Antidepressants are currently some of the most commonly prescribed drugs today. For people who suffer from mood and anxiety disorders, antidepressants like Lexapro and Zoloft are often recommended. The choice between Lexapro and Zoloft can be a difficult one. These two treatments, used expressly to manage depression, might also work for other disorders that affect mental health, such as anxiety if present in moderate levels.
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So how do you choose between Lexapro vs. Zoloft? Which SSRI is the best?
1. Lexapro Vs. Zoloft: Drug Features and Uses
Lexapro and Zoloft are both serotonin reuptake inhibitors that may be useful in treating depression. Selective serotonin reuptake inhibitors are most widely used to treat depression. They are also helpful for other mental health conditions like anxiety disorders. SSRIs, according to experts, are among the safest and most effective medicines for treating depression and anxiety.
What Is the Difference between Lexapro and Zoloft?
Zoloft’s generic name is sertraline, while Lexapro’s generic name is escitalopram. Both of these drugs are available as tablets and liquids. The two are members of the same class, but they still differ in many ways. Lexapro and Zoloft are both FDA-approved for treating depression and anxiety.
Each medication treats one or more conditions that fall into the broad category of clinical depression and anxiety. At the same time, Zoloft has been tested against mild-to-moderate depression related to postpartum psychological events like PPD (postpartum depression), which affects roughly one out of four women after giving birth.
When Is Zoloft Prescribed?
Doctors may prescribe Zoloft for many mental health disorders, including:
Depression is a severe mental health disorder. It is characterized by extreme stress and sadness, persistent and not removable simply with time/ passing events or occurrences in day-to-day life. While it can be challenging to deal with the depressed individual, one must remember that this state of mind is not a choice, nor can it be wished away by hoping for things to get better by themselves.
Professional help and assistance are necessary for the diagnosis and treatment of depression. Sertraline medication for depression works by influencing the chemicals in the brain and nerves. Some of the evidence presented indicates that it can relieve anxiety symptoms, improve mental health-related quality of life and improve mental health as reported by individuals taking it regularly.
Obsessive-Compulsive disorder is also considered a mental illness. Two particular characteristics mark it. The first one is obsessive thinking or repetitive thoughts that go on for extended periods. The second characteristic of obsessive-compulsive disorder is when the obsession triggers compulsive behavior.
This behavior is often followed with repetition to relieve anxiety, leading to more compulsive practices being engaged to alleviate that anxiety. Sertraline has been clinically proven to be more effective than placebo at reducing the frequency of obsessive-compulsive disorder (OCD) episodes in people suffering from this serotonin-deficiency disorder.
Social Anxiety Disorder
Another well-known anxiety disorder is social anxiety disorder. It is mainly characterized by social phobia. It could be a work meeting, meeting people new to you, a family gathering, a party, school, or workplace. Although social anxiety disorder is often misunderstood, misjudged, and stigmatized by other people, if left untreated, the symptoms can hold one back in many ways. There have been 336 ratings of sertraline for the treatment of social anxiety disorder, and the average rating is 7.3. Sixty-six percent of reviewers reported positive results.
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Posttraumatic Stress Disorder (PTSD)
As the name suggests, PTSD symptoms will surface after experiencing a traumatic event at some point in your life. However, these symptoms will only occur if it’s not adequately treated or unaddressed right away. You should be looking out for flashbacks, feelings of agitation, and anxiety.
Nocturnal symptoms include dreaming about the traumatic event repeatedly despite not wanting to recall it. There are also frequent moments of déjà vu, which could trigger flashbacks to the events themselves. Suppose you’ve experienced any of these symptoms. In that case, it’s essential to seek professional advice as soon as possible – symptoms aren’t instantly curable, but they can be managed to live with them better!
An analysis of the effectiveness of sertraline on functional and global outcome measures revealed that it was significantly better than placebo at treating PTSD. The efficacy analysis revealed that 53% of patients experienced much or very much improvement after treatment.
