Living with symptoms of anxiety or depression is difficult. Choosing the right medication shouldn’t be. In this article, we dive into Zoloft vs Celexa for treating anxiety and depression and what you need to know to talk to your provider.

Zoloft and Celexa are 2 commonly prescribed SSRIs or selective serotonin reuptake inhibitors (SSRIs) that are the first-line antidepressants used to treat anxiety and depression. Both medications have been found to be highly effective in improving mood and reducing thoughts that accompany anxiety.

Since these 2 medications belong to the same drug class, they have a similar mechanisms of action and side effect profiles, but there are key differences between them.

When anxiety or depression makes it difficult for you to enjoy your daily life, medications like Zoloft or Celexa may be the solution. If you need simple, insurance-free online depression or anxiety treatment, find a mental health provider who can recommend the right medication for you, if necessary, on Klarity Health. Schedule an appointment today and speak with an experienced healthcare provider in just 24 hours.*

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 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.

	Zoloft	Celexa
Drug Class	Selective serotonin reuptake inhibitor (SSRI)	Selective serotonin reuptake inhibitor (SSRI)
Brand / Generic Status	Brand name for sertraline	Brand name for citalopram
Form(s) of the Drug	• Clear, peppermint-flavored liquid suspension • Color-coded tablets	• Oval capsules • Round tablets • Clear, peppermint-flavored liquid suspension
Standard Dosage	Liquid suspension • 20 mg of sertraline per dose Standard tablet dosages: • Green indicates 25 mg • Blue indicates 50 mg • Pinkish-red indicates 100 mg	Capsules: • 30 mg dose Tablets: • 10 mg • 20 mg • 40 mg Liquid suspension: • 10 mg of citalopram per dose
Conditions Treated	FDA-approved uses: • Major depression • Obsessive-compulsive disorder (OCD) • Panic disorder • Post-traumatic stress (PTS) • Premenstrual dysphoric disorder (PMDD) • Social anxiety disorder Off-label uses: • Autism (mood stabilizing) • Alcoholism • Eating disorders • Diabetic neuropathy • Dementia • Hot flashes • Generalized anxiety disorder (GAD) • Fibromyalgia • Migraines • Personality disorders • Tourette syndrome • Premature ejaculation	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
Cost	Generic form (sertraline): • $11 for 30 days’ worth* Brand-name: • $466 for a 30-day supply* *Without a coupon or insurance	Generic form (citalopram): • $12-$19 30 days’ worth* Brand-name: • $965-$1,049 for a 30-day supply* *Without a coupon or insurance
Side-Effects	Common side effects: • Nausea or indigestion • Diarrhea or loose stool • Tremors or twitching • Decreased appetite and weight loss • Bruising and muscle aches • Decreased libido/trouble orgasming • Excessive sweating • Anxiety Serious side effects: • Heart arrhythmia • Bleeding and liver injury • Confusion and seizures • Suicidal thoughts • Changes in behavior • Serotonin syndrome	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
Warnings For Use	Contraindicated conditions: • Pregnancy or breastfeeding • Liver problems • Epilepsy and seizure disorders • Glaucoma • Bipolar disorder • Thyroid disease Adverse drug interactions: • Monoamine oxidase inhibitors (MAOIs) • Blood thinners • Antipsychotic and antiseizure medications • Alcohol—recreational and alcohol-based medications	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

What is Zoloft?

Zoloft (sertraline) is an SSRI medication that acts by blocking the re-uptake of a neurotransmitter in the brain called serotonin. It is one of the most commonly prescribed medications used to treat anxiety and depression.

Forms and doses of Zoloft

Zoloft is available in capsule, tablet, and liquid forms. Tablets and capsules are most commonly prescribed. The initial starting dose is typically 50 milligrams a day, which can then be increased in 25 milligram increments as needed. The typical maximum dose is 200 milligrams a day.

