Lexapro vs. Zoloft: Which one is better for me?
With all the different depression and anxiety medications on the market, it can be hard to know which drug is which. Lexapro and Zoloft are two of the more commonly prescribed medications for mood disorders such as depression.
These drugs are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing levels of serotonin, a substance in your brain that helps maintain your mood. Read on to learn more about similarities and differences between Lexapro and Zoloft.
Lexapro is prescribed to treat depression and generalized anxiety disorder. Zoloft is prescribed to treat depression, obsessive compulsive disorder, and several other mental health conditions. The table below compares the conditions each drug is approved to treat.
|generalized anxiety disorder||X|
|obsessive compulsive disorder (OCD)||X|
|post-traumatic stress disorder (PTSD)||X|
|social anxiety disorder||X|
|premenstrual dysphoric disorder (PMDD)||X|
The table below compares other key aspects of Zoloft and Lexapro.
|What is the generic drug?||sertraline||escitalopram|
|What forms does it come in?||oral tablet, oral solution||oral tablet, oral solution|
|What strengths does it come in?||tablet: 25 mg, 50 mg, 100 mg; solution: 20 mg/mL||tablet: 5 mg, 10 mg, 20 mg; solution: 1 mg/mL|
|Who can take it?||people 18 years and older*||people 12 years and older|
|What is the dosage?||determined by your doctor||determined by your 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 with this drug?||yes†||yes†|
*Except for treating OCD
† If you’ve been taking this drug for longer than a few weeks, don’t stop taking it without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms.
Cost, availability, and insurance
Both medications are available in most pharmacies in brand-name and generic versions. Generics are generally cheaper than brand-name products. At the time this article was written, the prices for the brand-name and generic versions of Lexapro and Zoloft were similar, according to Optum Perks.
Health insurance plans typically cover antidepressant medications such as Lexapro and Zoloft, but prefer you to use the generic forms.
The charts below list examples of side effects of Lexapro and Zoloft. Because Lexapro and Zoloft are both SSRIs, they share many of the same side effects.
|Common side effects||Lexapro||Zoloft|
|loss of appetite||X||X|
|Serious side effects|
|suicidal actions or thoughts||X||X|
|severe allergic reactions||X||X|
|seizures or convulsions||X||X|
|weight gain or loss||X||X|
|low sodium (salt) levels in the blood||X||X|
*Serotonin syndrome is a condition that can occur when the levels of serotonin, a chemical produced by your body, become too high. Serotonin syndrome can be life-threatening.
**Eye problems can include blurry vision, double vision, dry eyes, and pressure in the eyes.
A concern that many people have about taking antidepressants is weight gain. It’s true that many antidepressants can cause weight gain, but some drugs are thought to cause less weight gain than others. Lexapro and Zoloft are two antidepressants that may cause less weight gain. If you’re concerned about this effect from taking an antidepressant, talk with your doctor.
The drug interactions of Lexapro and Zoloft are very similar. Before starting Lexapro or Zoloft, tell your doctor about all medications, vitamins, or herbs you take, especially if they’re listed below. This information can help your doctor prevent possible interactions.
The chart below compares examples of drugs that can interact with Lexapro or Zoloft.
|monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine||x||x|
|blood thinners such as warfarin and aspirin||x||x|
|nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen||x||x|
|antidepressants such as amitriptyline and venlafaxine||x||x|
|anti-anxiety drugs such as buspirone and duloxetine||x||x|
|medications for mental illness such as aripiprazole and risperidone||x||x|
|antiseizure drugs such as phenytoin and carbamazepine||x||x|
|medications for migraine headaches such as sumatriptan and ergotamine||x||x|
|sleeping medications such as zolpidem||x||x|
|medications for irregular heartbeat such as amiodarone and sotalol||x||x|
*interacts if you’re taking the liquid form of Zoloft
Conditions of concern
Lexapro and Zoloft contain many of the same warnings for use with other medical conditions. For example, both medications are pregnancy category C drugs. This means that if you’re pregnant, you should only use these medications if the benefits are greater than the risk to your pregnancy.
The chart below lists other medical conditions you should discuss with your doctor before taking Lexapro or Zoloft.
|Medical conditions to discuss with your doctor||Lexapro||Zoloft|
Risk of suicide
Both Lexapro and Zoloft raise the risk of suicidal thinking and behavior in children, adolescents, and young adults. In fact, Zoloft is not approved by the Food and Drug Administration (FDA) to treat children younger than 18 years, except for those with OCD. Lexapro is not approved for children younger than 12 years.
You should not suddenly stop treatment with an SSRI such as Lexapro or Zoloft. Stopping these medications suddenly can cause withdrawal symptoms. These can include:
- flu-like symptoms
- sleeping trouble
If you need to stop one of these medications, talk to your doctor. They will slowly decrease your dosage to help prevent withdrawal symptoms.
Talk with your doctor
To find out more about how Lexapro and Zoloft are alike and different, talk with your doctor. They’ll be able to tell you if one of these drugs, or a different drug, could help you with your mental health condition. Some questions that might be helpful to ask your doctor include:
- How long will it take before I feel the benefits of this medication?
- What is the appropriate time of day for me to take this medication?
- Which side effects should I expect from this medication, and will they go away?
Together, you and your doctor can find a medication that’s right for you.