Panic attacks are the hallmark of panic disorder. There is heightened fear and stress without any evidence of danger. The symptoms of panic disorder are physical and mental, and sufferers may even lose control over their emotions and actions.
Panic disorders tend to be triggered by events that cause intense fear or arousal. These are characterized by physical symptoms, including chest pain, racing heart, shortness of breath, weakness in arms and legs, dizziness, hot flashes, nausea, shaking, or physical trembling.
According to studies, sertraline showed much more efficiency in reducing the number of panic attacks when compared to other antidepressants. The average time it took for this drug to start working was just over one week! Patients who started taking sertraline were already showing great improvement in their condition by the second week of treatment. Nearly two-thirds of the patients had achieved a 50% reduction in their average number of weekly attacks.
Premenstrual Dysphoric Disorder (PMDD)
Women who suffer from a premenstrual dysphoric disorder commonly experience feelings of extreme anxiety and depression. The onset of PMDD typically occurs about 2-3 days before the period begins, although they may persist for a few days after the start of periods.
While such symptoms can be expected in women with PMDD, they should always be treated. There is significant evidence that sertraline effectively treats PMDD, both continuously (at a dose of 50–150 mg) and premenstrually (at a dosage of 50–100 mg). The two dosing strategies for sertraline are well tolerated.
When Is Lexapro Prescribed?
Escitalopram is reportedly more effective than other SSRIs, and that sometimes it is as effective as SNRIs (such as venlafaxine and duloxetine) in the treatment of depression.
The average rating of escitalopram for the treatment of OCD is 8.5 out of 10. Over 80% of the reviewers expressed satisfaction with their experience, while 8% expressed disappointment.
An extensive amount of clinical data shows that escitalopram, 10-20mg per day, is an effective and well-tolerated first-line treatment option for managing panic disorders.
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Generalized Anxiety Disorder (GAD)
This condition is characterized by high anxiety, worry, and stress associated with everyday life without any real cause or explanation. People with GAD worry about a wide range of things, including health, money, relationships, work, and school. After comparing the effectiveness of escitalopram for GAD against a variety of other medications, including drugs commonly prescribed for anxiety and depression, it is reported to be most effective.
The table below summarizes the uses for both the drugs:
|Mental Health Disorders||Lexapro||Zoloft|
|Generalized anxiety disorder (GAD)||YES||NO|
|Obsessive-compulsive disorder (OCD)||YES||YES|
|Social anxiety disorder||YES||YES|
|Posttraumatic stress disorder (PTSD)||NO||YES|
|Premenstrual dysphoric disorder (PMDD)||NO||YES|
Zoloft and Lexapro are both in the same class of drugs, but they are formulated differently. The table below compares key characteristics of each drug:
|Name of the generic drug||Escitalopram||Sertraline|
|Available forms of the drug?||Oral solution |
|Oral solution |
|Available strengths||Tablet: 5 mg, 10 mg, 20 mg; |
Solution: 1 mg/mL
|Tablet: 25 mg,50 mg, 100 mg |
Solution: 20 mg/mL
|Age groups that can take it||Individuals 12 years and older||Individuals 18 years and older|
|Dosage||Prescribed by the doctor||Prescribed by the doctor|
|Treatment duration||Long-term duration||Long-term duration|
|Storage instructions||Store in a cool and dry place |
Avoid heat and moisture.
|Store in a cool and dry place |
Avoid heat and moisture.
|Associated withdrawal effects?||YES||YES|
2. Lexapro Vs. Zoloft: Mechanism of Action
The mechanism of action is similar for both Lexapro and Zoloft. They work by inhibiting serotonin reuptake. Understanding their mode of action will allow you to better understand the working of these depression drugs, which can affect your depression treatment progress.
How Do Selective Serotonin Reuptake Inhibitors Treat Depression?
It is believed that depression results from low levels of serotonin in the brain, which plays a part in regulating mood, other behaviors affected, and signs of anxiety. Selective serotonin reuptake inhibitors work by increasing the levels of serotonin in the brain and decreasing depressive symptoms.
