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Lexapro vs. Prozac

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If you have anxiety or depression, medication may be beneficial for managing your symptoms. However, there are many medications to choose from, and identifying which is right for you can be frustrating.

Lexapro and Prozac are among the most commonly-prescribed medications for anxiety and depression. They have a lot of similarities, but there are important differences that may make one better for you. 

It’s important to fully understand how these medications affect a person’s mental and physical health before taking them. In this post, we’ll review the differences between Lexapro and Prozac to help you make an informed decision about managing your chronic depression and anxiety symptoms.

For anxiety and depression treatment, take this brief self-evaluation, and we’ll match you with a healthcare provider on Klarity within 48 hours. We can help you get fast, budget-friendly assistance so you can live a more comfortable and satisfying life.

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255

Drug ClassSelective serotonin reuptake inhibitor (SSRI)Selective serotonin reuptake inhibitor (SSRI)
Brand/Generic StatusBrand name for escitalopramBrand name fluoxetine
Form(s) of the Drug• Immediate-release tablets
• Clear, peppermint-flavored liquid suspension
• Clear, peppermint-flavored liquid suspension
• Half-green, half-white capsules
Standard DosageImmediate-release tablets:
• 10mg per dose

Liquid suspension:
• 10mg per dose
Liquid suspension:
• 10mg per dose

• 10mg per dose
Conditions TreatedFDA-approved uses:
• Major depressive disorder
• Generalized anxiety disorder

Off-label uses:
• Obsessive-compulsive disorder (OCD)
• Binge-eating disorder
• Bulimia nervosa
• Post Traumatic Stress (PTSD)
• Premenstrual dysphoric disorder
• Panic disorder
• Insomnia
FDA-approved uses:
• Anxiety and stress
• Major depression
• Bulimia nervosa
• Premenstrual dysphoric disorder (PMDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Postpartum depression
• Schizoaffective disorder

Off-label uses:
• Anorexia nervosa
• Premature ejaculation
• Various anxiety disorders
CostGeneric form (escitalopram):
• $15.00 and $120.00 for a 30-day supply*

• $250.22 for a 30-day supply*

*Without insurance
Generic form (fluoxetine):
• $3 to $4 for 30-days’ worth of capsules*
• $12 for 30 days’ worth of liquid suspension

*May cost up to $100 for high dosages

• $460 to $1000 for 30 days’ worth of capsules
Side-EffectsCommon side effects:
• Dizziness and drowsiness
• Weakness, shakiness, or sweating
• Insomnia
• Loss of appetite or nausea
• Dry mouth
• Constipation
• Unexplained weight changes
• Decreased sex drive or impotence
• Difficulty having an orgasm

Serious side effects:
• Abdominal pain or bleeding
• Allergic reaction
• Blurred or tunnel vision
• Abnormal dreams or decreased focus
• Chest pain or irregular heartbeat
• Eye pain, swelling, or halos around lights
• Euphoria, depression, or unusual behavior
• Headache, confusion, or slurred speech
• Heartburn or vomiting
• Hot flashes
• Severe weakness or dizziness
• Feeling unsteady or uncoordinated
• Sweating and tremors
• Rigid muscles
Common side effects:
• Nausea
• Diarrhea or constipation
• Changes in appetite
• Headache and fatigue
• Increased sweating
• Trouble sleeping
• Impotence/sexual dysfunction

Serious side effects include:
• Fever
• High blood pressure
• Rigid muscles
• Seizures
• Kidney or respiratory failure
• Disorientation or delirium
• Serotonin syndrome
Warnings For UseContraindicated conditions:
• Liver or kidney problems
• Heart problems
• Seizures or convulsions
• Bipolar disorder
• Low sodium levels in the blood
• High blood pressure
• History of stroke
• Bleeding problems

Drug interactions:
• Aspirin
• St. John’s Wort
• Tryptophan
• Opioid-based painkillers
• Anti-psychotics
• Alcohol
Contraindicated conditions:
• Diabetes
• Liver disease
• Alcohol use disorder
• History of bipolar disorder
• History of suicide attempts
• Low blood sodium or dehydration
• Seizures
• Gastrointestinal ulcers
• Glaucoma

Drug Interactions:
• Monoamine oxidase inhibitors (MAOIs)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Aspirin and other blood thinners
• Antihistamines
• Opioid pain relievers
• St. John’s wort
• Cannabis and MDMA

What is Lexapro?

