Prozac and Celexa are two of the most common medications used to treat anxiety and depression. Although these medications are similar, there are key differences between the two that should be considered before starting a new medication.

In this article, we will give a full comparison guide of Prozac and Celexa so that you can have a more informed discussion with a healthcare provider about which medication is right for you.

When searching for the right medication for you, always consult with a medical professional to discuss your symptoms, potential side effects, and contraindications with other drugs. If you need an affordable, reliable healthcare provider, Klarity Health can help. We’ll connect you with a licensed provider in your state for online depression or anxiety treatment.

When you work with a provider on Klarity Health, you can receive an evaluation, diagnosis, and treatment for your symptoms, if applicable, in just 48 hours. Your provider can also help you determine if Prozac, Celexa, or another form of medication is right for you, and send any prescriptions directly to your local pharmacy. To finally experience relief from your symptoms, schedule an appointment today.

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately by dialing 988.

	Celexa	Prozac
Drug Class	Selective serotonin reuptake inhibitor (SSRI)	Selective serotonin reuptake inhibitor (SSRI)
Brand / Generic Status	Brand name for citalopram	Brand name fluoxetine
Form(s) of the Drug	• Oval capsules • Round tablets • Clear, peppermint-flavored liquid suspension	• Clear, peppermint-flavored liquid suspension • Half-green, half-white capsules
Standard Dosage	Capsules: • 30mg dose Tablets: • 10 mg • 20 mg • 40 mg Liquid suspension: • 10mg of citalopram per dose	Liquid suspension: • 10mg per dose Capsules: • 10mg per dose
Conditions Treated	FDA-approved uses: • Major depressive disorder (MDD) Off-label uses: • Obsessive-compulsive disorder (OCD) • Binge eating disorder • Alcohol use disorder • Generalized anxiety disorder • Panic disorder or PTSD • Premenstrual dysphoric disorder • Postmenopausal flushing • Premature ejaculation	FDA-approved uses: • Anxiety and stress • Major depression • Bulimia nervosa • Premenstrual dysphoric disorder (PMDD) • Obsessive-compulsive disorder (OCD) • Panic disorder • Postpartum depression • Schizoaffective disorder Off-label uses: • Anorexia nervosa • Premature ejaculation • Various anxiety disorders
Cost	Brand-name: • $4 for 30-day supply* *With coupon codes or insurance	Generic form (fluoxetine): • $3 to $4 for 30-days’ worth of capsules* • $12 for 30 days’ worth of liquid suspension *May cost up to $100 for high dosages Brand-name: • $460 to $1000 for 30 days’ worth of capsules
Side-Effects	Common side effects: • Nausea or GI upset • Dry mouth • Changes in appetite • Drowsiness or fatigue • Increased sweating • Blurred vision Serious side effects: • Worsening depression • Suicidal ideation • Serotonin syndrome • Rapid heart rate and high blood pressure • High fever, resulting in increased sweating, shivering, or goosebumps • Irregular heartbeat or palpitations • Agitation or restlessness • Loss of muscle coordination or uncontrollable muscle twitching or rigidity • Diarrhea • Headache • Dilated pupils • Confusion or altered consciousness	Common side effects: • Nausea • Diarrhea or constipation • Changes in appetite • Headache and fatigue • Increased sweating • Trouble sleeping • Impotence/sexual dysfunction Serious side effects include: • Fever • High blood pressure • Rigid muscles • Seizures • Kidney or respiratory failure • Disorientation or delirium • Serotonin syndrome
Warnings For Use	Adverse drug reactions: • MDMA • St. John's Wort • ADHD medications, such as Adderall • Antipsychotic medications • Tricyclic antidepressants • Buspar • Some migraine medications • Lithium • Antiplatelet and anticoagulant medications • MAOIs • Drugs that affect heart rhythm	Contraindicated conditions: • Diabetes • Liver disease • Alcohol use disorder • History of bipolar disorder • History of suicide attempts • Low blood sodium or dehydration • Seizures • Gastrointestinal ulcers • Glaucoma Drug Interactions: • Monoamine oxidase inhibitors (MAOIs) • Nonsteroidal anti-inflammatory drugs (NSAIDs) • Aspirin and other blood thinners • Antihistamines • Opioid pain relievers • St. John’s wort • Cannabis and MDMA

What is Prozac?

Prozac belongs to the class of medications called selective serotonin reuptake inhibitors (SSRIs), and is one of the most commonly prescribed medications for treating anxiety and depression. SSRIs work by increasing the levels of a neurotransmitter called serotonin.