The most common symptoms of depression include persistent feelings of sadness and hopelessness, fatigue, insomnia or oversleeping, feelings of worthlessness or self-hatred, a loss of interest in activities once enjoyed, and recurring thoughts about death or suicide.
These drugs are designed to affect brain receptors that are involved in the regulation of mood and behavior. By increasing the amount of serotonin available for nerve cells, these drugs can relieve emotional pain by improving signaling in the brain. For the treatment of depression, some of the most effective medications include:
How Does Lexapro Work in the Brain?
Scientists still don’t know precisely how Lexapro works to ease anxiety and depression symptoms. Due to Lexapro’s association with SSRIs, it can be said that it regulates brain serotonin levels to affect mood and behavior. There are many health issues for which Lexapro can be prescribed off-label, besides treating depression and anxiety. These include treatment for:
- Bipolar depression
- Chronic pain
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How Does Lexapro Make You Feel?
Lexapro will be able to change your mood as soon as you start taking it. As your depression gradually lifts, you may begin to fall asleep better, become more social, and gradually ease out of your depression symptoms if the drug is the right one for you. Your medication may take some time to show its efficacy, depending on how well you respond to it. A physician can recommend a specific medication duration for you. Results may take as long as a few months to become apparent.
How Does Zoloft Make You Feel?
Zoloft works in the same way as Lexapro. It is one of the most widely used antidepressant tablets and maintains serotonin levels in neurons for smooth signal transmission between nerve cells. Taking Zoloft as directed by your doctor can bring many positive changes.
You may find your energy rejuvenated and boosted as well as experience better sleep quality. Stress and panic attacks may also be significantly reduced as well. You need to consult your doctor to determine when and how long to take Zoloft. Typically, the medication is taken daily. This medication usually takes effect faster than Lexapro. Consequently, your symptoms may improve in a few weeks.
What Is a Better All-around Drug: Lexapro or Zoloft?
In addition to treating various depression and anxiety disorders, both drugs are effective against other diseases —most studies, as earlier explored, state that Lexapro is more effective in treating depression and anxiety disorders. Many other studies prove that Zoloft can be effective for major depressive disorder, posttraumatic stress disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder, and premenstrual dysphoric disorder.
The International Clinical Psychopharmacology published a study in 2014 which suggested that Lexapro had better tolerance than Zoloft and Paxil due to its different binding sites, which might explain its efficacy and tolerability. The findings of this study were challenged by another study suggesting Zoloft offered better or at least similar efficacy and tolerability than Lexapro and Celexa.
Which Is the Best Antidepressant in 2021?
Everyone reacts differently to medications, so you need your health expert’s advice before determining if either Zoloft or Lexapro is better for your condition. The role of genetics is interesting to consider when choosing the best medication for you. Experts claim genetics play an essential role in determining your best prescription. Suppose your doctor doesn’t feel like a particular medication is the best fit for you based on prescribing criteria.
In that case, they may suggest that you try a similar drug that has worked well for your relative’s similar diagnoses and medical histories to yours. You shouldn’t stray from your medication schedule, and you should give the drug some time to work. Symptoms may take longer to improve or react to a drug for some people. Take an antidepressant for 3-4 weeks before you rule out negative or positive results. Be sure to inform your doctor about side effects and drug reactions when experiencing them.
3. Lexapro Vs. Zoloft: Side Effects & Warnings
There are many side effects and warning signs of drugs in the selective serotonin reuptake inhibitor class, including Lexapro and Zoloft. Lexapro is known to cause the following side effects:
- Weight issues
- Skin rashes
- Nausea and vomiting
- Abnormal ejaculation
- Sexual dysfunction
Zoloft has the following common side effects:
- Serotonin syndrome
- Allergic reactions
- Sexual dysfunction
- Increased intensity of depression
- Abnormal cardiac rhythms
- Liver function alteration
- Triggered mania
- Abnormal bleeding
- Suicidal behavior
Even though both drugs are associated with several common side effects, many overlap and can even differ.
