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Lexapro vs Prozac: Choosing the Right Antidepressant

Written by:
Wafaa Amjad Dar
Pharm-D
Reviewer:
Dr. Bradley Noon
MD
Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs. Read more

Highlights

  • Both Prozac and Lexapro are effective for treating various mental health conditions, such as depression and anxiety disorders.
  • Lexapro is mainly used for depression and generalized anxiety disorder while Prozac is approved for a broader range of conditions.
  • Prozac may cause more side effects due to its longer half-life, while Lexapro is often associated with fewer side effects.
  • Weight gain is more commonly associated with Prozac than Lexapro, although both medications can cause weight changes in some individuals.
  • The choice between these medications should be based on individual factors, including the specific condition being treated, side effects, and personal response to the medication.

Prozac and Lexapro are widely used antidepressant medications for depression and anxiety disorders. Though both of them are under the same category as SSRIs (selective serotonin reuptake inhibitors) and have some other similarities, there are also certain differences. Read on to learn more about the features of each medication.

Get the most suitable treatment, including medication chosen according to your symptoms, diagnosis, and health history.

A General Overview of Prozac vs Lexapro

Prozac (fluoxetine) and Lexapro (escitalopram) are prescription medications FDA-approved to treat various mental health conditions, such as major depressive disorder, panic disorder, obsessive-compulsive disorder, and some others.

Both medications belong to the class of selective serotonin reuptake inhibitors. They influence serotonin levels [1*] , reducing the reuptake of this neurotransmitter and therefore improving its availability in the brain. With time, this effect promotes positive emotions, balances mood, and contributes to a better sense of well-being in general.

Lexapro

Lexapro [2*] (generic name escitalopram [3*] ) is primarily prescribed for the treatment of major depressive disorder and generalized anxiety disorder. It works by increasing the levels of serotonin, which plays a key role in mood regulation. 

Lexapro is highly selective for serotonin transporter and has minimal effects on other neurotransmitters. That is why it may have a faster onset of action compared to Prozac, potentially leading to quicker relief of symptoms for some patients.

Prozac

Prozac [4*] (generic name fluoxetine [5*] ) is another SSRI commonly used to treat depression, panic disorder, and obsessive-compulsive disorder (OCD), among other conditions. Like Lexapro, Prozac also works by increasing serotonin availability and helps to alleviate anxiety and depression symptoms.

In addition to influencing serotonin levels, fluoxetine may also affect other neurotransmitters, including norepinephrine and dopamine. This can influence energy and appetite. Also, fluoxetine has a comparatively longer half-life (48-72 hours compared to 27-33 hours for escitalopram), resulting in a more prolonged presence in the body and longer relief of symptoms. However, note that different medications can be more or less effective for different patients depending on individual health features.

An In-Depth Look at Prozac vs Lexapro

Prozac 

Lexapro

Generic name

Fluoxetine

Escitalopram

Available Strengths

Capsules: 10 mg, 20 mg, and 40 mg

Liquid: 20mg/5mL

Tablets: 5 mg, 10 mg, 20 mg

Liquid: 5mg/5mL

Dosage

Usual daily dosage: 20 mg daily.

Maximum daily dose: 60 mg to 80 mg (some patients require higher doses to relieve symptoms).

Starting daily dose: 10 mg.

The doctor may increase the dosage to 20 mg or reduce it to 5 mg if necessary.

Half-life

48-72 hours

27-33 hours

Effectiveness

It may take 4 to 6 weeks to notice full effects. Continue taking medication as prescribed because the effects can be delayed.

It typically shows full effects in 4-8 weeks. You may experience improved appetite, higher energy, and better sleep.

The Difference in the Mental Health Conditions Treated

Condition

Signs and symptoms

Prozac

Lexapro

Major depressive disorder

Changes in sleep and appetite, loss of interest in daily activities, suicidal thoughts and behaviors.

Generalized anxiety disorder

Insomnia, restlessness, an increased heart rate, panic attacks, and trouble concentrating.

