Lexapro vs Zoloft: which to take for depression and/or anxiety

If you suffer from anxiety or depression, there are several medications prescribed to treat symptoms of these conditions, 2 of the most common being Lexapro (escitalopram) and Zoloft (sertraline). But when it comes to Lexapro vs Zoloft, what are they, how do they work, and which might be best for you? 

Whether it’s Zoloft, Lexapro, or another medication, you need to work with a healthcare provider to find the best drug to relieve your symptoms. In this article, we discuss the similarities and differences between the 2 medications so that you can have an informed discussion with your healthcare provider.

If you’re looking for a medical provider for anxiety or depression treatment, find a provider online or in person with Klarity today, and within 48 hours, be seen by a licensed healthcare practitioner who can help you determine if either medication is right for your anxiety and depression symptoms. 

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 National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

Lexapro vs Zoloft: What is the difference?

Lexapro and Zoloft are 2 types of selective serotonin reuptake inhibitors (SSRIs). They have different uses and side effects that affect how suitable they are for you. 

Lexapro (escitalopram) is often chosen for treating major depressive disorder (MDD) and generalized anxiety disorder (GAD) because it has more tolerable side effects. Zoloft (sertraline), on the other hand, covers more mental health disorders, including panic disorder, social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD), alongside depression and anxiety. 

The choice between Lexapro and Zoloft may also hinge on your health history and response to previous treatments. Zoloft’s slight edge in treating a wide range of anxiety-related disorders may make it the preferred option for you if you have a complex psychiatric profile. However, you might find Lexapro appealing because it can start working faster and has fewer interactions with other drugs.

Ultimately, the decision should be guided by a healthcare professional, who will consider your specific symptoms, medical history, and lifestyle factors.

What is Lexapro?

Lexapro is an SSRI commonly prescribed to treat MDD and GAD. As an SSRI, Lexapro is a relatively safe medication, and most users experience few side effects. By balancing the serotonin levels in the brain, Lexapro regulates mood and increases energy levels.

Lexapro forms and doses

Lexapro is the name-brand form, while the generic is escitalopram. The generic form has all of the same properties, typically with the added benefit of being less expensive. They are both taken orally as a tablet.

Lexapro comes in 3 different dosages: 5 milligrams, 10 milligrams, and 20 milligrams. It is often taken once daily, but the exact dosage and frequency of administration may vary depending on your specific needs and your instructions from your healthcare provider. Lexapro is commonly prescribed with 30 tablets per month, but you can check with your insurance company to see if they’ll cover more than a 30-day supply.

Conditions Lexapro treats

Lexapro is effective in treating symptoms of depression and anxiety, but it also has some off-label uses. Off-label use is when a medication is prescribed for a condition that it is not U.S. Food and Drug Administration (FDA)-approved to treat. 

Your healthcare provider can ethically and safely prescribe medications for off-label use if scientific evidence, expert judgment, or published literature has proven to alleviate symptoms. To understand the full range of Lexapro’s effectiveness, it’s worth evaluating how it affects both anxiety and depression, as well as insomnia.

Anxiety

Most SSRIs aren’t meant to treat anxiety; however, Lexapro is proven effective at reducing the severity of anxiety symptoms. While anxiety can be caused by various factors, it’s often a result of lowered serotonin levels, so an SSRI like Lexapro can help decrease your persistent nervousness and tendency to panic.

Depression

Lexapro’s serotonin-restoring ability is especially effective at treating depression, as the neurotransmitter is essential to regulating a person’s mood. Depression is marked by persistent feelings of sadness and hopelessness, so altering how the brain uses serotonin with Lexapro can help contribute to a greater sense of well-being.

Insomnia

Lexapro can be prescribed off-label to treat insomnia. Perimenopausal and menopausal women have demonstrated improvements in the quality of their sleep after taking Lexapro, and although these effects are largely limited to this group, it can nevertheless be a valuable resource for women looking for insomnia relief during this time in their lives.

Obsessive-compulsive disorder (OCD)

While not FDA-approved specifically forOCD treatment, Lexapro is effective in reducing the symptoms of OCD. By restoring serotonin levels in the brain, Lexapro helps alleviate the severity of obsessions and compulsions, leading to improved quality of life.

Lexapro costs

Generic escitalopram is a relatively inexpensive medication, much like other SSRIs, often costing as little as $13 for 30 tablets of the 10-milligram dosage. 

Brand name Lexapro can be much more expensive, costing as much as $533 for the same dosage and quantity of medication. This makes it much more financially viable to opt for the generic form.

Most insurance plans are far more likely to cover escitalopram than Lexapro. Contact your insurance company to confirm your coverage.

Lexapro side effects

Like most depression and anxiety medications, Lexapro has some side effects, which often resolve after the first few weeks of taking it. If you experience persistent or worsening side effects, contact your medical provider to discuss adjusting your dose or changing medications. 

