Using Celexa to Treat Anxiety

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
March 10, 2022

Celexa is a prescription medication typically used to treat symptoms of depression. Doctors may also use it for anxiety disorders.

In this article, we’ll explore how Celexa may be effective for anxiety, potential side effects, how to take it, and other ways to support anxiety care.

What is Celexa?

Celexa (citalopram hydrobromide) is an FDA-approved antidepressant medication used to treat adults who have been diagnosed with depression.

While the FDA has not approved Celexa for generalized anxiety disorder (GAD), your doctor may prescribe it for this reason, which is known as “off-label” use.

Celexa belongs to a class of medications called  selective serotonin reuptake inhibitors (SSRI).

SSRIs work to increase the amount of serotonin the brain by slowing the rate at which serotonin is cleared.

Serotonin is an important brain chemical that is partially responsible for regulating your mood, sleep, and metabolism.

Giving the brain more access to serotonin can result in an improved mood…which means it can be beneficial for both anxiety and depression. 

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Celexa uses

Celexa is approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) or other depression-related symptoms or conditions.

It is also used off-label for other purposes, including anxiety.

How Celexa works

Celexa affects how your central nervous system (CNS) processes serotonin.

Serotonin is a brain chemical that helps regulate mood, sleep, and metabolism.

As an SSRI, Celexa  prevents the reuptake or clearance of serotonin by neurons in the brain, which means that your brain has more access to serotonin.

Additionally, while Celexa affects serotonin, it doesn’t effect other neurotransmitters, such as norepinephrine and dopamine, making it a highly selective medication and resulting in fever unwanted side effects than some other SSRIs.

Can Celexa Treat Anxiety?

While the FDA has not specifically approved Celexa for treating anxiety, doctors have been using Celexa and other SSRIs off-label to successfully treat generalized anxiety disorder (GAD) and other forms of anxiety, as well as other imbalances in the brain.

Celexa may produce feelings of calm in the brain by increasing serotonin levels, which may help to reduce feelings of anxiety or panic.

Off-label uses of Celexa

There are several common off-label uses of Celexa, in addition to GAD, which include:

  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Social anxiety disorder (SAD)
  • Separation anxiety disorder
  • Premenstrual dysphoric disorder (PMDD)
  • Binge eating disorder
  • Post-traumatic stress disorder (PTSD)

What the research says

While Celexa has not been FDA-approved specifically for anxiety, research is promising.

In a small 12-week trial that used a dose range of 10-60 mg per day of Celexa, all of the study subjects experienced partial or full improvement in their anxiety symptoms.

This led to an improvement r in both social and occupational function. Notably, several patients felt better on Celexa than they did with previous SSRI trials.

Additionally, even at lower doses of 20-30 mg, Celexa was able to reduce anxiety levels in older adults who live in a community home setting, where anxiety is more frequently noted.

Why your doctor may prefer Celexa

Your doctor will select a medication for anxiety based on your health conditions, your symptoms, other medications you are taking, and many other factors.

Some doctors prefer Celexa because it is a highly selective SSRI, more so than other medications in this drug class, and it may lead to fewer changes to other neurotransmitters.

This may lead to fewer long-term side effects and more of the desired result.

Other Treatments for Anxiety

Your doctor has a variety of ways to treat anxiety.

They may recommend more than one way to address your symptoms.

Medications

There are many different types of medications that can address symptoms associated with anxiety disorders.

Your doctor will prescribe the one that they believe will be most effective.

Anxiety medications include:

Therapies

Certain types of therapy have been shown to be effective for anxiety disorders.

What works for you may not work for everyone else, and vice versa.

Work with your doctor or therapist to communicate what helps and what doesn’t.

As with medication, therapy may take some time to reach the desired effects. 

Therapies that may support people with anxiety include:

Lifestyle changes

Lifestyle changes may help some people lessen the severity of anxiety or panic attacks.

Additionally, maintaining a healthy and balanced lifestyle is good for overall mood support and health, and will support other treatments for anxiety disorders.

Lifestyle changes to consider include:

  • Get regular physical activity
  • Cut back on caffeine
  • Don’t smoke
  • Reduce alcohol intake
  • Try herbal teas or supplements
  • Use a weighted blanket
  • Get enough sleep
  • Eat a nutritionally balanced diet
  • Spend time outdoors

Celexa Side Effects

Common side effects may resolve after your body adjusts to the medication.