Lexapro is a selective serotonin reuptake inhibitor (SSRI) often prescribed to treat anxiety and depression symptoms. Like other SSRIs, Lexapro alters how the brain uses the neurotransmitter serotonin, a chemical central to mood regulation. 

By increasing the amount of serotonin in the brain and slowing down its reabsorption, Lexapro balances your mood and restores a sense of calm. Without a consistent level of serotonin in the brain, you can experience various symptoms of depression and anxiety.

Lexapro Forms and Doses

Lexapro is available as an oral solution or tablet in 5mg, 10mg, and 20mg dosages. The typical daily dose is 10 mg, and higher quantities are often prescribed to individuals with severe symptoms or minimal reaction to the lower doses. 

When you speak with a healthcare provider on Klarity, they’ll help determine which form and dosage are best for treating your specific symptoms.

Conditions Lexapro Treats

Lexapro is primarily prescribed to treat depression. Because low serotonin levels impact several mental health conditions, some SSRIs can also treat other conditions like anxiety. If you experience both anxiety and depression, Lexapro could be an ideal choice for you.

Like many medications, there are also off-label uses for Lexapro. Any off-label treatment should only be done with the guidance of a healthcare professional.

Symptoms of Anxiety Lexapro Can Treat

Lexapro effectively treats many anxiety symptoms. By stabilizing your serotonin levels, this medication helps you feel at ease in the present, greatly reducing apprehension toward current and future events. This process can affect other symptoms, reducing the severity of panic attacks and irregular thought patterns and helping people relax in their daily life.

Symptoms of Depression Lexapro Can Treat

Lexapro treats a host of depression symptoms. By boosting your serotonin, this SSRI can reduce feelings of nervousness and increase your overall sense of well-being and general contentment. 

Off-Label Uses For Lexapro

In addition to treating anxiety and depression, Lexapro also has several off-label uses to help individuals with other mental conditions related to serotonin deficiency. 

Some of these conditions include:

  • Obsessive-Compulsive disorder (OCD)
  • Binge eating disorder
  • Bulimia nervosa
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)

Lexapro Costs

The cost of Lexapro can vary based on whether you’re prescribed the name brand or its generic form, escitalopram. For 30 tablets of the 10mg dose, generic escitalopram can cost between $13 and $129, depending on the pharmacy you use.

Name brand Lexapro is much more expensive, with the same amount and dosage costing as much as $534. If you can get your prescription covered by insurance, it can be much more affordable, whether you get the name-brand or generic form.

Lexapro Side Effects

Like other antidepressant medications, Lexapro has side effects you should be aware of before taking it. Some of these side effects can become less severe as you acclimate to the medication, but if they persist or worsen over time, notify your healthcare provider immediately.

The most common side effects include:

  • Insomnia
  • Tiredness
  • Nausea
  • Dry mouth
  • Dizziness
  • Sweating
  • Diarrhea

Lexapro Warnings For Use

When taking Lexapro, there is a chance you may experience serious health issues. Most of these can be prevented with careful guidance from your healthcare provider, while others can be more unpredictable. The medical professionals on Klarity can review your health history to determine if Lexapro is right for you.

Warning signs include:

  • Serotonin syndrome: 

This is a rare but potentially life-threatening condition where the brain has too much serotonin. If you’re taking multiple serotonin-boosting medications, side effects can include sweating, rapid heart rate, muscle spasms or stiffness, fever, and confusion. 

