Healthcare providers often consider prescribing Lexapro or Zoloft for anxiety and depression. Both medications belong to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and help stabilize mood. This guide outlines everything you need to know about Lexapro and Zoloft, from their usage and dosage to unique differences and side effects.
Conditions Treated by Lexapro and Zoloft
Both Lexapro and Zoloft are FDA-approved to treat depression and anxiety and fall under the same medication class. However, they have differences in composition, dosage, and uses. Let’s review the latter feature first.
Escitalopram, sold under the brand name Lexapro, is prescribed for acute and maintenance treatment of major depressive disorder (MDD) due to its
On the other hand, sertraline, sold under the brand name Zoloft, is prescribed for a wider range of conditions. It can be used to treat
| Conditions treated | Lexapro | Zoloft |
| Major depressive disorder | ✅ | ✅ |
| Generalized anxiety disorder | ✅ | ✅ |
| Panic disorder | ❌ | ✅ |
| Social anxiety disorder | ❌ | ✅ |
| Post-traumatic disorder | ❌ | ✅ |
| Obsessive-compulsive disorder | ❌ | ✅ |
| Premenstrual dysphoric disorder | ❌ | ✅ |
Lexapro vs Zoloft: How Do They Work?
As selective serotonin reuptake inhibitors (SSRIs), Zoloft and Lexapro have a similar mechanism of action. Their primary function is to inhibit the serotonin reuptake by nerve cells, thus preventing its reabsorption and consequently elevating its levels in the brain. Serotonin is a neurotransmitter that plays a crucial role in regulating mood and cognitive functions. So, its higher levels can enhance mood and alleviate symptoms of anxiety and depression.
How Long Do You Need to Take Lexapro vs Zoloft?
Both Lexapro and Zoloft are typically prescribed for long-term treatment, from a few months to years. The duration varies based on an individual’s diagnosis, health specifics, and response to the prescribed medication (reaching stable effects may take several weeks). In most cases, individuals are advised to continue the medication for up to six months after symptom improvement to reduce the risk of recurrence. However, the exact period should be decided in consultation with your healthcare provider, and it’s essential to follow their instructions.
In addition, it’s important to note that the discontinuation of either Zoloft or Lexapro should not be abrupt. Patients should follow the tapering schedule and reduce the dosage gradually to avoid withdrawal symptoms.
Similarities and Differences Between Lexapro and Zoloft
Although their mechanisms are similar, Zoloft has a broader area of action compared to Lexapro. In addition to depression and generalized anxiety disorder, it can help with panic attacks and reduce obsessive-compulsive behaviors. The comparison table below shows other important similarities and differences between Lexapro and Zoloft:
| Lexapro | Zoloft | |
| Drug Class | Selective serotonin reuptake inhibitor (SSRI) | Selective serotonin reuptake inhibitor (SSRI) |
| Generic Name | Escitalopram oxalate | Sertraline hydrochloride |
| Dosage form | Tablets and oral solution | Tablets and oral solution |
| Dosage strength | Tablets: 5mg, 10mg, 20mg Oral Solution: 1 mg/ml |
Tablets: 25 mg, 50 mg, 100 mg Oral Solution: 20 mg/ml |
| Typical duration of treatment | 6 months to 1 year. However, many patients continue for years | It ranges from several months to a few years |
| Age | Commonly prescribed for adolescents and adults; may sometimes be prescribed for children aged 6 and older (off-label) | Prescribed for children above 6 years, adolescents, and adults |
Lexapro vs Zoloft: Dosage and Administration
To increase the chances for effective treatment, you have to use the right dosage depending on the condition and its severity, your age, and your medical history. Sometimes, there is a need to adjust the dosage during the treatment process according to response to medication. Carefully follow instructions and consult your healthcare provider for any questions.
The dosage information provided below is based on standard usage and doesn’t consider individual requirements. Don’t change your dose without your doctor’s guidance.
Lexapro Dosage and Administration
The FDA recommends
- Major depressive disorder. The recommended dose for adults is 10 mg once daily. Your doctor may increase your dosage to a maximum of 20 mg if necessary.
- Generalized anxiety disorder. The recommended dose for adults is 10 mg once daily.
Zoloft Dosage and Administration
Zoloft comes in tablet and oral solution forms and
- Major depressive disorder. Initiated with 50 mg daily; dosage may be gradually increased up to 200 mg if necessary.
- Obsessive-compulsive disorder. Starts with 50 mg daily for adults; the dose can be increased up to 200 mg if required.
- Panic disorder, post-traumatic stress disorder, social anxiety disorder. The initial dose is 25 mg daily, which can be increased up to 200 mg as prescribed.
