From the Guidelines
Celexa (citalopram) is not the preferred medication for treating anxiety disorders, as the most recent and highest quality study recommends SNRIs, such as duloxetine, as a first-line treatment for anxiety. According to the study published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2020 1, SNRIs have been shown to be effective in the treatment of anxiety disorders, likely due to their complex interactions with other neurotransmitters, including serotonin.
Key Points to Consider
- The study highlights that duloxetine is the only SNRI with an FDA indication for the treatment of generalized anxiety disorder in children and adolescents 7 years old 1.
- While Celexa (citalopram) is an SSRI, which can be used to treat anxiety disorders, the provided evidence does not support its use as a first-line treatment for anxiety, especially when compared to SNRIs like duloxetine.
- The typical starting dose of Celexa (citalopram) is 10mg once daily, which can be increased to 20mg after one week if needed, with a maximum recommended dose of 40mg daily, as stated in the guidelines for managing Alzheimer's disease: part II, treatment, published in the American Family Physician in 2002 1.
- Common side effects of Celexa (citalopram) include nausea, dry mouth, increased sweating, drowsiness, and sexual dysfunction, which often improve over time 1.
Important Considerations for Treatment
- It is essential to take Celexa (citalopram) consistently at the same time each day and not to stop abruptly, as this can cause withdrawal symptoms.
- While using Celexa (citalopram), it is crucial to avoid alcohol and inform your doctor about any other medications you're taking to prevent interactions.
- If you experience severe side effects like suicidal thoughts, severe agitation, or allergic reactions, seek medical attention immediately.
- Regular follow-up appointments with your healthcare provider are essential to monitor your response and adjust treatment as needed.
From the Research
Effectiveness of Celexa (Citalopram) for Treating Anxiety
- Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI) that has been studied for its effectiveness in treating anxiety disorders 2.
- A retrospective case observation study found that citalopram was effective in treating generalized anxiety disorder (GAD), with 13 patients experiencing full or partial improvement in GAD and depressive symptoms after 12 weeks of treatment 2.
- Another study found that escitalopram, the (S)-enantiomer of citalopram, was effective and well tolerated in the treatment of depression and anxiety disorders 3.
- A randomized, controlled trial found that sertraline, another SSRI, was effective in treating anxiety disorders in older adults, with superior results on worry symptoms compared to cognitive-behavioral therapy (CBT) 4.
- A study on the effectiveness of antidepressant medication augmented with CBT for GAD in older adults found that sequenced treatment combining pharmacotherapy and CBT boosted response and prevented relapse 5.
- A systematic review of the comparative effectiveness of second-generation antidepressants, including citalopram, found that the strength of the evidence was moderate or low for most comparisons, and that evidence guiding the selection of an SSRI based on accompanying symptoms of depression is limited 6.
Key Findings
- Citalopram may be an effective treatment for GAD, with improvements in anxiety and depressive symptoms 2.
- Escitalopram, the (S)-enantiomer of citalopram, has a favorable pharmacokinetic profile and is effective in treating depression and anxiety disorders 3.
- SSRIs, including citalopram, may be effective in treating anxiety disorders in older adults, with or without CBT 4, 5.
- The selection of an SSRI based on accompanying symptoms of depression is limited by the strength of the evidence, which is often moderate or low 6.