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Lexapro vs. Prozac: Choosing Which Is Right for You

Published: January 24, 2023 Updated: January 25, 2023
Published: 01/24/2023 Updated: 01/25/2023
Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD
  • Lexapro Vs. ProzacLexapro Vs. Prozac
  • How Do Prozac & Lexapro Work?Prozac & Lexapro
  • What Are Lexapro & Prozac Used to Treat?How They're Used
  • Side Effects of Lexapro & ProzacSide Effects
  • Severe Side Effects & Allergic ReactionsAllergic Reactions
  • Insurance Coverage & Cost EffectivenessInsurance & Cost
  • Prozac Vs. Lexapro: Warnings & Associated RisksWarnings & Risks
  • Interactions With Lexapro Vs. ProzacInteractions
  • Lexapro or Prozac: Which Drug Is More Effective?Which Drug Is More Effective?
  • Can You Take Lexapro & Prozac Together?Lexapro & Prozac Together
  • Questions to Ask Your Health TeamQuestions to Ask
  • Final ThoughtsConclusion
  • Additional ResourcesResources
Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD

Both Lexapro and Prozac are effective medications for relieving symptoms of depression, anxiety, and other mental health conditions. They are only available via prescription. Some side effects common for both include headaches, nausea, and vomiting. How a person reacts to these substances may determine if they choose one over the other. Your doctor can help you determine which medication is better suited for your individual needs and condition.

Boxed Warning: Escitalopram (Lexapro)

Boxed Warning: Risk of Suicidal Thoughts and Behaviors in Certain People
Escitalopram, the active ingredient in Lexapro, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Escitalopram can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with escitalopram and any other medications before starting treatment.

Boxed Warning: Fluoxetine (Prozac)

Risk of Suicidal Thoughts and Behaviors in Certain People
Fluoxetine, the active ingredient in Prozac, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Fluoxetine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with fluoxetine and any other medications before starting treatment.

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 ComponentsProzacLexapro
What is the Generic Name?

FluoxetineEscitalopram
What forms does it come in?Tablet
Capsule
Solution
Tablet
Solution
What are the typical dosages?20mg once per day10mg or 20mg once per day
How is it administered?OrallyOrally
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?YesYes
What is the drug class?Selective serotonin reuptake inhibitor (SSRI)Selective serotonin reuptake inhibitor (SSRI)
Approval date19872002

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 EffectsProzacLexapro
Major depressive disorderFDA-approvedFDA-approved
Generalized anxiety disorder (GAD)Off labelFDA-approved
Obsessive-compulsive disorder (OCD)Off labelOff label
Bulimia nervosaOff labelNo
Panic disorderFDA-approvedOff label
Premenstrual dysphoric disorder (PMDD)FDA-approvedOff 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 EffectsProzacLexapro
Nausea22%15%
Headache21%24%
Diarrhea11%8%
Dry mouth9%6%
Sweating7%5%
Insomnia19%9%
Dizziness9%5%
Nervousness13%0%
Decreased libido4%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. Which one is more effective for treating depression?
  4. Does my medical history increase my risk of experiencing side effects?
  5. How long can I expect side effects to last?
  6. Which one is the best for treating anxiety?
  7. How often should I see you for checkups while taking Lexapro or Prozac?
  8. Should I be concerned about combining Lexapro or Prozac with other medications or substances?

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.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Virtual Psychiatry

Talkiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month). Get Started

Medication + Therapy

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Choosing Therapy partners with leading mental health companies and is compensated for marketing by Brightside, Hims / Hers, and  Talkiatry.

6 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • LEXAPRO- escitalopram tablet, film coated LEXAPRO- escitalopram solution. (2021). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13bb8267-1cab-43e5-acae-55a4d957630a

  • PROZAC- fluoxetine hydrochloride capsule. (2021). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c88f33ed-6dfb-4c5e-bc01-d8e36dd97299

  • Chu, A. & Wadhwa, R. (2022). Selective serotonin reuptake inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/

  • InformedHealth.org. (2020). Depression: How effective are antidepressants? – InformedHealth. https://www.ncbi.nlm.nih.gov/books/NBK361016/

  • Posternak, M. A. (2005). How quickly do antidepressants begin to work? Psychiatric Times. Retrieved from https://www.psychiatrictimes.com/view/how-quickly-do-antidepressants-begin-work

  • Cipriani, A., et al. (2009). Escitalopram versus other antidepressive agents for depression. The Cochrane database of systematic reviews, (2), CD006532. Retrieved from https://doi.org/10.1002/14651858.CD006532.pub2

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Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Headshot of Benjamin Troy, MD
Reviewed by:

Heidi Moawad

MD
  • Lexapro Vs. ProzacLexapro Vs. Prozac
  • How Do Prozac & Lexapro Work?Prozac & Lexapro
  • What Are Lexapro & Prozac Used to Treat?How They're Used
  • Side Effects of Lexapro & ProzacSide Effects
  • Severe Side Effects & Allergic ReactionsAllergic Reactions
  • Insurance Coverage & Cost EffectivenessInsurance & Cost
  • Prozac Vs. Lexapro: Warnings & Associated RisksWarnings & Risks
  • Interactions With Lexapro Vs. ProzacInteractions
  • Lexapro or Prozac: Which Drug Is More Effective?Which Drug Is More Effective?
  • Can You Take Lexapro & Prozac Together?Lexapro & Prozac Together
  • Questions to Ask Your Health TeamQuestions to Ask
  • Final ThoughtsConclusion
  • Additional ResourcesResources
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