Those who suffer from anxiety and depression tend to have lower serotonin levels in the brain, and SSRI medications help restore this neurochemical imbalance.

Common doses and forms of Prozac

Prozac is available in a few different forms, including an oral solution, tablet, and capsule. The dose is typically started around 20 mg and can then be gradually titrated up weekly. The maximum dose should not exceed 80 mg per day.

Capsules are available as

10 mg
20 mg
40 mg
90 mg delayed release

Tablets are available in the following dosage forms:

10 mg
20 mg
60 mg

The oral solution is the least commonly prescribed form and is typically reserved for use in the pediatric population. It is available in one strength of 20 mg/5 mL.

Conditions Prozac treats

Prozac is one of the most effective medications for treating several types of anxiety and depressive disorders.

Prozac is FDA-approved for:

Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Eating disorders, such as Bulimia nervosa
Panic disorder
Premenstrual dysphoric disorder (PMDD)

In addition, when used in combination with Zyprexa, Prozac is useful in the treatment of:

Acute depressive disorders in patients with bipolar I disorder
Treatment-resistant depression

Prozac can treat symptoms of Anxiety and Depression

Prozac has been shown to improve mood and increase energy levels, which are commonly seen in people with depression. In addition, Prozac helps stabilize your mood and reduce feelings of helplessness and hopelessness.

Prozac is also effective in treating anxiety by decreasing the constant feelings of nervousness, restlessness, or worry. With continued long-term use of this medication, feelings of anxiety associated with social situations and ruminating or intrusive thoughts tend to lessen over time.

Off-label uses for Prozac

The term “off-label” is used to describe any use of the medication that is not FDA-approved. This does not mean that it is ineffective in treating the following conditions, but it simply has not had dedicated clinical trials with the FDA for the specific use.

Some off-label uses include

Generalized anxiety disorder
Migraine headaches
Fibromyalgia
Neuropathy or nerve pain caused by long-term diabetes
Premature ejaculation

Prozac Costs

Prozac is available in name brand and generic form, called fluoxetine. Most commercial health insurance plans typically cover both formularies. Without insurance, a 30-day supply of name-brand Prozac can cost anywhere between $500-1000 a month, depending on the dosage.

With the use of coupon codes and generic formularies, an average monthly supply costs around $10. Coupon codes are available at all major pharmacies for those who do not have health insurance coverage.

Prozac Side Effects

As with any medication, there is a possibility of experiencing side effects when starting a new medication. Although serious side effects are rare, it is important to take note of changes in your body and discuss them with your healthcare provider.

As with most SSRI medications, there are a number of potential mild side effects that may occur when initially starting the medication. These effects tend to lessen with long-term use.

Some of the most common side effects associated with Prozac include

Difficulty falling asleep or insomnia
Drowsiness or fatigue
Changes in bowel movements, including diarrhea or constipation
Changes in appetite
Headache
Increased anxiety or nervousness
Tremor
Dry mouth
Sexual dysfunction, including lack of desire and orgasm

Prozac Warnings

There are a few rare but serious side effects associated with taking Prozac, and therefore, the medication should be taken under close supervision when starting and stopping this medication. It is important to take Prozac as prescribed and to contact your healthcare provider if you begin to experience any of the following serious side effects.

Suicidal thoughts and behaviors

In young adults under the age of 24, there is a risk that Prozac may worsen your depressive symptoms and may even result in new or increased suicidal ideation or behaviors.

If you begin to experience thoughts of self-harm, contact your healthcare provider immediately or seek urgent medical care at the nearest ER. The Suicide and Crisis Lifeline is available 24/7 at 988.

Serotonin Syndrome

Serotonin Syndrome is another rare but potentially fatal health condition that results from an overload of serotonin in the body. This is most commonly seen in people who are taking multiple medications that increase the levels of serotonin.

Common signs and symptoms of serotonin syndrome include:

Fever
High blood pressure
Increased heart rate or irregular heartbeat
Agitation or restlessness
Diarrhea
Dilated pupils
Muscle spasms, stiffness, or loss of muscle coordination
Confusion, or even coma

Withdrawal or Discontinuation Syndrome

If you are considering discontinuing Prozac, it is important to discuss this with your healthcare provider so that you can be titrated off of the medication and avoid unwanted adverse effects from sudden withdrawal or discontinuation of the medication.

