Celexa Begins Working Faster Than Previously Thought

Most classes of antidepressant medications, including the selective serotonin reuptake inhibitors (SSRIs), are thought to require 2 or more weeks of use before therapeutic effects become noticeable. The consumer guidelines for a drug like Celexa (citalopram) clearly advise patients not to expect immediate benefits but to continue taking their medication as prescribed. However, a recent study has cast doubt on the notion that SSRIs really take weeks to build up to therapeutic levels. If the results are confirmed with subsequent experiments, then our understanding of these medications will be greatly enhanced. Observing the neurochemical mechanism behind specific SSRIs will naturally lead to more beneficial prescribing patterns and better patient outcomes.

In a study of the SSRI Celexa, 26 participants were given either a single dose of the drug or a dose of placebo, a harmless sugar pill. None of the participants had depression, a fact which allowed researchers to study specific physiologic responses without interference. Three hours later, participants were shown images of frightened faces while brain activity in their amygdala was measured via magnetic resonance imaging. Psychiatrists have theorized that hyperactivity in the amygdala is a measurable effect of depression that places the individual in a constant state of heightened anxiety. In the single-dose Celexa study, participants given medication showed a muted response in their amygdala when viewing frightened or anxious faces. Researchers observed a spike in amygdala activity in those who received placebo. These findings demonstrate that potentially therapeutic effects begin as quickly as a few hours after the first dose of Celexa, and by extension any SSRI. Interestingly, none of the participants reported either a change in mood or unusual side effects. The study authors theorize that the action on the amygdala has both immediate benefits on an unconscious level and longer term effects on anxiety.

Depression is often described as a constellation of symptoms and effects. Because of its many manifestations, the disease is a long way from being fully understood. There is currently no fool-proof, one-size-fits-all treatment for depression. Research on antidepressant medications like Celexa helps us identify what’s happening in the depressed brain. Armed with that knowledge, we can tailor more effective medications in the future. The study under discussion, for example, highlights the possibility that Celexa’s beneficial effects begin with the amygdala, the brain’s primitive fear center. More importantly, these effects begin almost immediately, contrary to previous assumptions.

Murphy, S., Norbury, R., O’Sullivan, U., Cowen, P., Harmer, C. (2009). Effect of a single dose of citalopram on amygdala response to emotional faces. British Journal of Psychiatry, 194(6), 535-540.

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  • Jonathon


    October 22nd, 2013 at 1:53 PM

    If the participants were healthy volunteers (not patients with depression) how can you conclude that celexa ‘works’? How can an antidepressant be said to ‘work’ on a non-depressed individual?

  • Marlies


    June 18th, 2019 at 1:20 PM

    I just got put on it and after a couple of hours, I had a weird feeling of like out of it kind of feeling with also an upset stomach. But after a few 10-15 minutes of that, it disappeared. I do not know what that was all about but who knows.

  • Jonathon


    October 22nd, 2013 at 1:55 PM

    It’s been known for years that antidepressants increase serotonin levels in a few hours or more. That doesn’t mean they are ‘working’ in a few hours.

  • Kelli


    July 25th, 2018 at 6:42 AM

    I weaned myself of Celexa because I had been on it for a very long time and was hoping I no longer needed it. I was fully off it for about three months and determined, unfortunately, that I DO need it and went back on. When I took the first pill I had been experiencing depression, and worse, bouts of rage and uncontrollable anger, which is really why I needed the celexa to begin with. I took it when I got home from work and by the next morning was already feeling calmer and less ragey. For me, it worked quite quickly, and thank god because my poor family was suffering.

  • Dennis W.

    Dennis W.

    May 16th, 2019 at 10:49 AM

    I went on medical cannabis ( cbd ) for arthritis pain and concluded I no longer needed celexa ( 30mg ) but after an 18 month break feeling depressed and irritable after a long hard winter went back on 10mg. I concur with beneficial effects after just a few hours and day 2 was just so much better – hope it lasts.

  • name


    January 23rd, 2020 at 10:31 AM

    Went off of celexa 40 through a long long taper. 4 months later, Just started to feel super happy again and balanced. I have PMDD and its worse than ever. Good thing I had leftover pills. I take 10mg now at first sign of PMDD, the mood drop, and it balanced me right back out. No WD after either. I don’t care what it is called “working” or what, I call it a win. It worked for me.

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