Lexapro (escitalopram) and Zoloft (sertraline) are medications that can be used to treat symptoms of depression and anxiety. Taking either drug can result in side effects such as nausea, insomnia, and dry mouth. A doctor will determine whether Lexapro or Zoloft is suitable for a patient based on their age, the disorder being treated, and pre-existing health conditions.
Lexapro vs. Zoloft: Key Differences
Lexapro (escitalopram) and Zoloft (sertraline) are both selective serotonin reuptake inhibitors (SSRIs) that work by regulating the reabsorption of serotonin in the brain.1, 2 This balances serotonin levels which plays an important role in influencing one’s mood and mental well-being.3 Lexapro and Zoloft are only available through prescription and can be prescribed by psychiatrists, primary care providers, licensed nurse practitioners, or licensed assistant physicians.
The table below compares the different components of each medication:1, 2
| Key Components | Zoloft | Lexapro |
| What is the generic Name? | Sertraline | Escitalopram |
| What forms does it come in? | Oral tablet Oral solution | Oral tablet Oral solution |
| What are the typical dosages? | Tablet: 25 mg, 50 mg, 100 mg Solution: 20mg/mL | Tablet: 5 mg, 10 mg, 20 mg Solution: 1 mg/mL |
| How is it administered? | Orally | Orally |
| Who can take it? | Adults Children over 12 | Adults Children over 12 |
| Is there a risk of addiction? | No | No |
| Is there a risk of withdrawal effects? | Yes | Yes |
| Drug class | SSRI | SSRI |
| How long is the typical treatment? | Long-term (six months to one year) | Long-term (several months to years) |
How Do Zoloft & Lexapro Work?
Lexapro is FDA-approved for treating symptoms of depression, anxiety, and other mental disorders. Similarly, Zoloft is approved for certain types of depression and anxiety, including major depressive disorder (MDD) and generalized anxiety disorder (GAD). As noted, both medications block serotonin reuptake in the body, leading to increased levels of the neurotransmitter.1
While Lexapro and Zoloft work in the same ways, they each have different chemical compositions and associated side effects. A prescriber will determine which medication is better suited for a patient.
How Are Lexapro & Zoloft Used in Treatment?
Lexapro and Zoloft can be prescribed to treat several conditions including depression and anxiety.
The table below compares the different uses of medication: 1, 2
| Conditions | Zoloft | Lexapro |
| Depression | FDA-approved | Yes, on-label |
| Generalized Anxiety Disorder (GAD) | FDA-approved | Yes, on-label |
| Obsessive-compulsive disorder (OCD) | FDA-approved | No |
| Post-traumatic stress disorder (PTSD) | FDA-approved | No |
| Premenstrual dysphoric disorder (PMDD) | FDA-approved | No |
Side Effects of Lexapro & Zoloft
Like many antidepressants, research shows that taking Lexapro and Zoloft may result in side effects. Sometimes, these initial reactions improve within one or two weeks into treatment.4 However, these vary from person to person depending on their age.
The table below compares the possible side effects of each medication: 1, 2
| Side Effects | Zoloft | Lexapro |
| Nausea | 26% | 18% |
| Diarrhea | 20% | 8% |
| Sexual problems | 8% | 14% |
| Dry mouth | 14% | 9% |
| Sleepiness | 11% | 13% |
| Insomnia | 20% | 12% |
Severe Side Effects & Allergic Reactions
Side effects of Lexapro and Zoloft may be severe and require immediate medical attention. The likelihood of serious side effects greatly increases if either medication is taken alongside another substance such as alcohol. Additionally, those who have a history of allergic reactions to other antidepressants should alert their doctor before taking Lexapro or Zoloft.
Insurance Coverage & Cost Effectiveness
Prescriptions can be expensive, especially if a person does not have insurance. Lexapro and Zoloft are typically covered by both insurance and Medicare part D. Both prescriptions can be purchased at a lower price and co-pay in their generic forms.
Generally, Lexapro costs about $379 for 30, 10 mg tablets. Generic versions sell for between $0 and 30. Brand name Zoloft costs about $365 for 30, 10mg, while the generic version ranges between $0 and $13. Medications can also be purchased at a reduced price by using coupons from various providers.
Zoloft vs. Lexapro: Warnings & Associated Risks
It is important to be aware of both the benefits and risks associated with Zoloft and Lexapro. Children and young adults who take these medications may be at an increased risk of suicidal thoughts and behaviors. Additionally, individuals with preexisting health conditions, such as bipolar disorder, seizures, or liver problems, may experience worsened symptoms. It is essential to disclose one’s medical history with a doctor before starting a medication.
Zoloft and Lexpro should be prescribed with caution to individuals who have a history of or are currently:1, 2
- Liver problems
- Suicidal ideation
- Pregnant
- Breastfeeding
- Bipolar disorder
- Seizures
- Glaucoma
- Bleeding problems
Interactions With Lexapro vs. Zoloft
Taking certain medications, herbs, or supplements alongside Lexapro and Zoloft can change how Lexapro and Zoloft work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, 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.
Just like other antidepressants, Lexapro and Zoloft have unique chemical components that can interact with other substances, medications, or dietary supplements. For this reason, mixing other substances with Lexapro or Zoloft is not recommended. Consuming alcohol with either medication can worsen the sedative effects of alcohol such as drowsiness and dizziness. Discuss these possibilities with a doctor before considering Lexapro or Zoloft.
Substances that can interact with Lexapro and Zoloft include:1, 2
- Blood thinners
- NSAIDs
- Benzodiazepines
- Others SSRIs
- Migraine medications
- Pimozide
- MAOIs
- Thioridazine
- Alcohol
Lexapro or Zoloft: Which Is More Effective?
Both Lexapro and Zoloft have been proven to be more effective than placebo medications in clinical trials.1 One study suggested that Lexapro may be better tolerated than Zoloft, as findings implied that Lexapro’s binding site increased its beneficial effects.6 However, more research is needed to determine which medication is more successful in treatment.
Do Either Work Faster or Last Longer?
Individuals taking Lexapro or Zoloft may not experience improved symptoms until a few weeks after their initial dosage.5 Everyone reacts differently to medication, but antidepressants typically begin to work within four weeks. However, some may not experience symptom relief for six or eight weeks.
Can You Take Lexapro & Zoloft Together?
Both Lexapro and Zoloft are SSRIs that can interact with each other, possibly resulting in serotonin syndrome. Combining these medications can result in excess serotonin in the body which can be life-threatening.
Questions to Ask Your Health Team
It’s always important to discuss the risks associated with antidepressants before considering Zoloft or Lexapro. A prescriber will assess a patient’s medical history in order to determine which medication is better suited for them.
Questions to ask your care team when considering Lexapro vs. Zoloft include:
- Is it safe to take Lexapro or Zoloft with my other medications?
- Will my insurance cover Lexapro or Zoloft?
- Does my medical history increase the risk of side effects?
- How long can I expect side effects to last?
- Which one is better for treating anxiety?
- How often should I see you for checkups while taking Lexapro or Zoloft?
- What are the best online psychiatry options to get a prescription?
- Can I take Lexapro and Zoloft together?
- Can I overdose on Lexapro or Zoloft?
Final Thoughts
Lexapro and Zoloft can be used to treat depression, anxiety disorders, and other mental health conditions. As a person’s body adjusts to either medication, they may experience mild side effects. Some patients may experience persistent side effects. However, if side effects worsen, it is recommended to seek immediate medical attention. Discuss the benefits and risks of Lexparo and Zoloft with a prescriber.