  • Suicidal thoughts and behavior: In individuals 24 years or younger, Lexapro can cause new or worsening depression and suicidal thoughts or behaviors, primarily during the first few months of treatment. If you experience suicidal ideation or thoughts of self-harm, seek help immediately and notify your healthcare provider.
  • Withdrawal: SSRIs have a low risk of dependency, but it’s still possible to experience withdrawal if you suddenly stop taking them. Symptoms can include anxiety, agitation, nausea, trouble sleeping, and flu-like symptoms, beginning within three days of stopping Lexapro. Speak with your healthcare provider to safely avoid withdrawal.

Lexapro Drug Interactions

Lexapro can have adverse interactions with other medications or supplements, potentially causing health issues or making one or both substances ineffective. Your healthcare provider may choose not to prescribe you Lexapro because of its possible drug interactions or suggest an alternative medication.

Below are the medications that can have unfavorable interactions with Lexapro. This is not a complete list, and you should notify your healthcare provider of all medications you are taking before receiving a Lexapro prescription.

  • Bepridil
  • Cisapride
  • Fluconazole
  • Methylene Blue
  • Pimozide
  • Rasagiline
  • Selegiline
  • Thioridazine
  • Ziprasidone

What is Prozac?

Prozac is an SSRI medication that treats symptoms of depression. Similar to Lexapro, Prozac increases serotonin levels in the brain to create a chemical balance that regulates your mood and emotions. 

Prozac Forms and Doses

Prozac has more forms than Lexapro, with an oral solution, capsule, and tablet available for prescription. If you are prescribed the oral solution, it is available in a 120ml bottle, with the dosage being 20mg for every 5ml. The capsule form is then available in 10mg, 20mg, and 40mg doses, while the tablet only comes in 10mg and 20mg doses. 

The exact dosing for Prozac depends on your age and specific health concerns. That said, the usual dosage ranges from 10mg to 60mg by mouth once daily.

Conditions Prozac Treats

Though primarily prescribed to treat depression and anxiety symptoms, Prozac has off-label uses as well. If your Klarity healthcare provider believes your specific condition can be treated using Prozac, they may recommend it even if you don’t explicitly have anxiety or depression.

Symptoms of Anxiety Prozac Can Treat

Prozac treats key symptoms of anxiety, including consistent feelings of nervousness that can interfere with daily activities. As your treatment progresses, these symptoms will likely decrease, allowing you to experience greater calm and more positive thought patterns.

Symptoms of Depression Prozac Can Treat

Prozac is an effective method for treating depression’s many symptoms, including feelings of hopelessness and general emotional instability. Compared to other medications, Prozac is especially effective at contributing to greater energy levels, making it useful for individuals who struggle with low energy as a symptom of their depression.

Off-Label Uses For Prozac

Prozac’s off-label uses aside from treating anxiety and depression include other conditions like the following:

  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Bulimia nervosa

If your healthcare provider prescribes you Prozac off-label, only take it exactly as instructed.

Prozac Costs

Prozac is more affordable in its generic form of fluoxetine. For 30 capsules of the 20mg dose, fluoxetine can cost as little as $12 and only reaches prices as high as $69. Name-brand Prozac is much more costly, as much as $653 for the same amount and dosage of medication.

Prozac Side Effects

Prozac has similar side effects compared to other antidepressants, many of which can lessen in severity as your body adjusts to the medication. If these side effects aren’t going away or are getting worse, contact your healthcare provider immediately.

The most common side effects of Prozac include:

  • Insomnia
  • Drowsiness
  • Headache
  • Anxiety
  • Nervousness
  • Nausea
  • Diarrhea
  • Anorexia
  • Dry mouth
  • Tremor
  • Throat pain

Prozac Warnings For Use

When taking Prozac, there are warnings for use that may result in serious health complications. To prevent issues from occurring, only take Prozac as instructed by your healthcare provider, and notify them immediately if you experience any dramatic changes to your health. 

