The FDA has approved both drugs to treat anxiety and depression. Let’s find out which is better? Lexapro vs Zoloft. Also, you will learn the similarities and differences between the two.
Selective serotonin reuptake inhibitors (SSRIs) are the most frequently used category of antidepressants for depression and anxiety. Both Lexapro and Zoloft belong to the SSRI class. SSRIs work by balancing the levels of a chemical called serotonin in the brain and nerve cells.
Lexapro is the brand name of the SSRI escitalopram. Zoloft is the branded version of another SSRI sertraline.
Want to know which drug might be a better option for your treatment plan? Are you thinking of switching from one medication to another? Before you talk to your doctor, read this Lexapro vs Zoloft guide to learn the pros and cons of each drug.
Lexapro vs Zoloft: How Do They Compare?
Below is the outline of the similarities and differences between the two drugs.
FDA approval date
Lexapro: 2002.
Zoloft: 1991.
Conditions treated
Doctors prescribe Lexapro to treat depression and generalized anxiety disorder (GAD). Zoloft has a broader range of use and is used to treat:
- Depression
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
- Premenstrual dysphoric disorder (PMDD)
Available preparations
Both are available as oral tablets and oral solutions.
Available strengths
Lexapro tablets come in the following strengths: 5 mg, 10 mg, and 20 mg. 1 mL of the solution contains 1 mg of escitalopram.
Zoloft tablets come in the following strengths: 25 mg, 50 mg, and 100 mg. 1 mL of the solution contains 20 mg of sertraline.
Age of the intended recipient
Lexapro is intended for individuals 12 years and older.
Zoloft is approved for use in people 18 years and older.
Risk of withdrawal
Both drugs carry a similar risk of withdrawal symptoms. Withdrawal can occur when you suddenly stop a drug you have been using for an extended period, typically six weeks.
Withdrawal symptoms can include:
- Flu-like symptoms
- Headache
- Unusual tiredness
- Abdominal cramping and pain
- Diarrhea
- Nausea/vomiting
- Appetite changes
- Nightmares
- Inability to fall or stay asleep (insomnia)
- Dizziness
- Vertigo
- Blurred vision
- Numbness
- Tremor
- Anxiety
- Agitation
- Low mood
- Delusions
- Hallucinations
Side effects
These drugs have a similar set of side effects, which can be mild or serious. Yet, sleep issues and taste changes are more likely to occur in Lexapro users. Skin rashes and diarrhea are more frequent in Zoloft users.
Mild side effects can include:
- Nausea
- Sleepiness
- Weakness
- Dizziness
- Anxiety
- Difficulty sleeping
- Sexual problems
- Sweating
- Shaking
- Loss of appetite
- Dry mouth
- Constipation
- Respiratory infections
- Yawning
- Diarrhea
- Indigestion
Serious side effects can include:
- Suicidal actions or thoughts
- Serotonin syndrome (a potentially fatal condition caused by too much serotonin in the body)
- Severe allergic reactions
- Abnormal bleeding
- Seizures or convulsions
- Mania
- Weight gain or loss
- Low blood sodium levels
- Blurry or double vision
- Dry eyes
- Increased pressure in eyes
Drug interactions
The drug-interaction profiles of these two drugs are pretty similar. They can interact with the following drugs and supplements:
- Monoamine oxidase inhibitors (MAOIs) like selegiline and phenelzine
- Pimozide
- Blood-thinning agents, such as warfarin and aspirin
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen
- Lithium
- Other antidepressants such as amitriptyline and venlafaxine
- Anti-anxiety drugs, such as buspirone and duloxetine
- Antipsychotic agents, such as aripiprazole and risperidone
- Antiseizure drugs, such as phenytoin and carbamazepine
- Migraine medications, such as sumatriptan and ergotamine
- Sleep medications, such as zolpidem
- Metoprolol
- Disulfiram
- Medications to treat irregular heartbeats, such as amiodarone and sotalol
- St John’s wort
- Natrol 5-HTP
Specific Warnings
Both drugs come with boxed warnings for increased risk of suicidality in young people. Besides, the FDA has not approved Zoloft for children below 18 years, except for those with OCD. Lexapro is not approved for children below 12 years.
Use during pregnancy
Lexapro and Zoloft are pregnancy category C medicines. A doctor may recommend them during pregnancy only if the potential benefits outweigh the risks to the mother and fetus.
Alcohol use
It is wise to avoid drinking while taking any of these medicines. Alcohol can temporarily worsen the side effects, such as dizziness, tiredness, and appetite changes. Besides, long-term alcohol abuse during treatment may worsen anxiety and depression symptoms. Moreover, there is a higher risk of an accidental overdose on a drug when you are intoxicated.
Lexapro vs Zoloft: Which is Better?
There is no black-and-white answer. Moreover, only limited studies have directly compared the effectiveness of these drugs.
Limited evidence suggests that Lexapro might be better for depression than Zoloft and other SSRIs.
For example, according to researchers from the U.S., U.K., and Denmark, escitalopram has better efficacy and tolerability than paroxetine and sertraline. However, this finding contradicts an earlier result that showed sertraline was the most cost-effective medicine for depression.
Regarding the cost, no significant difference exists between the two brands of SSRIs. Furthermore, insurance generally covers antidepressants, including Lexapro and Zoloft.
Lexapro vs. Zoloft: FAQs
- Can Zoloft make anxiety worse?
Anxiety is a mild side effect you may experience while taking Zoloft, Lexapro, or other SSRIs. Moreover, some people may have anxiety when they suddenly stop taking the drug.
- Is Lexapro for teens?
Lexapro is intended for individuals 12 years and older.
- Is Zoloft for teens?
Zoloft is approved for use in people 18 years and older.
Summary
The following table summarizes the differences and similarities between Lexapro and. Zoloft.
| Parameters | Lexapro | Zoloft |
| Use | Depression and Generalized Anxiety Disorder (GAD) | Depression, Obsessive-compulsive disorder (OCD), Panic disorder, Post-traumatic stress disorder (PTSD), Social anxiety disorder, Premenstrual dysphoric disorder (PMDD) |
| Available preparations | Tablets and solutions (oral) | Tablets and solutions (oral) |
| Age of the intended recipient | 12 years and older | 18 years and older |
| Side effects | More likely to cause sleep issues and taste changes. Risk of serotonin syndrome | More likely to cause skin rashes and diarrhea. Risk of serotonin syndrome |
| Pregnancy category | C | C |
| Alcohol use | Not recommended | Not recommended |
| Efficacy | Might be more effective in depression | |
| Withdrawal | Yes | Yes |
To learn more about treatment options for teens with anxiety in Southern California, contact Hillside Horizon for Teens at 855-746-8378.