Panic disorder

Intense panic and panic attacks resulting in chest pain, heart palpitations, and shortness of breath.

Bipolar disorder

Manic and depressive episodes.

Obsessive-compulsive disorder (OCD)

Persistent, anxiety-provoking thoughts followed by compulsive behaviors.

Premenstrual dysphoric disorder

Anxiety, irritability, low energy, binge eating, headaches before menstruation.

Binge eating

Repetitive episodes of consuming large amounts of food and feeling distressed afterward.

Bulimia nervosa

Purging after binge eating or after normal meals.

Post-traumatic stress disorder (PTSD)

Intrusive thoughts or memories, avoidance of specific places or situations, persistent negative emotions, hypervigilance, irritability, and aggressive behavior.

Social anxiety disorder

Extreme panic related to social situations and fear of being embarrassed and judged.

Does Prozac or Lexapro Work Better for Anxiety Disorders?

When it comes to Lexapro vs Prozac for anxiety treatment, both have been shown to be effective. Some studies [6*] suggest that fluoxetine may have a slight edge over escitalopram in the treatment of anxiety disorders, but more research is needed to confirm this. Also, individual responses to medication can vary, so what works well for one person may not necessarily work as effectively for another.

Related: Lexapro vs Zoloft

Which Is Better for Depression?

Similarly, both Lexapro and Prozac have demonstrated efficacy in treating major depressive disorder. Again, individual factors such as medical history, severity of symptoms, and potential side effects need to be considered when determining the most suitable medication. Some studies suggest that Lexapro may have a faster onset of action compared to Prozac, but the overall effectiveness of both medicines in treating depression appears to be comparable.

Our healthcare providers are ready to examine your symptoms online and develop an individual treatment plan.

Prozac vs Lexapro: Side Effects

Like all medications, both Lexapro and Prozac can cause side effects. It’s typical to experience only a few side effects, with the selection varying among patients. These adverse reactions may also vary according to the mental health condition being treated. The most common ones are listed below.

Prozac 

Lexapro

  • Nausea
  • Headaches
  • Insomnia
  • Weakness
  • Loss of appetite
  • Weight change
  • Diarrhea
  • Sexual dysfunction
  • Constipation
  • Nervousness
  • Drowsiness
  • Fatigue
  • Tremors
  • Nausea
  • Insomnia
  • Drowsiness
  • Ejaculation disorder
  • Weight changes
  • Diarrhea
  • Constipation
  • Anxiety
  • Sweating
  • Fatigue
  • Dry mouth

It’s important to discuss any concerns or disturbing experiences of side effects with your healthcare provider.

Are You More Likely to Experience Weight Gain on Lexapro or Prozac?

Weight gain is a potential side effect of both Lexapro and Prozac. Studies have shown that both drugs can be relatively weight-neutral with fluctuations of about 2 kg in some individuals. But, the extent of weight gain may vary from person to person.

If weight gain is a concern, it’s important to discuss this with your healthcare provider, who can help monitor your weight and make any necessary adjustments to your treatment plan.

Interactions of Lexapro and Prozac With Other Medications

Both Lexapro and Prozac can interact with other medications, supplements, and substances. That is why it’s important to disclose all medications and supplements you are taking to your healthcare provider before starting treatment.

Drug interactions with other medications:

  • Other SSRIs, SNRIs or tryptophans.
  • Monoamine oxidase inhibitors (MAOIs).
  • Tricyclic antidepressants (TCAs).
  • Anticoagulants such as warfarin or aspirin.

Interactions with other substances:

  • Alcohol.
  • Caffeine.
  • Grapefruit juice.

Your healthcare provider can provide personalized guidance to ensure appropriate use of your medication.

Related: Combining Lexapro and Alcohol

Switching From Lexapro to Prozac or Backwards

Switching from one antidepressant to another, whether it’s from Lexapro to Prozac or vice versa, should always be guided by a healthcare provider. Abruptly stopping one medication and starting another can lead to withdrawal symptoms, potentially worsening depression or anxiety symptoms and causing other adverse effects.

