Depression is a common yet severe medical illness that can negatively affect how you think, how you feel, and how you act. It causes feelings of sadness and loss of interest in things you enjoyed. It can also cause various physical or emotional problems that can negatively affect the quality of your life.

Fortunately, depression is treatable, and various medicines are available for its management. Deciding on an ideal medicine to treat depression can be challenging, and your doctor may have to try a couple of them before choosing the right one for you. 

Cipralex and Citalopram are two commonly used antidepressants.

Here is more about these drugs so that you understand your options and discuss the same with your doctor.

How Does Medication Help in Treating Depression?

Before understanding how antidepressants help, it is essential to know why depression occurs in the first place.

Brain chemicals (neurotransmitters) are responsible for sending signals from one brain area to another. Their action depends on the type of brain cells they influence. For instance, the neurotransmitter serotonin supplies cells related to mood, social behavior, appetite, sexual desire and function, learning and memory, and temperature regulation.

Antidepressants act on one or more of these neurotransmitters that affect your mood, improving their levels in the brain. However, the effect is temporary, and the brain state returns to the previous state once you stop them.

Some common classes of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Dopamine reuptake blocker
• Tetracyclic antidepressant
• Tricyclic antidepressants (TCAs)
• 5-HT2 receptor antagonists
• 5-HT1A receptor antagonist
• 5-HT3 receptor antagonist
• Noradrenergic antagonist
• Monoamine oxidase inhibitors (MAOIs)

Both Cipralex and Citalopram belong to the group SSRIs. 

Cipralex And Treating Depression

As mentioned before, serotonin is a neurotransmitter responsible for regulating your mood. SSRIs inhibit the reuptake or reabsorption of serotonin into nerve cells. This increases its level in the brain and improves the transmission of messages between nerve cells. As these drugs affect mainly serotonin and no other neurotransmitters, they are called selective.

So, Cipralex works by improving the serotonin level in your brain. It can also help manage other conditions, such as anxiety disorders.

Citalopram and Depression

Similar to Cipralex, Citalopram also belongs to the SSRIs group of drugs and work by increasing serotonin levels in the brain.

Comparing the Two- Similarities V/S Differences

Let’s understand their adverse-effects, interactions, and contraindications.

Cipralex Side-effects

Table 1: Common side-effects

	Side effects	Cipralex	Citalopram
Common	Nausea	Yes	Yes
	Sleepiness	Yes	Yes
	Weakness	Yes	Yes
	Dizziness	Yes	Yes
	Trouble sleeping	Yes	Yes
	Sexual problems	Yes	Yes
	Sweating	Yes	Yes
	Anxiety	Yes	Yes
	Loss of appetite	Yes	Yes
	Shaking	Yes	Yes
	Constipation	Yes	Yes
	Respiratory infections	Yes	Yes
	Yawning	Yes	Yes
	Dry mouth	Yes	Yes
	Diarrhea	No	Yes
Serious	Severe allergic reactions	Yes	Yes
	Seizures	Yes	Yes
	Changes in weight and appetite	Yes	Yes
	Visual problems	Yes	Yes
	Suicidal thoughts	Yes	Yes
	Abnormal bleeding	Yes	Yes
	Maniac episodes	Yes	Yes
	Low sodium levels	Yes	Yes

Common side-effects

• Blurred vision
• Insomnia
• Fever
• Headache
• Nausea
• Increased sweating
• Decreased libido, sexual ability, or ejaculatory delay
• Restlessness
• Agitation
• Drowsiness
• Dizziness
• Dry mouth
• Diarrhea
• Indigestion
• Frequent urination
• Increased or decreased appetite
• Weight changes
• Tremors

Rare side-effects

• Suicidal tendency
• Pain in neck and shoulders
• Influenza-like symptoms

Severe side-effects

• Abnormal bleeding
• Manic episodes
• High fever
• Muscle rigidity
• Glaucoma
• Suicidal thinking and behavior
• Seizures
• Confusion
• Slurred speech
• Low sodium

Withdrawal symptoms

• Tingling
• Vivid dreams
• Poor mood
• Dizziness
• Tiredness
• Irritability

In order to avoid these symptoms, the dose is slowly reduced, and medicine is not stopped abruptly.