Common withdrawal symptoms include:

Dizziness or vertigo
Headache
Fatigue
Tremor or visual disturbances
Nausea, vomiting, diarrhea
Increased anxiety or agitation
Confusion or irritability
Insomnia

Caution in Use with Elderly Patients

SSRI medications, including Prozac, should be used with caution in the older population due to additional potential health complications, including low blood pressure and electrolyte imbalances, which could result in increased falls.

Prozac drug interactions

SSRI medications are relatively safe medications but are known to have potential interactions with other medications or over-the-counter supplements. Before starting any new medication, it is important to disclose all medications you are taking with your healthcare provider.

Some common medications to avoid while taking Prozac include:

Monoamines oxidase inhibitors
NSAIDs
Blood thinning medications, including Warfarin and aspirin
Opioids
Anti-nausea medications, including Zofran
Thiazide diuretics
Medications that increase serotonin levels: ADHD medications including Adderall, TCAs, Buspar, antipsychotics, Lithium, migraine medications, over-the-counter supplements such as St. John’s Wort and recreational drugs like MDMA

What is Celexa?

Similar to Prozac, Celexa is an SSRI medication that works by increasing serotonin levels in the brain. Celexa is commonly prescribed for depression and anxiety. Of note, Celexa is likely not the best treatment option for those who have chronic heart or liver problems.

Common doses and forms of Celexa

Celexa is available in capsule, tablet, and oral solution forms. The tablet form is most commonly used in the adult population due to the various forms of dosing available. Celexa is typically started at 10 mg by mouth daily and can be titrated up by 10 mg weekly, as needed.

The maximum dose is 40 mg per day, and in patients over 60 years of age, the maximum dose is 20 mg per day due to cardiac concerns in this population.

Celexa is available in tablet form in the following doses:

10 mg
20 mg
40 mg

Celexa capsules are available in 30 mg doses only.

Like Prozac, the oral solution of Celexa is available in one dose of 10 mg/5 mL and is typically reserved for the pediatric population.

Conditions Celexa treats

Celexa is used in the treatment of several different depressive and anxiety disorders. The FDA has only formally approved the medication to treat major depressive disorder (MDD), but there are a number of off-label uses for this SSRI medication listed below.

Celexa can treat symptoms of Anxiety and Depression

Celexa is used to treat depression by improving mood and increasing the patient’s ability to enjoy everyday life activities that they once enjoyed.

Additionally, Celexa can improve sleep disturbances and improve appetite, as well as calm the thought process, including anxious, restless, or intrusive thoughts associated with various anxiety disorders.

Off-label uses for Celexa

As previously stated, the term “off-label” is used for any use of a medication that is not FDA approved for the medication. There are a number of “off-label” uses for Celexa, including:

Obsessive-Compulsive Disorder (OCD)
Binge eating disorder
Alcohol use disorder
Generalized anxiety disorder
Panic disorder or PTSD
Premenstrual dysphoric disorder
Postmenopausal flushing
Premature ejaculation

Celexa Costs

When compared to Prozac, Celexa is less expensive, with the average cost of a 30-day supply being roughly around $300-500 for name-brand Celexa without insurance. But when using a generic formulary and coupon codes, a 30-day supply is affordable at around $4. Most insurance plans typically cover Celexa, and prescription coupon codes are widely available at any major pharmacy.

Celexa side effects

Prozac and Celexa have similar side effects because they belong to the same class of drugs and have the same mechanism of action on serotonin receptors in the brain.

Some common side effects seen with Celexa include:

Nausea or GI upset
Dry mouth
Changes in appetite
Drowsiness or fatigue
Increased sweating
Blurred vision

Celexa warnings

As with Prozac, there are a few rare but serious warnings to keep in mind when starting Celexa, including increased incidences of worsening depression and increased suicidal ideation. If you are having thoughts of suicide or self-harm behaviors, contact your healthcare provider immediately or go to the nearest emergency department.

The national suicide hotline can be reached by dialing 988 and is available 24/7.

Serotonin syndrome is an uncommon but serious condition caused by elevated levels of serotonin in the brain. This is most commonly seen in patients who are taking multiple medications that work by increasing serotonin.

It is important to contact your healthcare provider or seek medical care if you begin to experience the following side effects:

Rapid heart rate and high blood pressure
High fever, resulting in increased sweating, shivering, or goosebumps
Irregular heartbeat or palpitations
Agitation or restlessness
Loss of muscle coordination or uncontrollable muscle twitching or rigidity
Diarrhea
Headache
Dilated pupils
Confusion or altered consciousness

Another important consideration with any SSRI is the potential for withdrawal syndrome. When considering discontinuing or decreasing the dose of your medication, it is important to discuss this plan with your healthcare provider so that they can guide the process and slowly titrate the medication.