If you suppose you need to change medication, discuss it with your healthcare provider. They will evaluate your current condition, response to the current treatment, potential side effects and interactions, and other factors. If the change is appropriate, most probably you will gradually taper off your current medication over a period of several weeks or months, depending on your individual needs, and then gradually start the new medicine.

During this period, you might notice a temporary worsening of symptoms or side effects. Your healthcare provider will monitor symptoms and adjust dosages as needed. Communicate any changes you notice with your doctor promptly.

Can You Take Prozac and Lexapro Together?

Combining multiple antidepressants of the same class is generally not recommended. Since both Prozac and Lexapro are SSRIs, they work by increasing the levels of serotonin in the brain. So, taking them together can potentially lead to an excessive accumulation of serotonin, a dangerous condition known as serotonin syndrome. Its symptoms include confusion, agitation, rapid heartbeat, high blood pressure, dilated pupils, muscle rigidity, sweating, tremors, and in severe cases, it can lead to coma or death.

If your healthcare provider determines that combination therapy is absolutely necessary, close monitoring is vital to minimize the risk of severe adverse effects.

Summing Up: Which Is Better‍, Lexapro or Prozac?

Both medications are worth considering for the treatment of anxiety, depression, and some other mental health conditions. But despite their many similarities, each medication has some key differences.

The choice between Lexapro and Prozac should be made in consultation with a healthcare provider, taking into account individual factors such as medical history, symptom severity, and individual needs. At MEDvidi, our medical team works closely with you to find the medication that is the best fit for your unique needs and circumstances.

Frequently Asked Questions

Zoloft (sertraline), Lexapro (escitalopram), and Prozac (fluoxetine) are all SSRIs used to treat depression symptoms and anxiety. Sertraline affects serotonin and mildly dopamine and is used for various disorders; escitalopram is highly selective for serotonin, with fewer side effects, treating anxiety and depression; fluoxetine, with a long half-life, is commonly used to treat major depressive disorder, OCD, bulimia, and panic disorder. Side effects vary, with Zoloft causing more gastrointestinal issues and Prozac having more initial side effects but fewer withdrawal symptoms.

The intensity of each medication’s effects depends on individual response and other health features. Both are effective for treating depression and anxiety, with some studies [7*] suggesting fluoxetine might be slightly more effective for certain individuals. Consult with your healthcare provider to learn what medication can help you best.

Prozac’s stimulating effects can lead to increased energy and alertness. It makes it beneficial for patients experiencing low energy or fatigue due to depression. Whereas Lexapro has a more neutral or calming effect. It can improve energy levels and mood, but it’s less likely to cause stimulation. Individual responses differ, so while some people may feel more energized on these medications, others may not.
20 mg of Lexapro is approximately equivalent to 40-60 mg of Prozac (fluoxetine). However, it might not be correct to compare the dosing and effects of these medications because individual needs may vary, so the treatment regimen should always be created and guided by a healthcare professional.
Yes, it is possible to experience weight loss when taking these medications, though they are more commonly associated with weight gain. Weight changes can vary among individuals, and some people may lose weight due to side effects like nausea or decreased appetite. Always consult with a healthcare provider about any significant weight changes while on these medications.

Sources

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7 sources
  1. Mechanisms of action of selective serotonin reuptake inhibitors in the treatment of psychiatric disorders
    Source link
  2. Lexapro
    Source link
  3. Escitalopram
    Source link
  4. Prozac
    Source link
  5. Fluoxetine: a review on evidence based medicine
    Source link
  6. Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis
    Source link
  7. Impact of Sertraline, Fluoxetine, and Escitalopram on Psychological Distress among United States Adult Outpatients with a Major Depressive Disorder
    Source link
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Written by:
Wafaa Amjad Dar
Pharm-D
Reviewer:
Dr. Bradley Noon
MD
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This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of experts strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.