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Citalopram (Celexa) and escitalopram (Lexapro) are two commonly prescribed SSRIs used for the treatment of depression and anxiety disorders. This brief multimedia tutorial explores the differences and similiarities of these two antidepressants.

Citalopram (Celexa) 和 escitalopram (Lexapro)是兩個常見用以治療憂鬱症及焦慮症的 SSRIs。

Let me highlight some useful points before getting into more detail about these two medications.
• Citalopram and escitalopram have no significant drug-drug interactions. This is because of their low potential to inhibit CYP 450 isoenzymes.

兩個藥物都沒有明顯的藥物交互作用，因為兩者抑制CYP 450的效力不高。
• Citalopram is linked to QT prolongation. This drug was initially approved to be used in a range from 20 to 60 mg/day. In 2011, the FDA recommended against its use in doses higher than 40 mg/day.

Citalopram會延長QT。此藥原本的建議計量為20~60mg，但在2011年後，fda將最大劑量修改為每天40mg。
• Regarding prescribing tips, escitalopram equivalent dose is half that of citalopram

escitalopram的等效劑量為citalopram的一半。

Citalopram was approved in 1998 for the treatment of depression. It is produced as a racemate, this means that it is a mixture of two stereoisomers: R-citalopram and S-citalopram.
Escitalopram is only one enantiomer, s-citalopram. This drug was approved in 2002 and was developed with the goal of better tolerability.

Both drugs are among the most selective of the SSRI class. They don’t have significant affinity for muscarinic, dopaminergic or norepinephrine receptors.
In addition to SERT inhibition, citalopram is a mild antagonist at histamine 1 receptors. Escitalopram is also a SERT inhibitor, but doesn’t block histamine 1 receptors.

Regarding FDA approved indications, both SSRIs are approved for depression. Citalopram was approved in 1998 and escitalopram in 2002. Escitalopram is also approved for generalized anxiety disorder.

適應症：

Citalopram：憂鬱

Escitalopram：憂鬱、焦慮

資料來源：http://psychopharmacologyinstitute.com/antidepressants/ssris/citalopram-escitalopram-differences-similarities/

Other off label uses include:
• OCD
• Panic disorder
• PTSD
• Social anxiety disorder
• Premenstrual dysphoric disorder