The most common warnings for use include:

  • Suicidal thoughts and behaviors: If you’re 24 or younger, there’s a chance that Prozac may worsen depression symptoms and increase the risk of suicidal thoughts or behaviors within the first few months of treatment or if your dosage changes. It’s essential to monitor your own mental health and thought patterns during this time. 
  • Serotonin syndrome: This is a rare but potentially life-threatening syndrome where you have too much serotonin in your system. You’re at a greater risk of developing symptoms, including sweating, fever, increased heart rate, confusion, and muscle stiffness or spasms, if you take more than one serotonin-boosting drug at once.
  • Withdrawal: Although SSRIs aren’t typically flagged for dependency, withdrawal symptoms can occur if you suddenly stop taking Prozac. These symptoms can include nausea, trouble sleeping, and dizziness. If you want to stop taking Prozac, speak to your healthcare provider to figure out a safe method of tapering off your medication.

Prozac Drug Interactions

Prozac may interact with other medications or supplements, causing one or all medications to become less effective. Notify your healthcare provider of all medications and supplements you’re taking before receiving a prescription for Prozac, as they may recommend an alternative medication to prevent any adverse interactions.

Below are some of the medications that can have unfavorable interactions with Prozac. This is not a complete list, and only generic names are used.

  • Dronedarone
  • Iproniazid
  • Phenelzine
  • Rasagiline
  • Selegiline
  • Toloxatone
  • Ziprasidone

Frequently Asked Questions About Prozac and Lexapro

Do SSRIs Make You Gain Weight?

Most weight gain caused by SSRIs is a result of improving anxiety and depression symptoms, as these conditions commonly cause people to have a lower appetite and fewer cravings. As serotonin levels in the brain become regulated, some individuals may notice they are hungrier or eat more because they’re adjusting to a more regular appetite.

Should You Take Lexapro and Prozac Together?

Lexapro and Prozac should not be taken together because they are both SSRIs, and taking both at the same time could result in serotonin syndrome. This condition is rare, but it’s marked by dangerously high levels of serotonin in the brain, which can lead to life-threatening symptoms.

Which Has Sexual Side Effects? Lexapro or Prozac?

Lexapro is more likely to have sexual side effects, including ejaculation issues, decreased sexual drive, and problems with orgasm. Prozac can cause a general decrease in sexual desire, but its sexual side effects are not as widespread as Lexapro’s.

Which Is Better For Sleep? Lexapro or Prozac?

Many antidepressants can cause sleep problems, such as insomnia or drowsiness, and both Lexapro and Prozac have these side effects. While they are relatively uncommon, in some studies, insomnia has been shown to be a more common side effect when taking Prozac.

Can I Drive On Lexapro? On Prozac?

When taking any SSRI medication, it’s important to understand how it affects your body before driving or operating heavy machinery. Due to drowsiness that can be caused by Lexapro and Prozac, it’s recommended that you wait until your body acclimates to the medication before driving. If feelings of drowsiness persist or worsen as you take these medications, speak with your healthcare provider before getting behind the wheel.

Can I Drink Alcohol On Prozac? On Lexapro?

Drinking alcohol is not recommended while taking Lexapro or Prozac, as it can impact the effectiveness of the medications and worsen drowsiness and coordination. Let your healthcare provider know if you regularly drink alcohol so they can suggest alternative forms of medication.

What Is Better For Anxiety? Prozac or Lexapro?

While Prozac and Lexapro are both effective at treating anxiety, many studies have found that Lexapro is better at reducing symptoms and providing individuals with a greater sense of calm. 

What Is Better For Depression? Prozac or Lexapro?

Prozac and Lexapro are both SSRIs that treat depression symptoms in similar ways. However, compared to Prozac, Lexapro has shown to be slightly more effective at reducing how much depression affects a person’s ability to move through daily life.

How Klarity Pairs You With the Right Depression Medication

At Klarity, we’re committed to ensuring everyone has access to the mental health support they need when they need it. 

We’ll connect you with a licensed depression specialist who can evaluate your symptoms and recommend a medication based on your goals and medical history. They can even send your prescription to your local pharmacy for your convenience. 

If the medication is well-tolerated and alleviates your symptoms, you may be eligible for a direct prescription refill from your provider on Klarity. 

Start today, and discuss your symptoms with a specialist who can help.

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