Some of the most common side effects include:

• 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 with orgasms

The following side effects are less common but more serious. If you experience any of these side effects, contact your healthcare provider immediately: 

• 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 

If you choose to stop taking Lexapro, consult with your healthcare provider beforehand to avoid any negative withdrawal symptoms. They can help you taper off the medication safely.

Lexapro warnings for use

Individuals with certain conditions or the potential for specific conditions should use extreme caution when taking Lexapro. The most common contraindicated conditions include: 

• 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

Another serious side effect of taking Lexapro can be an increased risk of serotonin syndrome, which can be fatal if left untreated. Serotonin syndrome occurs when there’s too much serotonin in your system due to taking serotonin-enhancing medications. If you have any of the following symptoms of serotonin syndrome, contact your healthcare provider immediately.

• Shivering
• Diarrhea
• Muscle rigidity
• Fever
• Seizures

Additionally, if you notice an increase in thoughts of suicide or self-harm, or observe changes in behavior, contact your healthcare provider or call the National Suicide Prevention Lifeline at 988. 

Finally, those who are pregnant or are planning to become pregnant shouldn’t take Lexapro. Discuss your medical history in detail with your healthcare provider so they can determine whether Lexapro, Zoloft, or another medication is right for you. 

Lexapro interactions

When taking Lexapro, it’s important to exercise caution if you’re currently taking or plan to take any other medications. There are many drugs that shoulnd’t be taken with Lexapro for a variety of reasons. Be sure to talk with your healthcare provider before taking any additional medications with Lexapro.

Some of the drugs you should avoid taking while on Lexapro include:

• Vascor (bepridil)
• Multaq (dronedarone)
• ZYVOX (linezolid)
• Reglan and Metozolv ODT (metoclopramide)
• Matulane (procarbazine)
• Seldane (terfenadine)

What is Zoloft?

Zoloft, like Lexapro, is an SSRI used to treat symptoms of depression and anxiety. It can also be used to treat PTSD, OCD, and other mental health conditions. Zoloft helps prolong the presence of serotonin in the brain before it’s absorbed by neurons.

Zoloft forms and doses

Zoloft can be prescribed in its name-brand form, or your healthcare provider may suggest the generic sertraline as a cheaper alternative. Both medications are administered orally as tablets. 

Zoloft comes in three dosages: 25 milligrams, 50 milligrams, or 100 milligrams. It is typically taken once a day, and it is recommended that you take it in the morning if you already have difficulty sleeping. Zoloft is usually prescribed in quantities of 30 tablets, but you can check with your insurance provider to see if they will cover more than 30 days’ worth. 

Conditions Zoloft treats

Zoloft is effective in treating mental health conditions tied to lowered serotonin levels. Similar to Lexapro, it can also have some off-label uses for individuals who don’t explicitly suffer from anxiety or depression. Here are some of the common conditions Zoloft can treat.

Anxiety

Zoloft is proven effective at treating both social anxiety disorder and panic disorder, which are both associated with lowered serotonin levels. By blocking the reuptake of serotonin, the neurotransmitter remains active in the brain for longer and contributes to a greater sense of emotional stability and ease in social situations.

Depression

In addition to treating anxiety, Zoloft is also an effective treatment for depression. Serotonin is a key neurotransmitter for mood regulation, which is why lowered serotonin levels result in feelings of despair associated with depression. By increasing serotonin levels, Zoloft can help stabilize your mood and decrease the overall severity of depression symptoms.

Insomnia

Zoloft’s effectiveness at treating insomnia isn’t entirely clear, as it can improve or worsen your sleep quality. Considering SSRIs, in general, can increase energy levels, if Zoloft is taken too late in the day, it may prevent you from falling asleep. Zoloft can also have the opposite effect, as increased serotonin levels may help you relax and fall asleep easier.

Obsessive-compulsive disorder (OCD)

Clinical studies have demonstrated the effectiveness of Zoloft in reducing the severity of OCD symptoms and improving overall functioning for adults and children aged 6 years and older. By blocking the reuptake of serotonin in the brain, Zoloft helps alleviate the symptoms of OCD, including intrusive thoughts and compulsive behaviors. 

Zoloft costs

Generic sertraline is relatively inexpensive, costing as little as $10 for 30 of the 100 milligram tablets. Similar to Lexapro, the name-brand Zoloft is significantly more expensive, costing as much as $510 for the same amount of medication. 

There is no difference in effectiveness between the generic and name-brand medications, and insurance is more likely to cover the generic form of the drug.

Zoloft side effects

Those taking Zoloft may experience side effects ranging from mild to severe. If your side effects last for an extended period or become overwhelming to manage, contact your healthcare provider immediately. 

