Difference in escitalopram and citalopram

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Escitalopram and citalopram are both commonly prescribed antidepressants that belong to the selective serotonin reuptake inhibitor (SSRI) class of medications. While they are similar in many ways, there are key differences between the two drugs that may affect their efficacy and tolerability for individual patients.

Escitalopram, which is the S-enantiomer of citalopram, is often touted for its slightly improved tolerability profile and potentially greater efficacy in treating depression and anxiety disorders. Some studies suggest that escitalopram may have a faster onset of action and be more effective at lower doses compared to citalopram.

On the other hand, citalopram is a racemic mixture of both the R- and S-enantiomers, with the S-enantiomer being the active ingredient in escitalopram. Some patients may find that citalopram is equally effective for their symptoms and may prefer its lower cost compared to escitalopram.

Ultimately, the choice between escitalopram and citalopram should be based on individual factors such as tolerability, side effects, and treatment response. It is important to consult with a healthcare provider to determine the best option for your specific needs.

Understanding Escitalopram and Citalopram

Escitalopram and citalopram are two commonly prescribed medications used in the treatment of anxiety and depression disorders. While both belong to the class of selective serotonin reuptake inhibitors (SSRIs), they have slight differences in their chemical structures that result in varying pharmacological actions.

Escitalopram is the S-enantiomer of citalopram, meaning it is the mirror image of one of the molecules in citalopram. This structural dissimilarity contributes to the differences in their pharmacodynamics and efficacy.

Escitalopram is known for its high affinity and selectivity for the serotonin transporter, leading to a more potent inhibition of serotonin reuptake compared to citalopram. This increased potency often results in improved efficacy and a potentially lower incidence of side effects.

Citalopram, on the other hand, is a racemic mixture of both the S- and R-enantiomers. While citalopram is effective in treating depression and anxiety, some patients may experience side effects due to the R-enantiomer’s interference with the serotonin transporter.

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In conclusion, understanding the subtle differences in the chemical structures of escitalopram and citalopram can help healthcare providers make informed decisions when choosing the appropriate medication for their patients.

Key Differences in Chemical Structures

Key Differences in Chemical Structures

Escitalopram and Citalopram are both selective serotonin reuptake inhibitors (SSRIs) used in the treatment of depression and anxiety disorders. The main difference between these two drugs lies in their chemical structures.


  • Escitalopram is the S-enantiomer of the racemic compound citalopram.
  • It is the more active form of citalopram and is responsible for the therapeutic effects of the drug.
  • Escitalopram has a more potent action on serotonin reuptake inhibition compared to citalopram.


  • Citalopram is a racemic mixture of the R- and S-enantiomers.
  • It is less potent than escitalopram in terms of serotonin reuptake inhibition.
  • Citalopram may have a higher risk of certain side effects due to its action on other receptors.

Understanding the differences in the chemical structures of escitalopram and citalopram is important for healthcare professionals to make informed decisions about the choice of medication for their patients.

Pharmacological Variations and Mechanisms of Action

Escitalopram and citalopram are both selective serotonin reuptake inhibitors (SSRIs) that are commonly used to treat depression and anxiety disorders. While they belong to the same class of antidepressants, there are key pharmacological differences between the two drugs.


Escitalopram is the S-enantiomer of citalopram, meaning it is the active form of the drug. It works by blocking the reuptake of serotonin in the brain, increasing the levels of this neurotransmitter. This action helps to regulate mood and emotions, leading to an improvement in depressive symptoms.


Citalopram, on the other hand, is a racemic mixture containing both the S-enantiomer (escitalopram) and the R-enantiomer. While citalopram also works by blocking serotonin reuptake, the presence of the R-enantiomer may contribute to a higher risk of side effects such as cardiac arrhythmias.

Aspect Escitalopram Citalopram
Mechanism of Action Selective inhibition of serotonin reuptake Non-selective inhibition of serotonin reuptake
Side Effects Less likely to cause cardiac side effects Higher risk of QT prolongation and cardiac arrhythmias
Efficacy Considered more potent due to higher concentration of active form May require higher doses to achieve therapeutic effect
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Overall, understanding the pharmacological variations between escitalopram and citalopram can help healthcare providers make informed decisions when prescribing these medications for patients with depression or anxiety.

