difference of half life means that it takes a lesser time for citalopram to reach maximum potential in the body and therefore it may start working sooner than sertraline.

However, in the comparison of sertraline vs citalopram, we would be remiss not to compare the addictive or withdrawal potential for these drugs, and based on the half lives of both sertraline and citalopram, it is evident that citalopram may be harder to come off than sertraline, because sertraline is likely to be eliminated from the body much sooner.

Another key difference between sertraline vs citalopram is that sertraline does not cause as intense side effects as citalopram might, for example weight gain or hair loss, and the side effects of sertraline may also be fewer in comparison.

Another sertraline vs citalopram difference is that citalopram is only available in an oral tablet form, sertraline is also available in an oral solution form in addition to the oral tablet one like citalopram.

Lastly, because of its relatively milder side effects and shorter half life, sertraline is also likely to be good for treating many other disorders than just depression, and some of them include Obsessive Compulsive Disorder (OCD), Panic Disorder (PD), Post-Traumatic Stress Disorder (PTSD), Social Anxiety Disorder (SAD), and Premenstrual Dysphoric Disorder (PDD).

Citalopram may also be used to treat these disorders but the chances of sertraline being used are much higher.

You can view some Sertraline reviews by real people here.

Citalopram Side Effects

Some of the common citalopram side effects include the following:

  • Dry mouth 
  • Drowsiness
  • Excessive sweating
  • Loss of appetite
  • Tiredness
  • Blurred vision 
  • Excessive yawning 

While the above side effects are relatively easier to bear and more common, the next few side effects are more uncommon and you need to seek immediate help if you get them.

  • Easy bruising/bleeding.
  • Fainting
  • Fast/irregular heartbeat
  • Changes in sexual ability
  • Seizures
  • Eye pain/swelling/redness
  • Widened pupils
  • Vision changes (such as seeing rainbows around lights at night).
  • Black stools
  • throw-up that looks like coffee grounds
  • Shaking (tremor)
  • Decreased interest in sex

Sertraline Side Effects

A list of common sertraline side effects are given as follow:

  • Insomnia
  • Nausea
  • Increased sweating
  • Fatigue
  • Indigestion
  • Agitation
  • Shaking
  • Diarrhea
  • Somnolence
  • Decreased libido
  • Anorgasmia
  • Dizziness
  • Headache

Moving from Citalopram to Sertraline

Many people may be advised that moving from citalopram to sertraline may be better for them if they are experiencing too many side effects or if they feel that their condition is not getting better.

Moving from citalopram to sertraline may also be considered to be a good idea if the person is suffering from something other than depression and they are not able to feel any betterment with the citalopram.

There are some major ways in which moving from citalopram to sertraline may be handled, and these are enumerated below:

Direct switch: In this process, the person may directly change from citalopram to sertraline on the same day, they may just stop taking citalopram and start sertraline, and this may be snow if the person has not been taking citalopram for too long.

Taper off the first antidepressant gradually before starting the second agent: In this process, the person may move from citalopram to sertraline by first getting the citalopram out of their system by gradually reducing the dosage, and then before the medicine is completely out of their system they may get started with sertraline.

This method may be used most commonly in case of a switch between SSRI to SNRI and vice versa. 

Taper off the first antidepressant gradually and completely washout before initiating the second agent: In this process, the person moving from citalopram to sertraline first gets the citalopram completely out of their system and then once they are completely weaned off citalopram they start with sertraline, and this may be done when the potential for a harmful drug interaction that could place the person at increased risk of serotonin syndrome needs to be avoided. 

Cross taper: In this method of moving from citalopram to sertraline, the person may be required to have citalopram incrementally being withdrawn, while the sertraline is gradually being titrated up to take effect. 

Moving from Citalopram to Sertraline Review

Here are some reviews of people moving from citalopram to sertraline:

“Hi, I came off 40mg citalopram in Feb before switching to 50mg of sertraline. I came down 10mg for 3 days then another ten and so on. I was worried because I was having an awful time with anxiety (was switching to sertraline because it was supposed to be better for anxiety).I had very few side.effects from coming off the citalopram but had a couple of nausea type feelings starting the new meds. Am now on 200mg (top dose) of sertraline and it’s been really good for me. Hope this helps, good luck”

“I just finished off one pack and started the other. Am on 100mg and have been for about 6/8 weeks. I feel it’s only just starting to work now.”

“I switched from 40mg Citalopram to 100mg sertraline with no reduction. GP told me there was no need to reduce as they were both SSRIs.”

“Have just been switched from citalopram to sertraline as bad nausea in the morning and suffered racing heartbeat. Went up to 148 bpm one morning. Apparently citalopram shouldn’t be taken when your on beta blockers as can give heartbeat problems”

Citalopram Vs Sertraline: Reviews

Here are reviews of both citalopram and sertraline so that you may be able to compare how these medicines work for the same kind of disorders:

“For Premenstrual Dysphoric Disorder: “I just started Celexa 20mg for PMDD after being on Zoloft for two years. I must say Celexa is winning. I started my period and it’s been the most peaceful week in a long time. I am experiencing dry mouth and insomnia but anything is better than feeling like a crazy lady.”