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Following is a brief comparison of Lexapro’s side effects versus Zoloft:
|Sudden changes in weight||YES||YES|
|Vision and eye problems||YES||YES|
|Abnormal weight changes||YES||YES|
|Decreased sodium levels||YES||YES|
|Insomnia and sleep problems||YES||YES|
|Vomiting and nausea||YES||YES|
Are Lexapro’s Side Effects less Severe than Zoloft?
There are slight differences between Lexapro and Zoloft, but the data above do not show that one drug is safer than the other because your physical reactions may differ from what you read here. In addition, each person’s body reacts differently to drugs regardless of how severe the side effects might be. The table below outlines the intensity of side effects you will experience with Lexapro vs. Zoloft.
|Lethargy and sleepiness||13%||11%|
With high possibilities of common and severe side effects, both these drugs come with warnings and precautions.
Zoloft Vs. Lexapro Warnings
Due to the high risk of suicides associated with these drugs, both antidepressants are accompanied by black box warnings. Antidepressant patients under 25 need to be closely monitored as a result. Below are some warning signs to watch for:
Over time, because of long-term antidepressants, too much serotonin can build up in the brain, causing serotonin syndrome. There are several symptoms associated with serotonin syndrome:
- Increased heart rate
- Dilation of pupils
Antidepressants may cause withdrawal symptoms in those who suddenly stop taking them. It is common to experience withdrawal symptoms after taking antidepressants for four to six weeks or even longer. You may experience withdrawal symptoms such as:
- Muscle aches
- Flu-like symptoms
- Increased anxiety
- A sensation of electric shock
- Increased depression
It can be hard to tell if the symptoms are due to withdrawal or relapse. Talk with your doctor about tapering down dosages slowly and seek professional help if you start feeling low again.
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Epilepsy and seizures are more likely to develop in patients who are taking antidepressants long-term. Consequently, it is necessary to share your medical history with your mental health expert to determine the best medication for you.
Hyponatremia occurs when sodium levels are low. The disorder results from the absence of adequate levels of antidiuretic hormone (ADH). Medications that selectively inhibit serotonin reuptake cause the alteration of ADH. The following symptoms occur in hyponatremia patients:
- Memory issues
- Lack of concentration
Angle-closure glaucoma is a medical condition characterized by increased intraocular pressure. It develops when the fluid drainage of the eye becomes restricted. The specific cause is not always clear, but it’s generally associated with trauma affecting the angle between the iris and the lens, which blocks the normal flow of fluid through this area. Selective serotonin reuptake inhibitors have been linked to acute angle-closure glaucoma in patients.
Serotonin has been linked to excess bleeding, according to researchers. Antidepressants commonly prescribed for depression and anxiety increase the risk of developing this condition.
Activation of Mania
Bipolar disorder and mania are particularly prevalent in antidepressant users with unipolar depression.
Lexapro Vs. Zoloft: Pregnancy Warnings
When taking antidepressants, including Lexapro and Zoloft, mothers should take them only if their need is greater than the potential harm to their baby’s health. The mother’s condition must be evaluated throughout if her medication is to be abruptly stopped. Stopping the drug abruptly can cause relapses of depression and anxiety.
Zoloft Vs. Lexapro: Breastfeeding Considerations
Breastfeeding women should exercise caution when taking Zoloft and Lexapro. If you are currently taking antidepressants, inform your healthcare provider before getting pregnant. An expert should monitor the baby throughout and notify the parents if any adverse effects occur. Zoloft contains approximately 12% alcohol, which is why it should be taken with caution by pregnant women and nursing mothers.
