What is a good alternative to Citalopram? (+3 options)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss the alternative options for Citalopram to treat anxiety and depression-related conditions. We will further look into the strategies to choose the best alternative antidepressant drug.
What is a good alternative to Citalopram?
Various antidepressants could serve as good alternatives to Citalopram, including:
- Other Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Atypical antidepressants
Other Selective serotonin reuptake inhibitors (SSRIs)
SSRI antidepressants are generally the most commonly prescribed antidepressants for treating depression and other related psychiatric disorders. They are preferred antidepressants due to their tolerability, safety, and efficacy (1).
SSRIs are generally considered safe to use in children and adults. The FDA has approved SSRIs to be used to treat major depressive disorder, panic disorder, bipolar depression, obsessive-compulsive and many other psychiatric disorders (1).
SSRIs exert their action by inhibiting serotonin reuptake thereby, increasing serotonin activity in the brain. Usually, it takes 4-6 weeks for SSRIs to show their full therapeutic potential (1).
SSRIs have relatively lower side effects as compared to other antidepressants. Some common side effects include sleep disturbances, sexual dysfunction, anxiety, dizziness, weight variation, and gastrointestinal disturbances (1).
Citalopram also belongs to SSRI antidepressants. Some other drugs belonging to this class that could be alternative to Citalopram include:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Fluvoxamine (Luvox)
- Escitalopram (Lexapro)
If a patient is allergic to Citalopram, then your doctor should carefully monitor you before prescribing any other drug from this class. Due to the same mechanism of action or structural similarities, other SSRIs could also cause allergies or potentially harmful effects.
Always consult your healthcare provider before switching or changing medications even within the same drug class. It is preferred to switch drugs within the same class due to fewer side effects and withdrawal symptoms.
Under your doctor’s guidance and supervision, if your medication does not show clinical efficacy then you can switch medications within the same drug class of antidepressants such as Sertraline to Escitalopram or Sertraline to Fluoxetine.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Drugs belonging to this class inhibit the reuptake of both serotonin and norepinephrine. SNRIs have the FDA’s approval for generalized anxiety disorder, major depressive disorder, panic disorder, and social phobia (2).
Just like SSRIs, SNRIs also take 4-6 weeks to show clinical efficacy and their therapeutic effects. SNRIs are also associated with causing sleep disturbances, sexual dysfunction, and dizziness (2).
Common drugs from this drug class that could be used as Citalopram alternatives are (2):
- Venlafaxine (Effexor)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Milnacipran (Savella)
Atypical antidepressants
You can also switch from Citalopram to atypical antidepressants which increase energy and work on dopamine and norepinephrine neurotransmitters in the brain (3).
Some common atypical antidepressants which can be prescribed in place of Citalopram include (3):
- Bupropion (Wellbutrin)
- Mirtazapine (Remeron)
- Trazodone (Desyrel)
Some antidepressants are good at increasing motivation and energy levels. Your doctor can switch you from Citalopram to these antidepressants to boost your energy levels and elevate your mood.
What are the ways to choose a good alternative to Citalopram?
To choose a good alternative to Citalopram, your doctor needs to closely examine and monitor your side effects. However, your doctor can prescribe you an alternate antidepressant that suits well to your medical condition.
No antidepressant matches the standard criteria for every patient. All these medications vary in their benefit-to-risk ratio based on the patient’s health and medical history.
Therefore, finding a suitable alternate antidepressant can sometimes lead to trial and error. Your doctor should prescribe you the medication that helps alleviate your depressive symptoms and does not lead to additive adverse effects as compared to Citalopram.
You should always consult your doctor for any depressive episodes or mental health conditions and do not abruptly stop Citalopram or start taking any antidepressant medication on your own.
Conclusion
We have discussed some of the alternatives to Citalopram. We have discovered antidepressant drugs from different classes and have measured their benefit-to-risk ratio. We have also discussed the ways to choose the best alternative antidepressant medication.
Was this helpful?
References
1.-
Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/
2.-
Sansone RA, Sansone LA. Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innov Clin Neurosci. 2014 Mar;11(3-4):37-42. PMID: 24800132; PMCID: PMC4008300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008300/
3.-
Horst, W. D., & Preskorn, S. H. (1998). Mechanisms of action and clinical characteristics of three atypical antidepressants: venlafaxine, nefazodone, bupropion. Journal of Affective Disorders, 51(3), 237–254. doi:10.1016/s0165-0327(98)00222-5 https://pubmed.ncbi.nlm.nih.gov/10333980/
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