Celexa drug interactions

As with any medication, there are a number of associated drug interactions that may occur. It is important to discuss all current medications you are currently taking, including over-the-counter medications and supplements.

Some medications that are known to interact with Celexa include

Medications that increase the risk for serotonin syndrome:
- Recreational drugs like MDMA or ecstasy
- St. John’s Wort
- ADHD medications, such as Adderall
- Antipsychotic medications
- Tricyclic antidepressants
- Buspar
- Some migraine medications, including sumatriptan, rizatriptan, tramadol
- Lithium
Antiplatelet and anticoagulant medications will increase the risk of bleeding
MAO inhibitors include linezolid, metaxalone, and methylene blue, to name a few. These medications should be discontinued two weeks before starting an SSRI.

Get Anxiety and Depression Treatment with Help From Klarity Health

If you are struggling with anxiety or depression, medications like Prozac or Celexa could help you find relief from your symptoms. However, you should never attempt to self-medicate your symptoms, and should always speak to a psychiatric professional to receive a safe and effective prescription.

At Klarity Health, we help you access quality anxiety or depression treatment right from the comfort of your own home. We’ll connect you with a licensed healthcare provider who will work with you to develop an individualized treatment plan based on your symptoms, including prescription medication like Prozac or Celexa, if necessary.

Schedule an appointment on Klarity Health today and be seen by a medical professional for your first private telehealth appointment in as little as 48 hours.

Frequently Asked Questions About Prozac and Celexa

Does Prozac Make You Gain Weight? Does Celexa?: Nearly all SSRI medications have the potential side effect of causing weight gain, although the actual amount of weight gain is around 1-10 lbs. When comparing Prozac and Celexa, Prozac is less likely to cause weight gain.
Is Prozac or Celexa Better for Anxiety?: Prozac is FDA-approved for treating anxiety, while Celexa is not, but both medications are equally effective for treating anxiety. Some studies showed that those taking Celexa experienced an improvement in their symptoms faster than those taking Prozac. It is important to remember that everyone reacts to medications differently, and your healthcare provider will help determine which medication is best for you.
Can I Replace Prozac with Celexa?: Both medications are SSRIs and technically can be interchangeable, but only under the close supervision of your healthcare provider. Since these medications have different dosing, your dose will need to be adjusted when switching to a different medication.
Is Prozac Energizing or Sedating? What About Celexa?: Prozac is known to be more energizing than most antidepressants, which makes this medication a good choice for someone who experiences low energy levels associated with depression. Celexa is not as energizing but is not sedating when compared to other antidepressants.
Can I Drink Alcohol On Celexa? On Prozac?: Due to the enhanced effects of alcohol while on an SSRI and the increased risk of side effects, it is generally advised not to drink alcohol while taking either medication.
Can I Drink Caffeine When I’m on Celexa? How About Prozac?: Drinking caffeine with either Celexa or Prozac is considered to be relatively safe. Remember that caffeine is a drug in itself and causes undesirable side effects when taken in large quantities.
What Is Better For Depression—Celexa or Prozac?: Celexa and Prozac are known to be well-tolerated and effective medications for the treatment of depression. While they are considered equally effective overall, some studies have shown that those taking Celexa may see improvement in their symptoms sooner than Prozac.

It’s important to remember everyone reacts to medications differently, and your healthcare provider will help determine which medication is best for you.

Sources: “Citalopram: Drug Information.” UpToDate. https://www.uptodate.com/contents/citalopram-drug-information

“Compare Celexa Vs. Prozac”. Iodine. https://www.iodine.com/compare/celexa-vs-prozac

“Fluoxetine: Drug Information.” UpToDate. https://www.uptodate.com/contents/fluoxetine-drug-information

“”Fluoxetine” Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/fluoxetine-oral-route/proper-use/drg-20063952

Karen Berger. “Celexa vs. Prozac: Differences, similarities, and which is better for you”. SingleCare. https://www.singlecare.com/blog/celexa-vs-prozac

Megan Huang. “How much is citalopram without insurance?” Singlecare. https://www.singlecare.com/blog/citalopram-without-insurance
How we reviewed this article: This article went through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author. Learn more about the editorial and medical review process and standards for the HelloKlarity site.

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The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.