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  • Key DifferencesKey Differences
  • Zoloft & LexaproZoloft & Lexapro
  • TreatmentsTreatments
  • Side EffectsSide Effects
  • InsuranceInsurance
  • Warning & RiskWarning & Risk
  • InteractionsInteractions
  • Which Is More EffectiveWhich Is More Effective
  • Question to AskQuestion to Ask
  • ConclusionConclusion
  • Additional ResourcesAdditional Resources

Lexapro vs. Zoloft: Choosing Which Is Right for You

Diana Rangaves, PharmD, RPh

Author: Diana Rangaves, PharmD, RPh

Diana Rangaves, PharmD, RPh

Diana Rangaves PharmD, RPh

Diana Rangaves is an accomplished pharmacist and expert in behavioral health pharmacology. Her areas of expertise include patient education, medication cost-reduction, and patient-centered treatment.

See My Bio Editorial Policy
Headshot of Heidi Moawad, MD

Medical Reviewer: Heidi Moawad, MD Licensed medical reviewer

Headshot of Heidi Moawad, MD

Heidi Moawad MD

Heidi Moawad, MD is a neurologist with 20+ years of experience focusing on
mental health disorders, behavioral health issues, neurological disease, migraines, pain, stroke, cognitive impairment, multiple sclerosis, and more.

See My Bio Editorial Policy
Published: January 25, 2023
  • Key DifferencesKey Differences
  • Zoloft & LexaproZoloft & Lexapro
  • TreatmentsTreatments
  • Side EffectsSide Effects
  • InsuranceInsurance
  • Warning & RiskWarning & Risk
  • InteractionsInteractions
  • Which Is More EffectiveWhich Is More Effective
  • Question to AskQuestion to Ask
  • ConclusionConclusion
  • Additional ResourcesAdditional Resources
Brand name:
Lexapro
Generic name:
Escitalopram
Is the generic available:
Yes
Class of drug:
SSRI
Boxed warning:
Yes
FDA-approved treatments:
Major Depression, Generalized Anxiety Disorder
Common Off-label Uses (non-FDA approved):
OCD, PTSD, Premenstrual Dysphoric Disorder (PMDD), Panic Disorder, Bulimia Nervosa, Binge Eating Disorder
Common alternatives:

Zoloft, Paxil, Prozac

View Drug Class, FDA-Approved Uses, Off-Label Uses, and more

*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Brand name:
Zoloft
Generic name:
Sertraline Hydrochloride
Is the generic available:
Yes
Class of drug:
SSRI
Boxed warning:
Yes
FDA-approved treatments:
Major Depression, OCD, Panic Disorder, PTSD, Social Anxiety Disorder, Premenstrual Dysphoric Disorder (PMDD)
Common Off-label Uses (non-FDA approved):
Bulimia Nervosa, Premature Ejaculation
Common alternatives:

Celexa, Lexapro, Prozac

View Drug Class, FDA-Approved Uses, Off-Label Uses, and more

*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

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.

If you’re considering a prescription for Lexapro or Zoloft or want to discuss your current prescription with a provider, an online psychiatry platform is a good place to start. Platforms like Talkiatry and Brightside Health can connect you with a provider quickly and offer assessments and prescription consultation.

Boxed Warning: Escitalopram (Lexapro) - Risk of suicidal thoughts and behaviors in certain people

Click here to open and close the box warning container.

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: Sertraline (Zoloft) – Risk of suicidal thoughts and behaviors in certain people

Click here to open and close the box warning container.

Sertraline, the active ingredient in Zoloft, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Sertraline 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 sertraline and any other medications before starting treatment.

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 ComponentsZoloftLexapro
What is the generic Name?SertralineEscitalopram
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?OrallyOrally
Who can take it?Adults
Children over 12
Adults
Children over 12
Is there a risk of addiction?NoNo
Is there a risk of withdrawal effects?YesYes
Drug classSSRISSRI
How long is the typical treatment?Long-term (six months to one year)Long-term (several months to years)

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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

ConditionsZoloftLexapro
DepressionFDA-approvedYes, on-label
Generalized Anxiety Disorder (GAD)FDA-approvedYes, on-label
Obsessive-compulsive disorder (OCD)FDA-approvedNo
Post-traumatic stress disorder (PTSD)FDA-approvedNo
Premenstrual dysphoric disorder (PMDD)FDA-approvedNo

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 EffectsZoloftLexapro
Nausea26%18%
Diarrhea20%8%
Sexual problems8%14%
Dry mouth14%9%
Sleepiness11%13%
Insomnia20%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.

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Online Psychiatry and Medication Management Covered by Insurance

Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment

Visit Talkiatry

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 Zoloft or Lexapro?
  • What are some alternatives to Lexapro or Zoloft?
  • How does Zoloft compare to Cymbalta?

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.

Additional Resources

To help our readers take the next step in their mental health journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com is compensated for marketing by the companies included below.

Online Psychiatry Covered by Insurance

Talkiatry – Work with a psychiatrist online. Insurance accepted, and new patients welcome. Get personalized mental care including medication. If allowed in your state and right for you, this can include controlled substances. Start with a short online assessment.

Circle Medical – Anxiety and Depression Treatment. Meet with an online doctor today! All prescriptions are based on necessity determined by a medical professional. Diagnosis and prescription over video. Insurance accepted. No membership or hidden fees. Same day appointments. Visit Circle Medical

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For Further Reading

How to Get a Lexapro Prescription: Everything You Need to Know
Lexapro Vs. Prozac: Choosing Which Is Right for You
Lexapro & Weight Gain: Everything You Need to Know
Lexapro Vs. Wellbutrin: Choosing Which Is Right for You
Escitalopram (Lexapro Generic) Cost: Prices, Coupons, & Tips for Saving
Lexapro (Escitalopram) Overdose: Signs, Precautions, & Treatment

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Best Online Psychiatry Services

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Sources

ChoosingTherapy.com 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. (2022). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13bb8267-1cab-43e5-acae-55a4d957630a

  • ZOLOFT– sertraline hydrochloride tablet, film coated ZOLOFT- sertraline hydrochloride solution, concentrate. (2021). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fe9e8b7d-61ea-409d-84aa-3ebd79a046b5

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

  • Antidepressants. (2022). MedlinePlus. Retrieved from https://medlineplus.gov/antidepressants.html

  • Sanchez, C., Reines, E. H., & Montgomery, S. A. (2014). A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike? International clinical psychopharmacology, 29(4), 185–196. Retrieved from  https://doi.org/10.1097/YIC.0000000000000023

  • Sanchez, C., Reines, E. H., & Montgomery, S. A. (2014). A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike?. International clinical psychopharmacology, 29(4), 185–196. Retrieved from https://doi.org/10.1097/YIC.0000000000000023

Show more Click here to open the article sources container.

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