Differences between Lexapro- and Zoloft
Lexapro vs. Zoloft
Lexapro (escitalopram) and Zoloft (sertraline) are both prescription medications classified as selective serotonin reuptake inhibitors (SSRIs).[1] They work by increasing the levels of serotonin, a neurotransmitter in the brain that plays a role in mood.[2][3] Both are commonly prescribed for major depressive disorder.[2][1] While they share a similar mechanism of action, there are notable differences in their approved uses, side effect profiles, and drug interactions.
Studies comparing the effectiveness of Lexapro and Zoloft for depression have produced mixed results, with some suggesting Lexapro may be more effective, others favoring Zoloft, and some finding no significant difference.[1] The choice between the two medications often depends on an individual's specific symptoms, medical history, and potential for drug interactions.[4]
Comparison Table
| Category | Lexapro (escitalopram) | Zoloft (sertraline) |
|---|---|---|
| Mechanism of Action | Allosteric serotonin reuptake inhibitor, which may result in a more potent increase in serotonin levels.[4][5] | Selective serotonin reuptake inhibitor (SSRI) that also has a mild effect on dopamine.[3] |
| FDA-Approved Uses | Major depressive disorder (MDD) in adults and adolescents (12 years and older), and generalized anxiety disorder (GAD) in adults and children (7 years and older). | Major depressive disorder (MDD), obsessive-compulsive disorder (OCD) in adults and children (6 years and older), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD) in adults.[1] |
| Common Side Effects | Nausea, sleepiness, sexual problems, sweating, and fatigue. | More likely to cause gastrointestinal issues like nausea and diarrhea; may also cause trouble sleeping.[1][3] |
| Drug Interactions | Has a lower potential for drug interactions due to minimal effects on drug-metabolizing enzymes.[3] Interacts with MAOIs, blood thinners, and NSAIDs. | Interacts more significantly with medications metabolized by the CYP2D6 enzyme system. Also interacts with MAOIs, blood thinners, and NSAIDs.[3] |
| Withdrawal Symptoms | Dizziness, irritability, headache, anxiety, and "brain zaps."[2] | Dizziness, irritability, headache, anxiety, and "brain zaps."[2] |
Additional Considerations
Both Lexapro and Zoloft carry a black box warning from the FDA for an increased risk of suicidal thoughts and behaviors in individuals under the age of 25.[3] Patients starting either medication should be closely monitored for any worsening of depression or the emergence of suicidal ideation.
Discontinuation of either Lexapro or Zoloft can lead to withdrawal symptoms, sometimes referred to as antidepressant discontinuation syndrome.[2] These symptoms can include dizziness, nausea, headache, and flu-like symptoms. A gradual tapering of the dosage under the guidance of a healthcare provider is recommended to minimize these effects.[2]
While both medications can be effective, the most suitable choice is a personalized decision made in consultation with a doctor who can weigh the potential benefits and risks for each individual.[4]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 "goodrx.com". Retrieved January 27, 2026.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 "charliehealth.com". Retrieved January 27, 2026.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 "psychplus.com". Retrieved January 27, 2026.
- ↑ 4.0 4.1 4.2 "talkiatry.com". Retrieved January 27, 2026.
- ↑ "nih.gov". Retrieved January 27, 2026.
