Lexapro and Zoloft are brand names for two antidepressants that are part of the drug class called selective serotonin reuptake inhibitors (SSRIs). They work by increasing levels of serotonin — a substance in the brain that helps with your mood.
Both of these medications may work well for you, but there are some similarities and differences between the two.
What conditions do they treat?
Doctors use escitalopram (Lexapro) to treat depression and generalized anxiety disorder (GAD). They may use sertraline (Zoloft) to treat depression, obsessive-compulsive disorder (OCD), and several other mental health conditions.
The table below shows which condition the Food and Drug Administration (FDA) approves each drug for.
| Health condition | escitalopram (Lexapro) | sertraline (Zoloft) |
|---|---|---|
| depression | ✓ | ✓ |
| GAD | ✓ | |
| OCD | ✓ | |
| panic disorder | ✓ | |
| post-traumatic stress disorder | ✓ | |
| social anxiety disorder | ✓ | |
| premenstrual dysphoric disorder | ✓ |
Key comparisons of Lexapro and Zoloft
The table below compares other key aspects of Lexapro and Zoloft.
| Generic drug name | escitalopram | sertraline |
|---|---|---|
| Brand name | Lexapro | Zoloft |
| What forms does it come in? | oral tablet, oral solution | oral tablet, oral solution |
| What strengths does it come in? | tablet: 5 milligrams (mg), 10 mg, 20 mg oral solution: 1 milligrams per deciliter (mg/mL) | tablet: 25 mg, 50 mg, 100 mg oral solution: 20 mg/mL |
| Who can take it? | people 12 years and older | people 18 years and older, except when treating OCD children ages 6 years and up for OCD |
| What is the dosage? | determined by a doctor | determined by a doctor |
| What is the typical length of treatment? | long term | long term |
| How do I store this drug? | at room temperature, away from excess heat or moisture | at room temperature, away from excess heat or moisture |
| Is there a risk of withdrawal? | yes | yes |
If you’ve been taking either drug for longer than a few weeks, you should not stop taking it without talking with a doctor, as you’ll need to taper off slowly to avoid withdrawal symptoms.
Need a refill for escitalopram oxalate (Lexapro) or sertraline (Zoloft)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes with no video or appointment needed. Learn more here.
What do the drugs cost?
Both medications are available in most pharmacies in both brand-name and generic versions. Generic options are typically more cost-effective than brand-name products.
Lexapro and Zoloft are similar in price, although the costs can fluctuate. You can check current Optum Perks prices by searching for each drug here.
Health insurance plans typically cover antidepressant medications such as Lexapro and Zoloft, but they may prefer you to use the generic versions. You can check your drug formulary, also called a drug list, to see which comes under your plan.
Side effects
As Lexapro and Zoloft are both SSRIs, they share many of the same side effects.
The table below lists some of the more common side effects you may experience when taking escitalopram (Lexapro) and sertraline Zoloft.
| Side effect | escitalopram (Lexapro) | sertraline (Zoloft) |
|---|---|---|
| nausea | ✓ | ✓ |
| sleepiness | ✓ | ✓ |
| weakness | ✓ | ✓ |
| dizziness | ✓ | ✓ |
| increased anxiety | ✓ | ✓ |
| difficulty sleeping or insomnia | ✓ | ✓ |
| sexual difficulties | ✓ | ✓ |
| sweating | ✓ | ✓ |
| shaking | ✓ | ✓ |
| decreased appetite | ✓ | ✓ |
| dry mouth | ✓ | ✓ |
| constipation | ✓ | |
| breathing difficulties | ✓ | ✓ |
| yawning | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| indigestion | ✓ | ✓ |
Some of the more serious side effects may include:
- thoughts of self-harm or suicide
- severe allergic reactions
- unusual bleeding
- seizures or convulsions
- manic episodes
- weight changes
- low sodium (salt) levels
- blurred or double vision
- dry eyes
Another serious side effect is serotonin syndrome. This is a condition that can occur when serotonin levels (a chemical the body produces) become too high, which can be life threatening.
| Call or text a crisis line or prevention hotline to speak to someone who can help you find the support you need. Try the 988 Suicide and Crisis Lifeline at 988. |
Weight gain
A concern that many people have about taking antidepressants is weight gain. While many antidepressants can cause weight gain, some drugs may cause less weight gain than others, including escitalopram (Lexapro) and sertraline (Zoloft).
Learn more here about antidepressants and weight gain.
Drug interactions
The drug interactions of escitalopram (Lexapro) and sertraline (Zoloft) are also very similar. Before starting either medication, tell your doctor about all drugs, vitamins, or herbs you take, especially if they’re listed below. This information can help your doctor prevent possible interactions.
The table below shows some of the drugs that SSRIs may interact with:
| Interacting drugs | escitalopram (Lexapro) | sertraline (Zoloft) |
|---|---|---|
| monoamine oxidase inhibitors, such as selegiline and phenelzine | ✓ | ✓ |
| pimozide | ✓ | ✓ |
| blood thinners such as warfarin and aspirin | ✓ | ✓ |
| nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen | ✓ | ✓ |
| lithium | ✓ | ✓ |
| antidepressants like amitriptyline and venlafaxine | ✓ | ✓ |
| anti-anxiety drugs such as buspirone and duloxetine | ✓ | ✓ |
| medications for mental illness like aripiprazole and risperidone | ✓ | ✓ |
| antiseizure drugs like phenytoin and carbamazepine | ✓ | ✓ |
| medications for migraine headaches such as sumatriptan and ergotamine | ✓ | ✓ |
| sleeping medications like zolpidem | ✓ | ✓ |
| metoprolol | ✓ | |
| disulfiram | ✓ | |
| medications for irregular heartbeat, such as amiodarone and sotalol | ✓ | ✓ |
Disulfiram may only interact when you’re taking sertraline (Zoloft) in liquid form.
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