Lexapro and Alcohol Vs. Zoloft and Alcohol
Lexapro and alcohol usage may have dangerous side effects, including liver failure, extreme sleepiness, and drowsiness. Lexapro should not be combined with alcohol to prevent any health risks. Zoloft, which is also an alcohol-containing drug, directly impairs the functions of the brain. To prevent any side effects to the nervous system, the FDA does not recommend that people take Zoloft and other antidepressants with alcohol.
Lexapro Vs. Zoloft: Weight Gain
The most common side effect of antidepressants is weight gain. The effect of antidepressants on metabolism and appetite may explain their link to weight gain. It has been reported that people taking antidepressants become hungrier. Then again, some people who have begun using antidepressants also noted that they gained weight even while eating a low-calorie diet.
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4. Lexapro Vs. Zoloft: Cost, Dosage, Availability, and Coverage
Zoloft and Lexapro both come in generic and branded forms. There are, however, several differences in the insurance coverage for the generic forms and the brand forms. Compared to the brand name forms of Lexapro, the generic version is much less expensive and is more likely to be covered by health insurance. Many insurance companies cover Zoloft generic versions, while some companies do not cover the brand version.
In the following table, we summarize the cost and coverage details:
|Medicare Part D coverage||Generics are covered, but brands might have high co-pays or may not be covered at all.||Generics are covered, but brands may have a higher co-pay or may not even be covered at all.|
|Average cost||The cost of an oral tablet of 10mg is around $46.38/ 30 tablets||The cost of an oral tablet of 50mg is about $139/ 30 tablets|
5. Lexapro Vs. Zoloft: Drug Interactions and FAQs
A life-threatening condition called serotonin syndrome can result from taking some drugs such as ‘Selegiline’ with Lexapro and Zoloft. Other drugs that should be observed for drug reactions due to the possibility of Serotonin Syndrome, include Triptans, Cymbalta, and Elavil. Lexapro and Zoloft also cause severe interactions when mixed with alcohol or NSAIDs.
Lexapro Vs. Zoloft Drug Interactions Table
|Drug/Drug Class||Lexapro drug interaction||Zoloft drug interaction|
|Selegiline, Tranylcypromine/ MAO Inhibitors||✅||✅|
|St.John’s Wort/ Supplement||✅||✅|
|Ibuprofen, Naproxen/ NASAIDs||✅||✅|
|Effexor, Prestiq/ SNRIs||✅||✅|
|Elavil, Pamelor/ TCA||✅||✅|
Lexapro and Zoloft Frequently Asked Questions
1. Are Lexapro and Zoloft the same?
Zoloft and Lexapro are members of the same antidepressant class known as selective serotonin reuptake inhibitors (SSRIs). They work in similar ways, even though they both have different indications.
2. What are the common side effects related to Lexapro and Zoloft?
There are several common side effects associated with these antidepressants:
- Diarrhea or constipation
- Feeling very sleepy
- Loss of appetite
- Feeling agitated
- Feeling sick
- Stomach aches
3. Does Zoloft change your personality?
Zoloft helps to reduce the symptoms of depression and anxiety. It tends to change your personality, but this can be either beneficial or detrimental, depending on the case. Nonetheless, don’t stop taking Zoloft abruptly as it will cause serious mood changes. Talk to your psychiatrist or physician about it.
4. Does Lexapro make you sweat?
Side effects like sweating, nausea and abnormal dreams are common when using this medication. It’s important to note that side effects vary in intensity for each individual.
5. Can I lose weight while on Lexapro or Zoloft?
Zoloft and Lexapro both increase serotonin, which has an impact on appetite. Your appetite might increase, and you might find that you crave food more than normal. The reason patients who take these drugs gain weight could be that they influence metabolism. The use of both of these drugs may also result in some individuals losing weight after adjusting.
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Lexapro and Zoloft are a type of medication that helps with anxiety and depression. While the two drugs are effective against mental health disorders, they do carry some side effects and concerns. Knowing what your body is sensitive to in this regard is essential when deciding on a brand-name drug to use – so make sure to consult your doctor to make the best decision for your long-term wellness.