Citalopram Side Effects

Very Common side effects

• Headache
• Difficulty in sleeping 
• Sleepiness 
• Loss of body strength, weakness 
• Changes in sleeping pattern 
• Nausea 
• Increased in sweating 
• Dry mouth 

Common side effects

• Decreased sex drive
• Agitation
• Lack of appetite
• Confusion
• Abnormal dreams
• Nervousness 
• Anxiety 
• Reduced emotions
• Dizziness
• Tremors 
• Migraine
• Numbness in hands or feet
• Problems in concentration 
• Loss of memory 
• Ringing in ears
• Loss of weight 
• Prickling of skin
• For women, failing to reach orgasm 
• For men, problems with ejaculation and excretion
• Stomach pain 
• Flatulence
• Constipation
• Increased in saliva
• Yawning 
• Palpitations
• Pain in muscle and joints
• Blocked nose or runny nose

Uncommon side effects

• Bruised easily 
• Increased weight
• Swelling in arms or legs
• Difficulty in urination 
• Excessive menstrual bleeding
• Sensitivity to sunlight
• Rash
• Loss of hair
• Increased appetite
• Aggression 
• Mania
• Hallucinations 
• Large pupils
• Fainting 
• Fast heartbeat
• Slow heartbeat
• Nettle rash

Rare side effects

• Feeling unwell
• Bleeding
• Hepatitis 
• Coughing
• Increased sex drive 
• Involuntary movements
• Taste disturbances 
• Convulsions

Citalopram Contraindications

• Liver disorders
• Kidney disorder
• Abnormal heart rhythm
• Diabetes
• Mania or panic disorder
• Epilepsy 
• Bleeding disorder
• If you have a history of bleeding in the stomach or intestine
• Low sodium levels
• Problems with eyes such as glaucoma 
• Electroconvulsive therapy 
• Low heart rate
• If you experience a fast or irregular heartbeat, collapse, fainting, or dizziness on standing up.
• History of heart attack 

Cipralex Contraindications

Talk to your doctor before starting the medicines if you have the following conditions:

• Liver disorders
• Kidney disorder
• Abnormal heart rhythm
• Diabetes
• Mania or panic disorder
• Epilepsy 
• Bleeding disorder
• If you have a history of bleeding in the stomach or intestine
• Low sodium levels
• Problems with eyes such as glaucoma 
• Electroconvulsive therapy 
• Low heart rate
• A fast or irregular heartbeat, collapse, fainting, or dizziness on standing up.
• History of heart attack 
• Pregnancy and lactation

Table 2: Common Interactions

Interacting drugs	Citalopram	Cipralex
Anxiety drugs	Yes	Yes
Blood thinners	Yes	Yes
Carbamazepine	Yes	Yes
Drugs for sleep	Yes	Yes
Ketoconazole	Yes	Yes
Lithium	Yes	Yes
MAOIS	Yes	Yes
Mental illness drugs	Yes	Yes
Migraine drugs	Yes	Yes
NSAIDs	Yes	Yes
Pimozide	Yes	Yes
Seizure drugs	Yes	Yes
Amiodarone	Yes	No
Chlorpromazine	Yes	No
Gatifloxicin	Yes	No
Methadone	Yes	No
Moxifloxacin	Yes	No
Pentamidine	Yes	No
Quinidine	Yes	No
Sotalol	Yes	No

