Yes, Celexa can cause nervousness. Celexa is the brand name, and citalopram is the generic name of the medication. Celexa is classified as an antidepressant, in the SSRI family (selective serotonin reuptake inhibitor). Other SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), and Lexapro (escitalopram). SSRIs, including Celexa, can cause activation as a treatment-emergent side effect. “Activation” is characterized by irritability, anxiety, and restlessness. Activation is a common side effect of the SSRIs and Celexa, and can cause more nervousness, anxiety and irritability, which are the symptoms that the SSRI or Celexa were meant to treat in the first place! This activation side effect only lasts a few days or a few weeks, and then it dissipates. Another issue is that the Celexa and the other SSRIs do not start to reduce the anxiety and depression until a few weeks later of taking the medication on a daily basis.
So how are you supposed to deal with increased nervousness, anxiety, and irritability when starting treatment with Celexa? Many doctors will prescribe a benzodiazepine as adjunctive treatment to the Celexa or other SSRI for anxiety or depression. The benzodiazepine will treat the activation symptoms and deal with the anxiety and irritability until the Celexa or other SSRI becomes effective for the anxiety and depression weeks later. When the Celexa or SSRI finally becomes effective for anxiety and depression, then the benzodiazepine can be slowly tapered and discontinued.
Clinically, of all the SSRIs, Celexa (citalopram), Lexapro (escitalopram), and Zoloft (sertraline) are associated with less activation symptoms than Prozac (fluoxetine) and Paxil (paroxetine). Prozac is the most activating of the SSRIs. But as a class, the SSRIs are less activating than the SNRIs (serotonin norepinephrine reuptake inhibitors), with Effexor (venlafaxine) being the most activating of all the antidepressants. In clinical practice, Effexor is known as “Side Effexor.”
photo credit: Citalopram, happiness pills via photopin (license)
2014 - 2022 © Copyright Anxiety Boss. All rights reserved.
The Paxil is not activating… It’s perhaps the least activating SSRI… Prozac and Zoloft are both way more activating in the whole class is SSRI’s. Celexa, Lexapro and Luvox are more neutral…
Thank you for your comment. These general observations I made were based on years of treating thousands of patients. Of course, there are individual variations. Paxil is a great medication for anxiety…it just has a short half-life, so it often requires twice daily dosing. I agree that Prozac is activating, as I stated. And I agree, Celexa and Lexapro are more neutral and less activating, as I stated. I disagree about about Zoloft generally being more activating…it is commonly prescribed precisely because of its low side effect profile, and is a commonly prescribed in primary care.
You are so right with your ssri, snri, activation incidence, don’t think it’s true though for Prestiq, this one has little to no activation, and as an active metabolite of effexor it is a really clean drug. thought I’d share. Downfall very expensive! 🙂
Thank you for sharing!
I am king celexa 10mg and amitripline 25 for sleep. is this combination good? I have anxiety and increased panic. I do not want to take clonopine or antianxiety med. HELP!!!
This combination can work, if you are being monitored by your psychiatrist. But nowadays, it is rare to prescribe tricyclic antidepressants (TCAs) such as amitriptyline (Elavil) for sleep, given the numerous side effects of TCAs. There are safer alternatives for sleep besides TCAs.
Hello Dr Carlo,
I’ve been on different doses of Celexa since March (I played with it too much and have been put on 15mg for 2 weeks), I’ve been taking 25mg for 4 days, prior to that 20mg for a week and 15mg for 2 weeks. I’m still having anxiety! I had an anxiety attack last night and had to take Xanax to sleep. I’m anxious this morning. Is this normal?
It can take up to 6 to 8 weeks for the full effect. If there is no improvement in symptoms after a month, then your psychiatrist should be considering other treatments. Please follow-up with a psychiatrist.
Thank you Dr Carlo! You meant when there is no improvement of taking the same dose of Celexa after one month. Correct?
One month of treatment in total- if no improvement, then may be time for your doctor to consider other treatments.
Got it, thank you!