Common side effects of Zoloft include: 

• Drowsiness or tiredness
• Feeling agitated or anxious
• Indigestion, nausea, diarrhea, or loss of appetite
• Sweating, tremors, or shaking
• Insomnia
• Decreased sex drive
• Impotence or difficulty having an orgasm

Zoloft may also cause some severe side effects. If you experience any of the following, seek medical attention right away: 

• Seizures or convulsions
• Blurred vision or tunnel vision
• Eye pain or swelling
• Headache
• Confusion or memory problems
• Severe weakness or feeling unsteady
• Racing thoughts or increased energy
• Unusual risk-taking behavior
• Extreme happiness
• Irritability or unusually talkative

You should always take Zoloft exactly as directed. If you want to stop taking Zoloft, speak with your healthcare provider to determine the safest way to wean yourself off the medication. 

Zoloft warnings for use

Discuss your full medical history with your medical provider so they can prescribe the anxiety or depression medication that’s right for you. Be sure to tell your healthcare provider about your allergies before taking Zoloft. Even if you’re not allergic to the medication itself, you may be allergic to one or more of the inactive ingredients. 

Tell your healthcare provider if you or your family has a history of any of the following conditions: 

• Bipolar disorder
• Bleeding problems
• Liver disease
• Seizure disorders
• Thyroid disease
• Angle-closure type glaucoma

Additionally, if you experience any changes in behavior, including thoughts of self-harm, contact your healthcare provider. It’s important to make sure you’re not potassium or magnesium-deficient, as this raises your chance of developing an arrhythmic heart condition on Zoloft. 

Zoloft interactions

Zoloft may have negative drug interactions with other medications, substances, or supplements. Make sure to disclose all medications and supplements to your healthcare provider before taking Zoloft. 

Contraindicated medications include: 

• Pimozide
• Clopidogrel
• Ibuprofen, naproxen, and all other NSAIDs
• Warfarin and dabigatran
• Aspirin
• Other SSRIs or SNRIs
• Sleep aids
• Antihistamines
• Opiate-based painkillers or cough suppressants
• MAOIs, which may cause a fatal interaction

Contraindicated supplements include: 

• St. John’s wort
• Tryptophan

Other contraindicated substances include: 

• Alcohol
• Marijuana
• MDMA (ecstasy)

Before prescribing Zoloft, your healthcare provider will discuss your medical history, your current medications, and any other considerations that may impact the drug’s ability to help you.

Which anxiety or depression medication should I take?

When deciding between Lexapro vs Zoloft, it’s important to speak with your healthcare provider to help determine which one is right for you. While both medications offer similar benefits in terms of how they help treat generalized anxiety disorder and depression, not everyone will react the same when taking them.

Klarity can help you get help for anxiety or depression

When you’re struggling with depression or anxiety, the last thing you need is to jump through hoops to access the right medications for your symptoms. 

Connect with board-certified medical professionals qualified to diagnose and treat your anxiety and depression symptoms online or in person. Find a provider on Klarity today.

Frequently asked questions about Lexapro vs Zoloft

Is Lexapro or Zoloft better for treating anxiety and depression? 

If your anxiety or depression symptoms are connected to post-traumatic stress disorder or obsessive-compulsive disorder, Zoloft may be able to provide more comprehensive relief. Your healthcare provider can help you decide based on your medical history and specific mental health needs.

Which has fewer side effects — Lexapro or Zoloft?

Lexapro and Zoloft have similar side effects, but Lexapro has fewer side effects overall. Not everyone responds to Lexapro in the same way, so if you are experiencing severe side effects, you may need to work with your medical provider and switch to another medication.

Can I drive on Lexapro?

When you first start taking Lexapro, it’s recommended that you avoid driving until you understand how the medication affects you. Some people experience drowsiness or slower reaction time when taking Lexapro, which can make driving dangerous. Discuss all potential side effects with your healthcare provider so they can help you choose the best medication.

Can I drive on Zoloft?

Driving on Zoloft poses the same risks as Lexapro, as the medication can cause you to feel sleepy and reduce your alertness. Be careful to take note of how Zoloft affects you before getting behind the wheel.

Can I drink alcohol while taking Lexapro or Zoloft?

While taking most antidepressant and anti-anxiety medications, it’s recommended that you don’t drink alcohol. If you do, you may experience worsened drowsiness and coordination or more pronounced negative side effects. Notify your healthcare provider if you regularly drink before getting a prescription for Lexapro or Zoloft.

How long does it take for Zoloft to work?

Zoloft doesn’t take effect right away, with most people only experiencing marginal improvements to their overall well-being after 2 weeks of taking the medication. After 6 to 8 weeks, you should begin to notice a positive change in depression symptoms overall.

How long does it take for Lexapro to work?

Lexapro follows a similar timetable as Zoloft, with most people only experiencing minimal changes in their mood after about 2 weeks. Some people may notice a marked improvement in as little as a month, but the full range of positive effects usually doesn’t materialize until 8 weeks in.

Sources

GoodRX. “Lexapro” 

https://www.goodrx.com/lexapro

GoodRX. “Zoloft”

https://www.goodrx.com/zoloft