Zoloft tablets are available in the following dosage forms:

25 milligrams
50 milligrams
100 milligrams

Zoloft is available in capsule form in the following doses:

150 milligrams
200 milligrams

Zoloft oral solution is available at 20 milligrams/milliliter.

Conditions Zoloft is used to treat

There are a number of different anxiety and depressive disorders that are commonly treated with Zoloft both on and off-label.

Off-label use is when your healthcare provider prescribes a medication that’s been shown to have beneficial effects, but isn’t U.S. Food and Drug Administration (FDA)-approved to treat a particular condition. For example, Zoloft is FDA-approved to treat major depressive disorder (MDD), but it can also be used to treat binge eating disorder, even though it’s not FDA-approved to do so.

Zoloft can be used to treat the following disorders:

Major depressive disorder
Generalized anxiety disorder
Social anxiety disorder
Obsessive-compulsive disorder (OCD)
Panic disorder
Post-traumatic stress disorder (PTSD)

Symptoms of anxiety that Zoloft can treat

Zoloft is commonly used to treat anxiety symptoms that affect everyday life, including to:

Calm racing or unwanted thoughts
Decrease fear that is out of proportion to the situation
Reduce the number and severity of panic episodes
Reduce the urges associated with performing repetitive tasks in OCD

Symptoms of depression that Zoloft can treat

Zoloft can improve a number of depressive symptoms and overall increase quality of life, including to:

Improve mood and interest in pleasurable activities
Improve sleep quality
Increase energy levels
Restore appetite

Off-label uses For Zoloft

Some off-label uses for Zoloft include:

Binge eating disorder
Body dysmorphic disorder
Bulimia nervosa
Premature ejaculation
Premenstrual dysphoric disorder
Neuropathic pain

Zoloft costs

Zoloft is available in both generic and name-brand formulations. At the the time of publishing, the average price of a 30-day supply of brand-name Zoloft oral tablets cost roughly $466 without a coupon code or insurance coverage according to drugs.com and with its discount. A 30-day supply of generic sertraline oral tablets cost roughly $11 per drugs.com. Zoloft and sertraline are covered by most insurance plans, and coupon codes are available at most large pharmacies or through sites like GoodRx, drugs.com, SingleCare, and others.

Side effects of Zoloft

All medication come with potential risks and benefits. Of note, SSRIs, including Zoloft, should be avoided or used with caution in elderly patients. This is due to the potential for an increased side effect profile, including electrolyte imbalances, such as sodium, calcium, and potassium, which are critical vital to key bodyily functions.

Common side effects ofZoloft include:

Nausea, vomiting, diarrhea, gastrointestinal (GI) upset
Drowsiness or dizziness
Dry mouth
Loss of appetite
Increased sweating
Insomnia or difficulty sleeping
Decreased libido, sexual dysfunction
Muscle cramps or weakness
Tremor

Zoloft warnings

It’s important to note that there have been reported incidences of worsening depression and increased suicidal ideation while taking Zoloft. If you have 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 texting 988 and is available 24×7.

Serotonin syndrome is a rare but serious drug reaction that occurs when excess serotonin levels build up in the brain. Call your healthcare provider or seek immediate medical attention if you begin to experience any of the following side effects:

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

With any SSRI, there’s a potential for withdrawal when abruptly stopping the medication or decreasing the dose. It’s important to talk to your healthcare provider if you’re thinking about discontinuing an SSRI medication, including Zoloft. Your healthcare provider will work with you to slowly decrease the dose so that you’re less likely to experience withdrawal.

Withdrawal syndrome symptoms include:

Dizziness or light-headedness
Vertigo
Fatigue
Headache
Nausea, vomiting, diarrhea
Tremor or visual disturbances
Irregular sensations, including an “electric-shock” sensation throughout your body
Increased anxiety or agitation
Confusion or irritability
Insomnia

Zoloft drug interactions

Whenever starting a new medication, it’s important to disclose all of the medications you’re currently taking, including over-the-counter medications and supplements. Zoloft interacts with a number of commonly prescribed medications.

