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.

  • Rachel

    March 3rd, 2020 at 5:34 PM

    Hi there, I experienced the same effect as you did. Was on 10mg for the first time and after 2-3 hours I began to have mild-moderate nausea, headache, tingling in fingers (left hand). Apart from nausea, all were alleviated by itself after 20-30 minutes.

  • 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.

    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.

  • Michael

    June 4th, 2020 at 6:06 AM

    I’ve just started (10mg) and within a few hours I felt it was having a positive impact. Call it a placebo affect, I don’t really care – I am starting to feel better already 2 days down!

  • David

    June 6th, 2020 at 1:59 AM

    I’ve been on ADs for around 35 years on and off, mostly on. After a year of ‘off’ I had become very depressed and have pretty much ceased functioning. My GP prescribed Citalopram and very strangely after only three days (ie three doses) I feel almost like my normal self. This may well just be a brief bit of respite, and I will possibly have to come back here and update with less happy news, but right now I feel pretty damned good. Not sure if it’s as a result of the Citalopram, but one thing is certain, I would know if it was a placebo effect as my depression is usually quite profound and certainly very physical as well as mental.
    Will keep an open mind.

  • Meme

    July 13th, 2020 at 6:47 PM

    How are ur results so far are they still up or have u had some down sides?

  • Michael

    July 14th, 2020 at 8:12 AM

    Meme, the medications appears to be working as intended. The initial “good feeling” only lasted a few days. However, I’ve had constant headaches on it so I am changing to something else.

  • kathy

    October 23rd, 2020 at 1:16 PM

    Has anyone noted unfavorable eye symptoms ie dry eye or glaucoma? And what about digestive issues?

  • Stephanie

    November 15th, 2020 at 1:41 AM

    This is my first time on citelapram. Day 3 my half pill could very well have meade me yawn my head off today. Im very swollen in the ankles and feet but could be due to having macdonalds for brekky then later fir dinner as was away from home for the weekend. Hope to update after a while

  • Erin

    January 9th, 2021 at 8:02 AM

    Michael, same. I’ve been on less than a week and honestly feel better. I don’t know or care if it’s the placebo effect. I feel better and that’s what matters.

  • Pam

    April 5th, 2021 at 4:28 PM

    I’m just starting to take Citalopram 10 mg has anyone had a big weight gain while taking it?

  • Rita

    April 10th, 2021 at 6:30 AM

    I started taking celexa because of high anxiety and insomnia also the first three week of taking it no side effects but now it he side effects are starting it’s horrible hot sweat and hot flashes and anxiety is up no appetite and loss three poundsi I’m taking 20 mg I call the pharmacist and told me to cut the pill in half anybody experience this do know if I will continue does it get better ?

  • Abby

    May 10th, 2021 at 4:35 PM

    I stated on 10 mg Celexa, now I’m taking 15mg, i’m supposed to go to 20mg. I still feel anxiety but it is less pronounced. I’m 8 weeks in, I have had some good days but I think because I started on 10mg then quit for 2 days and only took 5mg for a few days my progress had been slower, but I do feel a bit better, I hope that when I go to 20 and back to my normal happy self. I had to start slow because I am a poor metabolizer, my initial side effects were, dry mouth, jitters/nervousness, lots of yawing, poor appetite and I lost 10 lbs in 1 month, crying spells (only a couple of times then I could not cry for a month). Now I can eat better, no night sweats, less heart palpitations, but sometimes i still feel like I am in a constant mind fog, it comes and goes though…anyone else had the same experience?

  • Susan

    May 25th, 2021 at 6:08 AM

    I am 4 weeks in, and still having the terrible increased anxiety, poor appetite. Cannot believe you are not finding relief at 8 weeks. Best of luck. Because I am 76, my goal is only 10mg.

  • CB

    May 29th, 2021 at 3:25 AM

    I was on Sertraline 100mg for months. It worked last time I was prescribed it but this time I was dealing with maybe a more serious trauma. This time it only took out the major panic attacks but left me tired and still depressed. I was swapped to Citalopram 20mg and felt happier and more lively the day after. Hope it continues!

  • Jesse

    July 29th, 2021 at 1:38 PM

    I was on celexa for six years before went off of it and tried Effexor. Feeling better about being back on celexa right now I know that it works

  • Jennifer

    August 5th, 2021 at 6:01 PM

    I am going to ask to try this when I have my appointment Monday, I’m truly praying it helps get rid of the constant worry, anxiety and depression. I tried other SSRI’s, lexapro made me feel even WORSE! So I’m really hoping this one doesn’t do that because that was a struggle to get thru, and I truly can’t handle anymore struggling. Love to all. Thanks for all these reviews, it makes me feel there’s hope.

