Lexapro vs. Prozac: Choosing Which Is Right for You

Lexapro Vs. Prozac

Lexapro (escitalopram) and Prozac (fluoxetine) are FDA-approved medications for treating depression, anxiety disorders, and other mental health conditions.^1,2 Both medications belong to the selective serotonin reuptake inhibitors (SSRIs) class of drugs that works by regulating levels of serotonin in the brain.³

Lexapro and Prozac may be prescribed by:

• Licensed nurse practitioners
• Licensed physician assistants
• Psychiatrists
• Primary care providers and other physicians

The table below compares the different components of each medication:^1,2

Key Components	Prozac	Lexapro
What is the Generic Name?	Fluoxetine	Escitalopram
What forms does it come in?	Tablet Capsule Solution	Tablet Solution
What are the typical dosages?	20mg once per day	10mg or 20mg once per day
How is it administered?	Orally	Orally
Who is safe to take it?	Children Adolescents Adults	Adults Adolescents (12 and above)
Is there a risk of addiction?	No. But it can lead to dependence.	No. But it can lead to dependence.
Is there a risk of withdrawal effects?	Yes	Yes
What is the drug class?	Selective serotonin reuptake inhibitor (SSRI)	Selective serotonin reuptake inhibitor (SSRI)
Approval date	1987	2002

How Do Prozac & Lexapro Work?

Lexapro and Prozac are both SSRIs that work to regulate serotonin levels in the brain. By inhibiting the reabsorption of serotonin, these medications help to alleviate symptoms of depression.² Reabsorption is the process the body naturally uses to limit the action of serotonin. These medications prolong the action of serotonin.

The effectiveness of either medication will depend on several factors, including one’s age and health condition. However, it usually takes around two to four weeks for Lexapro to start working, and four to six for Prozac.^1,5

While Prozac and Lexapro work in the same way, a doctor can help you determine which one is right for you, depending on how you react to any side effects. However, some studies suggest that Lexapro may be more effective and better tolerated than other antidepressants.⁶

What Are Lexapro & Prozac Used to Treat?

Lexapro and Prozac are FDA-approved to treat major depressive disorder (MDD). They may also be prescribed off-label to treat other mental health conditions, such as post-traumatic stress disorder (PTSD). Off-label use of these substances should be done with caution and under a doctor’s guidance to prevent associated risks.

The table below compares the different medical conditions treated by each medication:^1,2

Side Effects	Prozac	Lexapro
Major depressive disorder	FDA-approved	FDA-approved
Generalized anxiety disorder (GAD)	Off label	FDA-approved
Obsessive-compulsive disorder (OCD)	Off label	Off label
Bulimia nervosa	Off label	No
Panic disorder	FDA-approved	Off label
Premenstrual dysphoric disorder (PMDD)	FDA-approved	Off label

Side Effects of Lexapro & Prozac

You are likely to experience side effects when using Lexapro or Prozac. These vary depending on how the drug interacts with a person’s body. Before starting your medication, you should discuss these possibilities with your doctor.

The table below compares the possible side effects of each medication:^1,2

Side Effects	Prozac	Lexapro
Nausea	22%	15%
Headache	21%	24%
Diarrhea	11%	8%
Dry mouth	9%	6%
Sweating	7%	5%
Insomnia	19%	9%
Dizziness	9%	5%
Nervousness	13%	0%
Decreased libido	4%	3%

Severe Side Effects & Allergic Reactions

Both Lexapro and Prozac can result in severe side effects that require immediate medical attention. These can occur due to drug interaction with other substances or allergic reactions in patients. Talk with your doctor about these possibilities if you are worried about these risks.

Insurance Coverage & Cost Effectiveness

Lexapro and Prozac are both covered by insurance and Medicare Part D. For those without insurance, filling a prescription for either can be expensive. However, generic versions are typically more cost-effective.

The typical price for Lexapro is about $379 for 30 10 mg tablets. Its generic version costs about $70 for 30 10mg generic tablets. Prozac costs about $600 for 30 20mg brand-name capsules. Its generic version costs about $30 for 30 20mg generic capsules. The drugs can also be purchased at reduced prices via coupons from licensed providers.

Prozac Vs. Lexapro: Warnings & Associated Risks

The FDA warns of increased side effects in specific populations. Other factors can also trigger severe adverse reactions, including life stressors, alcohol consumption, and substance abuse. Be sure to discuss any pre-existing conditions you have before considering Lexapro or Prozac.

Be sure to inform your prescriber if you are or experience:^1,2

• Breastfeeding
• Liver problems
• Suicidal ideation
• Pregnant
• Bleeding problems
• Glaucoma
• Heart issues

Interactions With Lexapro Vs. Prozac

Taking certain medications, herbs, or supplements alongside Lexapro and Prozac can change how Lexapro and Prozac work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctors, psychiatrist, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Harmful interaction can occur when Lexapro or Prozac are combined with other substances. This can lead to severe side effects that require immediate medical attention.

Substances you may be instructed to avoid when taking Lexapro or Prozac include:^1,2

• Blood thinners
• Non-Steroidal anti-inflammatory drugs (NSAIDs)
• Monoamine oxidase inhibitors (MAOIs)
• Benzodiazepines
• Other depression medications
• Migraine medications
• Thioridazine
• Pimozide
• Alcohol

Lexapro or Prozac: Which Drug Is More Effective?

Some studies suggest that Lexapro and Prozac are similarly effective at managing symptoms of depression. However, Lexapro may be more effective and better tolerated than other medications.⁶ Which medication is suitable for you will depend on which condition is being treated and how you respond to each prescription. For example, Prozac may not be the best choice if you have generalized anxiety disorder, as it can increase energy levels. On the other hand, it may be beneficial if you have depression and experience fatigue.

Which One Works Faster or Lasts Longer?

The effectiveness of Lexapro or Prozac generally depends on how the drug interacts with a person’s body. Generally, it takes about two to four weeks before users begin to experience symptom relief.⁵ However, it may take up to six weeks.^1,2

Which One Is Better for Short-Term or Long-Term Use?

Lexapro or Prozac can be used short or long-term, depending on an individual’s condition. Long-term use can result in other health complications, including physical dependence. A person may experience withdrawal symptoms if they abruptly cease their prescription.

Can You Take Lexapro & Prozac Together?

Combining Lexapro and Prozac is highly discouraged, as doing so can trigger worsened side effects of each substance. This can lead to possible overdose and sudden death. Talk with your doctor to understand these risks.

Questions to Ask Your Health Team

It is important to have an informative discussion with your doctor before considering Lexapro or Prozac. Your doctor will help you determine which medication is suitable for you. Additionally, you can ask your prescriber about substances that are safe to consume while on your medication or how long side effects typically last.

Below are questions to ask your doctor about Lexapro and Prozac:

1. Is it safe to take Lexapro or Prozac with my other medications?
2. Will my insurance cover Lexapro or Prozac?
3. Is it possible to overdose on Lexapro or Prozac?
4. Which one is more effective for treating depression?
5. Does my medical history increase my risk of experiencing side effects?
6. How long can I expect side effects to last?
7. Which one is the best for treating anxiety?
8. How often should I see you for checkups while taking Lexapro or Prozac?
9. Should I be concerned about combining Lexapro or Prozac with other medications or substances?
10. What are some alternatives to Lexapro or Prozac?

Final Thoughts

Lexapro and Prozac are both effective options for treating depression and other health conditions. However, taking these medications can result in side effects that may be severe. Before considering either prescription, talk with your doctor to better understand how your medical history, genetics, or current medication regime can impact your treatment.