Some common drug interactions associated with Zoloft include:

Serotonin syndrome: increased risk with other medications that increase serotonin, with the most common including:
- Recreational drugs, such as methylenedioxymethamphetamine (MDMA) or ecstasy
- ADHD medications, such as Adderall, increase the risk of serotonin syndrome.
- Antipsychotic medications
- Tricyclic antidepressants
- Buspar
- Some migraine medications, including sumatriptan, rizatriptan, tramadol
- Lithium
- St. John’s Wort
Monoamine oxidase inhibitors (MAOIs), including linezolid or methylene blue. These medications must be stopped 14 days before starting an SSRI
Antiplatelet or anticoagulant medications, which increase the risk of bleeding
Specific antibiotics and antifungal medications
Opioids, including methadone
Some antinausea medications, such as ondansetron or Zofran
Thiazide diuretics: increase risk of hyponatremia

What is Celexa?

Similar to Zoloft, Celexa (citalopram) is an SSRI medication that works by increasing serotonin levels in the brain. Celexa is commonly prescribed for the treatment of depression by improving mood and decreasing symptoms of anxiety.

Compared to Zoloft, Celexa has been shown to have fewer side effects and drug interactions. Although Celexa is found to be highly effective in treating anxiety and depression, it’s not the best choice for those who have chronic heart or liver issues.

Forms and doses of Celexa

Celexa is available in capsule, tablet, and oral solution forms. Tablets are most commonly used for adults.

The initial starting dose of Celexa is typically 10 milligrams daily and can be increased in 10 milligrams increments on a weekly basis, as needed. The maximum dose is 40 milligrams per day, and in patients over 60 years of age, the maximum dose is 20 milligrams per day due to cardiac concerns in this population.

Celexa is available in tablet form in the following doses:

10 milligrams
20 milligrams
40 milligrams

Celexa capsules are available in 30 milligrams dosing only.

Oral solution of Celexa is available in 10 milligrams/5 millileters dosing only.

Conditions that Celexa treats

Celexa or citalopram is commonly used in the treatment of a variety of depressive and anxiety disorders. The FDA has only formally approved the medication for major depressive disorder (MDD), but there are a number of off-label uses listed below.

Symptoms of anxiety Celexa is used to treat

There are a variety of anxiety symptoms that are treated with Celexa. Although these are all considered off-label uses, they have been found to be effective in treating the following anxiety symptoms:

Sleep quality
Anxious or racing thoughts
The anxiety or stress associated with eating disorders, including bulimia or binge eating disorder
Thought processing and urges associated with performing repetitive tasks in OCD
The number or severity of panic attacks in those who have PTSD, panic disorder, or social anxiety

Symptoms of depression Celexa can treat

Celexa is FDA-approved for the treatment of depressive symptoms and can potentially improve the quality of life of the patient.

Common symptoms of depression treated with Celexa include:

Depressed mood
Inability to enjoy regular activities
Sleep disturbances
Changes in appetite

Off-label uses for Celexa

The term off-label is used for any use of a medication that isn’t FDA approved for the medication. There are a number of off-label uses for Celexa, including:

OCD
Binge eating disorder
Alcohol use disorder
Generalized anxiety disorder
Panic disorder
PTSD
Premenstrual dysphoric disorder
Postmenopausal flushing
Premature ejaculation

Celexa costs

Brand-name Celexa costs roughly $965 to $1,049 for a 1-month supply of oral tablets according to drugs.com and with its discount. Citalopram, the generic form, costs about from$12 to $19 for a one-month supply. Those costs are without insurance. Celexa and citalopram are typically covered by insurance plans, and prescription coupon codes are widely available at major pharmacies and online at sites like GoodRx, drugs.com, SingleCare, and others.

Side effects from Celexa

There are potential side effects from starting or increasing the dose of any drug. Compared to Zoloft, there tend to be fewer side effects with Celexa, although everyone reacts differently to medications.