Premenstrual dysphoric disorder. The recommended dose for women with PMDD is 50 mg daily, with potential adjustments up to a maximum of 100 mg daily, based on the menstrual cycle stage. You can follow your doctor’s advice to use the medication daily or intermittently, during the luteal phase of your menstrual cycle.
Which Antidepressant Works Better: Lexapro or Zoloft?
Studies that compare Zoloft and Lexapro in terms of their effectiveness show different results. Some of them state that
These varied findings can be explained differently. One reason is that the effects of the same antidepressants are individual for every person. Even medications from the same pharmacological class, like Lexapro and Zoloft, may not produce the same results for another person.
Therefore, the only way to establish the most effective medication for you is through your healthcare provider. They will recommend the most appropriate option after a thorough evaluation that takes into account various factors, including your condition, health history, and any medications you may be taking. It’s also important to keep in touch with your clinician during the whole course of treatment to monitor your dynamics and alter the dosage or choose another medication if deemed necessary.
Side Effects of Lexapro vs Zoloft
While medications for depression and anxiety can effectively treat and help manage these conditions, they may also cause side effects. It may happen because of the general effect of the medicine on your body, specific individual responses, dosage, or other factors.
Usually, the most common side effects go away once your body starts getting used to the medication. However, in some cases, the side effects may continue for longer, become bothersome, or cause discomfort. In case of severe side effects, you may need to consult your healthcare provider about changing your dosage or switching to an alternative medication.
Lexapro and Zoloft are no exception and can cause certain adverse effects in some patients. Read on to know what signs you should keep track of while using these medications.
Common Side Effects of Lexapro and Zoloft
| Lexapro | Zoloft | |
| Agitation and restlessness | ✅ | ❌ |
| Stomach issues | ✅ | ✅ |
| Difficulty sleeping | ✅ | ✅ |
| Dizziness | ✅ | ✅ |
| Nausea | ✅ | ✅ |
| Dry mouth | ✅ | ✅ |
| Changes in appetite | ✅ | ✅ |
| Fatigue | ✅ | ✅ |
| Headaches | ✅ | ❌ |
| Tremor | ❌ | ✅ |
Possible Serious Side Effects of Lexapro and Zoloft
- Serotonin syndrome
- Suicidal thoughts and behaviors
- Seizures
- Manic episodes
- Increased risk of bleeding
- Angle-closure glaucoma
- Serious allergic reactions
- Hyponatremia
- Irregular heartbeats
- Priapism (prolonged erection)
The list above is not exhaustive, and different patients may experience different adverse reactions. Consult your healthcare provider to make sure any other health conditions do not increase the risk for side effects.
Sexual Side Effects
Sexual dysfunction is
Do Zoloft or Lexapro Cause Weight Gain?
The effects of antidepressants on weight differ depending on the medication class and individual response. Some studies state that SSRIs like Lexapro and Zoloft
While Lexapro and Zoloft can lead to increased weight as one of the possible side effects, it does not mean that everyone who takes them will gain weight. What’s more, you can counter the side effects by watching your diet and exercising to keep your weight in check when under medication.
Interactions of Lexapro and Zoloft
While Lexapro and Zoloft can effectively manage and treat depression and anxiety, they are not suitable for everyone. They may not be a good choice for individuals with certain medical conditions, such as seizures, glaucoma, etc. Some medications, foods, and herbs may also interact with these SSRIs and change their effect on the body, potentially causing adverse reactions.
Considering the fact of possible interactions, remember to ask about them during your consultation with a healthcare provider. Discuss all prescription and non-prescription medicines, herbs, and supplements you may be taking to help a medical practitioner take all the important details into account. Also, disclose any existing health conditions, if any, to help you avoid adverse effects.
Drug Interactions
Since both Lexapro and Zoloft are antidepressants and belong to the same category of SSRIs, they share potential drug interactions with similar medications. Combining Zoloft or Lexapro with other medications that affect serotonin levels increases the risk of serotonin syndrome — a potentially fatal medical emergency caused by an excess of serotonin. Medication categories that can interact with these antidepressants include:
- Serotonin-norepinephrine reuptake Inhibitors (SNRIs).
- Tricyclic antidepressants (TCAs).
- Monoamine oxidase inhibitors (MAOIs).
- Triptans (medications for treating migraines) such as Imitrex (sumatriptan).
- Macrolide antibiotics such as Zithromax (azithromycin).
- NSAIDs (nonsteroidal anti-inflammatory drugs) like Mobic (meloxicam).
- Painkillers such as Ultram (tramadol).
Note that the above-mentioned list of interactions is not exhaustive, it’s essential to read the label carefully and consult your healthcare provider.