Always inform your doctor if you notice new or worsening side effects or have concerns about how you feel while taking Celexa.

Around 10% of patients may experience side effects from Celexa.

Common side effects

Celexa is generally well-tolerated, but may cause some side effects, especially as you adjust to taking it as a new medication.

Common Celexa side effects include:

Some side effects occur more frequently when taking higher doses of Celexa. These may include:

  • Impotence
  • Fatigue
  • Drowsiness
  • Insomnia
  • Yawning

Severe side effects

Less commonly, severe side effects of Celexa may include:

  • Serotonin syndrome
  • Myocardial infarction
  • Hemorrhage
  • Cerebrovascular accident
  • Suicidal thoughts
  • Mania
  • Hyponatremia

How to Take Celexa

Celexa is available as a tablet or a liquid. Tablets come in 10, 20, or 40 mg tablets. The liquid dosage is 2 mg per mL.

This medication is taken one time per day at the same time, either morning or evening.

Your doctor and pharmacist will clearly explain your dosage and how to take it.

If you miss a dose of Celexa, take it as soon as you remember that you have missed it.

If you are closer to your next dose, skip the missed dose and resume your normal schedule with the next one.

Do not double up on Celexa doses.

How long does Celexa take to work?

It takes a week of consistently taking Celexa before your body reaches a steady concentration of the medication.

After that, like with other SSRIs, it may take up to six to eight weeks before you will experience the full effects of taking the medication.

Have questions about a Celexa prescription? Chat with a doctor today!
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Celexa Precautions

All antidepressants come with black box warnings.

While rare, they can increase the risk for self-harm or suicide in some people.

If you or someone you love are taking an antidepressant, including Celexa, you should watch for the following signs:

  • Agitation, aggression, or hostility
  • Increased or worsening anxiety
  • Panic attacks
  • Irritability
  • Insomnia
  • Impulsiveness
  • Unusual changes in behavior
  • Suicidal thoughts or discussion 
  • Restlessness
  • Manic behavior

All of these symptoms, or other feelings of concern, should be reported immediately to health care providers.

If you or someone you know is having any thoughts of hurting themselves or others, please make sure that they are safe and take them to the ER.

Do not stop taking Celexa suddenly. Antidepressants require tapering to prevent serious reactions or withdrawal.

If you need to stop taking it, your doctor will work with you to create a tapering schedule.

This will minimize negative effects and the potential for serious side effects.

Celexa has serious interactions with another class of drugs known as monoamine oxidase inhibitors (MAOIs).

People who are taking pimozide should not take Celexa.

Always tell your healthcare provider any other drugs, supplements, or OTC medications that you are taking.

People who are older than age 60 and those who have decreased liver function will experience higher concentrations of Celexa for longer periods of time.

If you have liver problems, make sure that your prescribing physician knows.

Dosage recommendations are lower for older adults and for liver problems, and it may take longer for it to clear your system in these cases.

Celexa and other SSRIs may increase the risk of bleeding, especially if you take aspirin, NSAID drugs, or anticoagulant drugs (warfarin, heparin, others).

If you take any type of blood-thinning medication or bruise or bleed easily, make sure that your health care provider knows before you start taking Celexa.

Frequently Asked Questions

Is Celexa the best medication for anxiety?
Celexa is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant that increases the amount of available serotonin in your brain. While it is FDA-approved for treating depression, it is also used off-label for anxiety. While there is more research supporting its use for depression, there are also some studies that have shown it is effective for anxiety.. Your doctor will recommend Celexa if they believe that it will be the best for you.
Is Celexa better for anxiety or depression?
Celexa is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant. While it is FDA-approved for treating depression, it is also used off-label for anxiety. There is more research supporting its use for depression, but that does not mean it won’t be effective for your anxiety. Your doctor will recommend Celexa if they believe that it will be the best option to try.
Does Celexa calm you down?
Celexa is an antidepressant and, like most other antidepressants, takes around six to eight weeks to start fully working. You may notice improvements in your mood or a decrease in your anxiety sooner, but a single dose of Celexa does not work to instantly calm you down. The medication needs to build up in your system to have a significant effect, which may eventually lead to feeling calmer and more balanced.
What is the most common side effect of Celexa?
The most common side effects of Celexa are nausea and dry mouth.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.

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