Lexapro vs Zoloft: Similarities, Differences, Drug Interactions, More

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Patients who have mental health conditions like depression and anxiety require medication treatment more often than not. While there are many options, Lexapro and Zoloft are two of the most commonly used to treat depression. This is because they are both practical and safe and easily tolerated by most people. This article discusses Lexapro vs Zoloft, their similarities, differences, drug interactions, and more.

When used properly, these two medications can help patients improve their emotions and rebalance their lives.

In addition, they have been proven to restore a person’s ability to live a healthy day-to-day life and combat depression symptoms.

There are several common elements of both medications. First, they are both a specific type of antidepressant known as an SSRI or selective serotonin reuptake inhibitor.

Serotonin is a neurotransmitter that impacts a person’s sleep, mood, and appetite. SSRIs increase the serotonin in the body, thereby aiding in balancing those areas.

While both medications are helpful for mental health conditions, it’s crucial to understand how they compare to decide the suitable one for each patient.

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What are the Main Differences Between Lexapro vs Zoloft?

While both medications are SSRIs, they come in different forms and have different dosage strengths.

Lexapro was approved for use in 2002. It comes in tablet and liquid form, in dosage strengths of 5mg, 10mg, and 20mg.

Zoloft was approved for use in 1999. It comes in capsule, tablet, and liquid form, in dosage strengths of 25mg, 50mg, and 100mg.

Conditions Treated by Lexapro and Zoloft

The FDA has approved both medications for use with similar conditions. However, each medicine treats specific conditions that the other does not.

Lexapro is used for:

  • Generalized anxiety disorder
  • Major depressive disorder for both adult and pediatric patients

There are also off-label uses of Lexapro, including:

Binge-eating disorder

Bulimia nervosa

Obsessive-compulsive disorder for adult patients

Post-traumatic stress disorder

Premenstrual dysphoric disorder

Zoloft is used for:

  • Major depressive disorder for adult patients
  • Obsessive-compulsive disorder for adults and pediatric patients
  • Panic disorder
  • Post-traumatic stress disorder
  • Premenstrual dysphoric disorder
  • Social anxiety disorder

The off-label uses of Zoloft include:

Binge-eating disorder

Bulimia nervosa

General anxiety disorder

Is Lexapro or Zoloft More Effective?

While both medications effectively treat their various conditions, it has been suggested that Lexapro may be more effective and better tolerated than Zoloft.

In addition, due to the binding side interactions of Lexapro, it may have better efficacy and tolerability.

However, the effects will differ for each person, and they should weigh their treatment options carefully with their doctor.

Coverage and Cost Comparison of Lexapro vs Zoloft

The cost of Lexapro vs Zoloft varies depending on the prescribed dosage, the form of medication (tablet vs. capsule), each patient’s insurance coverage, and the pharmacy they use.

Generic forms of these medications contain the same active ingredients and have the same effects.

They are only different in cost, which can be incredibly useful for many patients.

For example, the generic version of Lexapro is called Escitalopram, and the generic version of Zoloft is called Sertraline.

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Common Side Effects of Lexapro vs Zoloft

While all people will react differently to medications, there are some common adverse effects of Lexapro and Zoloft.

When taking Lexapro, people may experience the following:

  • Constipation
  • Dizziness
  • Dry mouth
  • Fatigue, drowsiness, sleepiness
  • Gas
  • Heartburn
  • Insomnia
  • Loss of appetite
  • Nausea
  • Ringing in the ears
  • Sexual dysfunction
  • Weight gain

When taking Zoloft, people may experience the following:

  • Agitation
  • Constipation
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Fatigue, drowsiness, sleepiness
  • Headache
  • Insomnia
  • Loss of appetite
  • Nausea
  • Sexual dysfunction
  • Skin rash
  • Weight loss

Drug Interactions of Lexapro and Zoloft

Many medications interact with both Lexapro and Zoloft.

Drug interaction of Lexapro include buspirone, fentanyl, lithium, tryptophan, St. John’s wort, amphetamines, or some pain or migraine medicines.