Efficacy and Side Effects Comparison

When comparing the efficacy of Escitalopram and Citalopram for anxiety and depression disorders, it’s important to consider their pharmacological differences. Escitalopram, as a selective serotonin reuptake inhibitor (SSRI), has been shown to have a slightly higher efficacy in treating symptoms of anxiety and depression compared to Citalopram.


Escitalopram has demonstrated a faster onset of action and slightly better response rates in clinical trials. Patients may experience improvement in their symptoms sooner when taking Escitalopram compared to Citalopram. However, individual responses to medication can vary, so it’s essential to work closely with a healthcare provider to find the most effective treatment.

Side Effects

Both Escitalopram and Citalopram may cause similar side effects, such as nausea, dry mouth, headaches, and sexual dysfunction. However, Escitalopram is often associated with fewer side effects due to its more specific action on serotonin reuptake. Some patients may find Escitalopram to be better tolerated than Citalopram in terms of side effects.

It’s crucial to discuss the potential side effects of these medications with a healthcare provider before starting treatment. Monitoring for side effects and adjusting the dosage as needed can help optimize the benefits of Escitalopram or Citalopram in managing anxiety and depression disorders.

Usage for Anxiety and Depression Disorders

Citalopram and Escitalopram are both commonly prescribed for the treatment of anxiety and depression disorders. They belong to a class of medications known as selective serotonin reuptake inhibitors (SSRIs), which work by increasing the levels of serotonin in the brain.

These medications are often used to help manage symptoms of anxiety disorders, such as generalized anxiety disorder, panic disorder, and social anxiety disorder. They are also effective in treating major depressive disorder and other forms of depression.

It is important to follow the prescription guidelines provided by your healthcare provider when using Citalopram or Escitalopram for anxiety and depression disorders. The dosage recommendations may vary depending on the severity of your condition and your individual response to the medication.

It is essential to take these medications as directed and to not stop or change the dosage without consulting your healthcare provider. Abruptly discontinuing the medication can lead to withdrawal symptoms and may worsen your condition.

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If you experience any side effects or have concerns about the effectiveness of Citalopram or Escitalopram in managing your anxiety or depression, be sure to communicate with your healthcare provider. They can adjust your treatment plan or recommend alternative options to better suit your needs.

Prescription Guidelines and Dosage Recommendations

When it comes to prescribing escitalopram and citalopram, it is crucial for healthcare providers to consider several factors. The dosage of these medications can vary depending on the individual’s condition, age, and medical history. Below are some important guidelines to keep in mind:

Escitalopram Dosage:

The typical starting dose of escitalopram for adults is 10mg per day, taken either in the morning or evening. The dose may be increased to a maximum of 20mg per day if necessary. For elderly patients or those with hepatic impairment, a lower dose may be recommended.

Citalopram Dosage:

Citalopram is usually started at a dose of 20mg per day for adults, with the option to increase to a maximum of 40mg per day if needed. Lower doses are recommended for elderly patients and individuals with hepatic impairment.

It is important for patients to follow their healthcare provider’s instructions carefully and not adjust the dosage on their own. Abruptly stopping these medications can lead to withdrawal symptoms or a recurrence of symptoms. If any side effects or concerns arise, patients should consult their healthcare provider promptly.

Patient Experience and Feedback

Many patients have shared their experiences and feedback about using Escitalopram and Citalopram for treating anxiety and depression disorders.

Positive Feedback

Escitalopram: Patients often report feeling more balanced and stable emotionally after starting Escitalopram. They appreciate the reduction in anxiety symptoms and improved mood.

Citalopram: Some patients find Citalopram to be effective in managing their depression symptoms and helping them cope with everyday stressors. They report feeling more relaxed and less overwhelmed.

Negative Feedback

Escitalopram: A few patients have reported side effects such as nausea, dizziness, and insomnia when first starting Escitalopram. However, these symptoms tend to subside over time for most users.

Citalopram: Some patients have experienced sexual side effects, such as decreased libido and difficulty achieving orgasm, while taking Citalopram. This can be a concern for some individuals.

In general, it’s important for patients to communicate openly with their healthcare provider about their experiences and any concerns they may have while taking these medications. Every individual’s response to treatment can vary, and adjustments to dosage or medication type may be needed to achieve optimal results.