Some common side effects of Celexa include:

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

Celexa warnings for use

There are a few rare but serious warnings with the use of Celexa, and should be carefully considered when discussing treatment options with your healthcare provider.

As with most SSRIs, it is important to note that there have been reported incidences of worsening depression and increased suicidal ideation. If you’re having thoughts of suicide or self-harm behaviors, contact your healthcare provider immediately or go to the nearest emergency department.

The national suicide hotline is available 24×7 by texting 988.

Serotonin syndrome is an uncommon but serious condition that is 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’s 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’s important to discuss this plan with your healthcare provider so that they can guide the process and slowly titrate (reduce) the medication.

Known Celexa drug interactions

As with any medication, there are a number of drug interactions that can happen with Celexa. Overall, there appear to be fewer drug interactions than with Zoloft. It’s still important to disclose all medications you’re currently taking to your healthcare provider, including over-the-counter (OTC) medications and supplements.

Some medications that 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
MAOIs, including linezolid, metaxalone, and methylene blue, to name a few. These medications should be discontinued 2 weeks prior to starting an SSRI
Drugs that affect heart rhythm, including amiodarone, procainamide, and sotalol

How a provider on Klarity Health can help you find the right medication

If you’re living with symptoms of anxiety or depression and aren’t sure which medication is right for you, schedule an appointment with a healthcare provider on Klarity Health today. On Klarity Health, find a healthcare provider in your state who specializes in the evaluation and treatment of anxiety and depression.

Schedule an appointment with a provider on Klarity Health today.

Frequently asked questions about Celexa vs Zoloft

Does Zoloft make you gain weight? Does Celexa?: Weight gain is a common concern for anyone starting on an SSRI medication. The simple answer is that either Zoloft or Celexa may result in a small weight gain of 1 to 5 pounds when starting either medication.

If this is a major concern for you or you develop serious weight gain when starting either medication, your healthcare provider can offer alternative treatment options.
Is Zoloft or Celexa better for anxiety?: Unlike Celexa, Zoloft is FDA-approved for the treatment of anxiety and has been shown to be one of the most effective SSRIs for various anxiety disorders. Although, Celexa is better tolerated in some patients and has shown to be effective in treating anxiety as well.
Can I replace Zoloft with Celexa?: Since both medications belong to the same drug class, they can be interchanged with one another under the supervision and direction of your healthcare provider.

Depending on how you tolerate either medication and the side effects you experience, changing SSRIs to find the best treatment option for you is a fairly common practice. Your healthcare provider will adjust your dose based on your current symptoms and side effects.
Is Zoloft energizing or sedating? What about Celexa?: While comparing the two medications, Celexa tends to be more sedating, while Zoloft has been found to be more energizing. Although, everyone reacts differently to each medication.
Does Zoloft cause brain fog? Does Celexa?: Brain fog is a common symptom of depression but can be a side effect associated with the use of SSRIs. When comparing the two medications, Zoloft was shown to have more side effects of reported brain fog than Celexa.
Can I drink alcohol on Celexa? On Zoloft?: You should avoid drinking alcohol while taking either Celexa or Zoloft. Even drinking a small amount of alcohol while on these medications can cause unwanted side effects. Plus, overall, drinking alcohol has been associated with worsening anxiety and depression.
Can I drink caffeine when I’m on Celexa? How about Zoloft?: It’s typically safe to consume caffeine on both Celexa and Zoloft, with no increased incidence of side effects reported.
What is better for depression — Celexa or Zoloft?: Although both medications have been found to be highly effective at treating depression, studies have shown that Celexa may provide relief of depressive symptoms more quickly than Zoloft.

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https://www.uptodate.com/contents/citalopram-drug-information?search=celexa&source=panel_search_result&selectedTitle=1~103&usage_type=panel&kp_tab=drug_general&display_rank=1#F151952

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https://www.singlecare.com/prescription/celexa/dosage
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.

*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.

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.