Drug interactions with Zoloft include monoamine oxidase inhibitors (MAOIs), tryptophan, St. John’s wort, meperidine, tramadol, cimetidine, pimozide, and warfarin.

Warnings of Lexapro and Zoloft

Specific selective serotonin reuptake inhibitors (SSRI) medications, including Lexapro and Zoloft, may affect healthy fetal development adversely.

Therefore, pregnant or breastfeeding women should talk to their healthcare experts about the risks and benefits of taking Lexapro or Zoloft.

In pediatric patients, Lexapro and Zoloft have also been linked to suicidal thoughts and behavior.

Therefore, be aware of younger patients taking these medications.

Symptoms of withdrawal

As with any medication, patients mustn’t stop taking Lexapro or Zoloft without talking to their doctor.

When patients stop taking the medication abruptly, they may have symptoms of withdrawal.

Withdrawal symptoms include fatigue, nausea, muscle aches, agitation, irritation, anxiety, hallucinations, insomnia, sweating, and blurry vision.

These symptoms typically last from one to two weeks.

Patients should always work with their doctor to slowly wean off their medications over time to protect themselves from withdrawal symptoms.

When to Seek Medical Attention

Those who suffer from mental health conditions, including anxiety and depression, may want to seek medical attention from their doctor.

This is especially true if the condition negatively impacts their life and if symptoms increase.

A physician can help determine if Zoloft or Lexapro is appropriate for each patient.

Read Also: Prozac vs Zoloft: Similarities, Differences, Warnings, More

Frequently Asked Questions (FAQs)

Both Lexapro and Zoloft can treat certain anxiety disorders. The FDA has approved Lexapro to treat generalized anxiety disorder (GAD), while Zoloft is only prescribed off-label for GAD in certain situations.

Lexapro is sometimes prescribed off-label as a treatment for PTSD and OCD. Zoloft is approved for panic disorder, SAD, PTSD, and OCD in adult and pediatric patients.

Lexapro comes in tablet and liquid form and in dosage strengths of 5mg, 10mg, and 20mg. It could potentially have greater efficacy than Zoloft.

Common side effects include:

  • Constipation
  • Dizziness
  • Dry mouth
  • Fatigue, drowsiness, sleepiness
  • Gas
  • Heartburn
  • Insomnia
  • Loss of appetite
  • Nausea
  • Ringing in the ears
  • Sexual dysfunction
  • Weight change
  • Suicidal thoughts

Making a direct medication switch from an SSRI to another drug in the same class is possible. As Zoloft and Lexapro are both SSRIs, they can be switched out for one another. The patient can start taking the second once the first drug has been stopped completely.

Lexapro and Prozac are both approved as a treatment for depression.

Lexapro is also approved for anxiety treatment, and Prozac is approved for other mental health conditions, such as GAD.

Unfortunately, both medications have similar side effects.

No. Lexapro is not approved for SAD or prescribed as an off-label treatment. Zoloft is FDA-approved as a treatment for social anxiety disorder.

Lexapro and Zoloft should never be taken together, as they are both SSRIs.

Taken together, they can cause a fatal condition called serotonin syndrome, which includes dangerously high serotonin levels in the body.

To switch medications, patients should be tapered off one and start the other once the former medication has been stopped completely.

There are conflicting studies comparing the two antidepressants.

Some suggest that Lexapro may have better efficacy and tolerability, while others show Zoloft as the best option.

Therefore, patients should always weigh their treatment carefully with their doctor.


It is important to understand that everyone’s experience with Lexapro or Zoloft will be unique. There are thousands of Lexapro and Zoloft reviews available on the internet.

Therefore, working closely with your doctor to find suitable dosage forms and treatment plan is vital. You can decide whether Lexapro is right for you once you have all the facts. While Lexapro may cause some side effects, many people find that the benefits of taking Lexapro far outweigh any negatives.

The content on Doctor Alexa’s blog is reviewed by Advanced practice registered nurses or pharmacist and is intended for educational purposes only. This information should not be relied upon as professional medical counsel. Be sure to always consult with your physician about the dangers and benefits of any medication, treatment or procedure.

You shouldn’t wait to see the doctor for simple health needs.