Alcohol and Food Interactions
Whether you are taking Lexapro or Zoloft, avoid drinking alcohol. Alcohol is a central nervous system depressant, so it can counteract the effects of antidepressant medications, worsen the symptoms of depression, and may increase the severity of side effects. For SSRIs, these include dizziness, drowsiness, difficulty concentrating, decreased alertness, and thinking impairment.
Besides alcohol, some types of food may also reduce the effectiveness of medication or lead to adverse effects when taken with Lexapro or Zoloft. These include grapefruit juice and foods rich in tyramine, such as aged cheese, pepperoni, salami, etc. In addition, herbs like St. John’s wort can interact with Zoloft and Lexapro.
Warnings for Lexapro and Zoloft
FDA issued a black box warning for several antidepressants, including Zoloft and Lexapro. To ensure you are on the safe side when seeking the right treatment for depression or anxiety, you can discuss the following warnings and precautions with your clinician.
Suicidal Warning
The FDA’s warning states that Lexapro and Zoloft, among other antidepressants, can increase the risk of suicide, so the signs of such effects should be monitored. The medications can increase the risk of suicidal thoughts and behaviors among children, adolescents, and young adults up to age 24, but it’s important to be aware of such effects even if you are older than 24.
Withdrawal Symptoms
Although antidepressants are not addictive, they may cause withdrawal effects if you discontinue them abruptly. It doesn’t happen for every patient, but it’s still important to stop your treatment gradually and after consulting a healthcare provider. In case you stop Lexapro or Zoloft without tapering off (decreasing the dosage step by step), you risk experiencing withdrawal symptoms such as:
- Anxiety.
- Mood swings or irritability.
- Suicidal thoughts.
- Fatigue or dizziness.
- Weight changes.
- Nausea.
- Headaches.
- Insomnia.
- Flu-like symptoms.
- “Brain zaps” (a feeling of small electrical shocks in your head).
The withdrawal symptoms may last for up to two weeks but the duration depends on many factors. To avoid or manage withdrawal symptoms, keep in touch with your healthcare provider, especially if these symptoms are severe or affect your daily life.
Other Warnings
- Serotonin syndrome. It may occur due to serotonin buildup. Symptoms to watch out for include hallucinations, seizures, and agitation.
- Individuals with seizures should be careful when using Lexapro or Zoloft.
- The risk of hyponatremia, which is characterized by headaches, concentration difficulties, memory loss, confusion, weakness, and unsteadiness.
- If you experience excessive dizziness that increases the risk of falls, seek immediate medical attention, which may necessitate discontinuing the medication.
- SSRIs may increase bleeding risk, especially with the concomitant use of blood thinners such as warfarin, aspirin, or NSAIDs.
- Activation of mania or hypomania in patients with bipolar disorder.
- You may use Lexapro or Zoloft during pregnancy and breastfeeding only if the benefits outweigh the risks to the baby.
- Discontinuing the medication may cause depression or anxiety to recur. Therefore, every patient requires an individual discontinuation plan discussed with a healthcare professional.
Switching From Lexapro to Zoloft or Backwards
Not all antidepressants work the same way for each patient. Therefore, if one medication does not provide satisfactory results, your healthcare provider may choose a suitable alternative. Sometimes, it may include switching from Lexapro to Zoloft. The most common scheme is tapering off the current medication for up to a few weeks and then starting the new medication at a low dosage, increasing it gradually. However, sometimes, a clinician may recommend another way of switching these two medications, so you have to discuss the plan and follow the instructions to reduce side effects and increase the chances for effective treatment.
Can you Take Lexapro and Zoloft Together?
Combining Lexapro and Zoloft is generally not recommended. Both are selective serotonin reuptake inhibitors (SSRIs) that increase serotonin levels in the brain. Concurrent use may lead to a dangerous serotonin syndrome. Always consult your doctor for personalized advice when considering or switching medications.
Summing Up
According to research and clinical use, both Lexapro and Zoloft have proven efficacy and tolerability for depression and anxiety. They have several similarities but also have differences despite belonging to the same class (SSRIs) and exhibiting therapeutic effectiveness.
While this guide gives you ample information about the two medications, it does not cover all possible pros and cons of taking any of them. Consult your healthcare provider to receive detailed instructions regarding their use.
Frequently Asked Questions About Lexapro and Zoloft
Is Zoloft stronger than Lexapro?
How much Zoloft is equivalent to Lexapro?
Are Lexapro and Zoloft energizing or sedating?
What is the best SSRI for anxiety?
The most commonly prescribed SSRIs for anxiety with proven effectiveness for this condition include sertraline (Zoloft), escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Prozac), and paroxetine (Paxil). Still, the choice of the most appropriate medication depends on the diagnosis, specific symptoms, and any co-existing health conditions, so your healthcare may recommend a medication not mentioned above. Also, other classes of medications or a non-pharmacological treatment approach may be suggested.