Cipralex Interactions 

• Monoamine oxidase inhibitors such as phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine. Even if you have finished taking one of the following MAOIs: phenelzine, iproniazid, isocarboxazid, nialamide, or tranylcypromine, you will need to wait for two weeks before you start taking your Citalopram tablets.
• Moclobemide
• Selegiline
• Linezolid
• Sumatriptan
• Tramadol
• Lithium
• Cimetidine
• Pimozide
• Imipramine and desipramine
• Fluconazole
• Bupropion
• Mefloquine
• Aspirin
• Ibuprofen
• Diclofenac
• Metoprolol
• Neuroleptics (used in the treatment of schizophrenia)
• Phenothiazine
• Pimozide
• Haloperidol
• Sparfloxacin
• Moxifloxacin
• Erythromycin IV
• Pentamidine
• Halofantrine
• Astemizole
• Mizolastine

Citalopram Side Interactions

• Monoamine oxidase inhibitors such as phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine. Even if you have finished taking one of the following MAOIs: phenelzine, iproniazid, isocarboxazid, nialamide, or tranylcypromine, you will need to wait for two weeks before you start taking your Citalopram tablets.
• Moclobemide
• Selegiline
• Linezolid
• Sumatriptan
• Tramadol
• Lithium
• Cimetidine
• Pimozide
• Imipramine and desipramine
• Fluconazole
• Bupropion
• Mefloquine
• Aspirin
• Ibuprofen
• Diclofenac
• Metoprolol
• Neuroleptics (used in the treatment of schizophrenia)
• Phenothiazine
• Pimozide
• Haloperidol
• Sparfloxacin
• Moxifloxacin
• Erythromycin IV
• Pentamidine
• Halofantrine
• Astemizole
• Mizolastine

Which Is The Right One For You?

As you can see, these drugs have similar side-effects, interactions, and contraindications. However, there are differences as to who can take based on these factors.

Your doctor will take a detailed history and determine the best option for you.

Prescription, Use, and Dosage

The ideal dose of Cipralex is 10 mg/day, and that of Citalopram is 20 mg/day.

Table 3: Use and Dosage

Medicine	Cipralex	Citalopram
Class of drug	Serotonin reuptake inhibitors (SSRIs)	Serotonin reuptake inhibitors (SSRIs)
Use	Depression and anxiety	Depression and anxiety
Age for which it is approved for	12 years and older	18 years and older
Available forms	Oral tablet, oral solution	Oral tablet, oral solution
Available strengths	Tablet: 5 mg, 10 mg, 20 mg, Solution: 1 mg/mL	Tablet: 10 mg, 20 mg, 40 mg, Solution: 2 mg/mL
Usual starting dose	10 mg/day	20 mg/day
Usual treatment duration	Long-term	Long-term
Risk of Withdrawal	Yes	Yes

Cipralex 

• Take it precisely the way your doctor tells.
• It is usually prescribed to be taken orally, once daily, preferably at the same time every day.
• You can take medicine with or without food
• The medicine is available in various strengths including, 5, 10, and 20 mg, and your doctor will decide the right dose for you. If you are taking it in the form of drops, your doctor will tell you the number of drops to be taken.
• If you forget to take a dose, take it as soon as you remember. However, if it is almost time for the next dose, do not take the missed dose and continue with your next scheduled dose. Do not take a double dose to compensate for the missed dose. 

Citalopram

• Take this medicine orally once a day in the morning or evening. It can be taken with or without food or as prescribed by your physician.
• Take this tablet daily at the same time every day.
• Follow all the instructions on the prescription label. 
• Do not stop taking this medication abruptly without consulting your doctor.
• Do not take it more or less, or take it more often than prescribed by your doctor.
• Do not stop using it even if you feel well.

• If you happen to miss a dose of Citalopram, take the missed dose as soon as you remember. 
• However, if it is almost time for the next dose, do not take the missed dose and continue with your next scheduled dose. 
• Do not take a double dose to compensate for the missed dose. 

Your physician may start you with a low dose and gradually increase your dose. It may take 1-4 weeks before you begin to notice the full benefits of the medication.

Final Thoughts

All in all, Cipralex and Citalopram work well for depression. These drugs have similar interactions, contraindications, and side-effects. However, there are differences too, including dosage and who can take them. All these factors influence which drug you can take.

So, consult your doctor before taking them, and they will help you decide the best choice for you.