  • Sam

    August 10th, 2021 at 11:01 PM

    Hi, do you guys take it in combo with Xanax? I’m about to take first dose of celexa but wondering if any crazy side effects. They put me on 10 mg , any unwanted side immediate effects of celexa?
    Thank you all!

  • Julie

    August 28th, 2021 at 10:12 AM

    I just took my first 10mg last night. Not sure if it was a side effect but I got very anxious and was still having high anxiety when I woke up. Tingling arms, face and legs. I took 1mg of Ativan (similar to xanax) because it was almost unbearable, and it helped. Hope it gets better…

  • Debbie

    August 29th, 2021 at 4:39 PM

    I started on Citalopram Hydrobromide three days ago and my anxiety is so much worst and I am nervous about how I feel

  • Corey

    October 11th, 2021 at 2:17 PM

    Hi All,
    I started on Celexa 4 days ago to help with migraines and anxiety however the anxiety has been unbearable especially when sitting at a desk all day for work, plus clammy hands that i have to keep constantly washing. How long before the anxiety and nausea dissaper? And does anybody else take it for migraines, has it helped you?

  • Aly

    October 13th, 2021 at 4:14 AM

    Been on cipramil for many years. Great for anxiety and irritability. Thought I would take a break so slowly came off it. Went 6 months but irritability, anxiety returned badly. Went back on it. Became calm, non irritable, relaxed within just a week. Noticed calming effect after 1st dose within hours unless that was a placebo effect but was so strung out think it was probably the actual drug working on amygdala.

  • erika

    November 2nd, 2021 at 10:15 AM

    Been on celexa for 1 weeks started the first 4 days with half and three with the 10mg, but was feeling very up and down… not sure if that is regulating or not but I stopped taking it 4 days ago and I feel so much better? not sure if its in my system or what is going on anyone else?

  • Tara

    November 27th, 2021 at 1:12 PM

    Im really surprised by how many people get off an SSRI medication after adverse effects in the first few days. Every doctor who has ever prescribed one to me has urged me to be patient, that it gets harder before it gets better while your brain adjusts to the change. Two weeks is the soonest Ive been told that most people start to feel an improvement. I jumped on here because Im searching for info to suggest Celexa starts helping more quickly than Lexapro, which was a bear to adjust to.

  • Michelle

    December 14th, 2021 at 4:57 PM

    I’ve been on and off of celexa for years. I was only on 10 and at one point 20. About a year and a half ago I got off and was going ok without it. In September I went through a very difficult breakup from a 4 year relationship which also happened right before my 50th birthday. For the past 3 months I’ve been horribly depressed and crying every day. I saw my doctor for my physical and he thought I should start taking it again. I started 2 and a half weeks ago, first 10 for a week then up to 20 for 3 weeks and then to 40 (which I haven’t gotten to yet) I’ve noticed an enormous difference already. I haven’t cried in over a week and I noticed over the weekend I’m feeling so much more positive. The break up bothers me but not that much anymore and I don’t feel complete hopelessness like I did a few weeks ago. I think for me celexa has been a godsend.

  • Toja

    December 14th, 2021 at 11:26 PM

    First day taking Celexa 20mg and I woke up a few hours later feeling more anxious nervous hot felt like I needed to go to the ER.My daughter reminded me that it was a new drug so my body has to get used to it being in my system.After about 20 mins I felt better.Im gonna continue to take it hopefully it will get better fingers crossed.

  • Heather

    November 16th, 2022 at 5:40 PM

    I felt better after the first day! It is amazing! I literally got my life back! I wish I hadn’t waited so long to get help! I had lost all interest in the things I used to love, and was crying constantly. This pill works!

  • Roberto

    December 12th, 2022 at 6:06 AM

    I was taking 20mg citalopram for about 2 months, I forgot to take one a few times but that didn’t affect me negatively. Previously, I was on Prozac, then Zoloft (Sertraline.) I stopped taking them about a week and a half ago and am feeling a lot more anxious, and get severe spells of sadness. I’m diagnosed with a moderate anxiety disorder, MDD, and OCD. I will start taking them again, because there are times in the day when I feel guilty for not taking them… because in the end, I need them. If you get side effects, stick through it because they will inevitably subside. There’s a study that claims Citalopram works within a few hours (with the first does anyway.) I’m not sure about the theories, I would just recommend taking one per day, for a good amount of time because anxiety is treacherous to deal with. I will start again tonight, and maybe update soon. Please be patient with it and you ill eventually reap the benefits.

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