“For Premenstrual Dysphoric Disorder: “I have only just recently started taking this anti-depressant, sertraline. A week to be exact, and I cannot tell you what a difference it has made, I am sleeping really well, actually quite tired come the end of a day albeit early evening I’m ready to go to bed which isn’t normal for me. So that seems to be the only downside right now, but otherwise, from being super sensitive, angry, emotional, cranky you name it, my mood has changed dramatically, to feeling elated, almost high *I don’t take drugs either*, calm and composed. I have had a couple of anxious moments during this time where l would have previously freaked out, however in this case I was calm and passive, which even surprised me! So this may or may not work for all but if you do feel the good side effects with a little fatigue etc don’t give up on them completely I believe they work.”

“For Anxiety and Stress: “Started on citalopram after my IBS symptoms would not settle. Tried 10mg as a last resort. My IBS is completely gone but I also feel so much less stressed. Things that would have upset me are now like water on a ducks back. My job is stressful and last year I found it very hard. This year with citalopram I feel like I can cope with pretty much anything. I feel great mentally and physically and I haven’t noticed any side effects. I tell everyone that I’m on a miracle drug!”

“For Anxiety and Stress: “I had been suffering from increased anxiety and panic attacks the last few months so I went to my dr who put me on 25mg Zoloft for a week, onto 50mg afterwards. From nearly the first day, I started having terrible side effects, including significantly increased anxiety, diarrhea, complete lack of appetite, insomnia, constant fidgeting, agoraphobia, teeth chattering/grinding, and depressive thoughts that I’ve never experienced in my entire life. These began over the first few days and got increasingly worse over the three weeks I took it. I cried and cried at how terribly I felt. It did not agree with my body or mind. My dr took me off Zoloft immediately and switched me to Effexor and buspar. My side effects went away after about two days and I have experienced none of those side effects since I’ve been on the new meds. Please just be cautious if you take this, know the risks, because they are very real. Also know when to quit and try something else.”

Conclusion

In this brief guide, we looked at differences and similarities of sertraline vs citalopram, or as they are known by their brand names, Zoloft vs celexa. We also looked at the side effects of both medications and what they are commonly used for.

Sertraline vs citalopram is a differentiation the clinician usually makes based on the unique needs of the individual and based on what symptoms they have.


Both of these medicines are used for more than just depression, even though they are technically antidepressants, so that is something else to be considered when they are being compared.

If you have any questions or comments about sertraline vs citalopram, please feel free to reach out to us at any time.

Frequently Asked Questions (FAQs): Sertraline vs Citalopram 

Is sertraline the same as citalopram?

Sertraline is not exactly the same as citalopram but both of them do belong to the same class of antidepressants, which is known as selective serotonin reuptake inhibitors (SSRI), and both of these drugs are prescribed for the treatment of depression primarily, although they have been used for the treatment of various other conditions as well.

Does sertraline have worse side effects than citalopram?

No, sertraline does not have worse side effects than citalopram, and this is because sertraline has a shorter half life than citalopram, which means that it stays in the system for shorter duration, causing less side effects and also side effects that are lesser in intensity as compared to the side effects caused by citalopram.

Is Escitaloprám stronger than sertraline?

Yes, escitalopram is stronger than sertraline, which was shown in a 2014 study published in the journal called International Clinical Psychopharmacology, where it was suggested that Lexapro (Escitalopram) may be more effective and better tolerated than Zoloft (Sertraline) or Paxil (Paroxetine). 

A possible reason that escitalopram is stronger than sertraline may be that escitalopram has different binding site interactions than sertraline, which means that it may have better efficacy and tolerability.

Which is the best SSRI for anxiety?

The best SSRIs for anxiety include SSRIs such as Prozac, Zoloft, Paxil, Lexapro, and Celexa.

Citations

https://www.singlecare.com/blog/celexa-vs-zoloft/

https://www.rxlist.com/zoloft_vs_celexa/drugs-condition.htm

https://www.drugs.com/compare/citalopram-vs-sertraline

http://www.smartcarebhcs.org/once-you-decide-it-is-time-to-switch-antidepressants-how-do-you-go-about-it-1-23-2020/

Divya is currently a Clinical Psychology Trainee in a Master of Philosophy program and holds a Master’s in clinical psychology. She has a special interest in Personality studies and disorders, having researched the subject before, and Neuropsychology; with an additional interest being Mood disorders. She likes to write about Psychiatric issues, having worked in multiple specialty setups during her time as a clinical psychology student, and in her free time she likes to cook and read.