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 Zoloft vs Prozac – What Is the Difference and Which One Should I Take?

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Choosing to take medication to manage your anxiety can be difficult, especially when you’re faced with a long list of available options. Even choosing between well-known medications like Zoloft and Prozac can be a significant challenge.  

Both of these medications are selective serotonin reuptake inhibitors (SSRI), which prevent neurons from reabsorbing serotonin, thereby increasing levels of available serotonin in the brain. Though Prozac and Zoloft are very similar, they have key differences that may make one a better choice than the other for each individual. The comparison guide below outlines these differences so you can choose the best one for your physical and mental health.

For more information about these medications or to talk to a licensed healthcare provider on Klarity, schedule an appointment today. We’re your one-stop shop for anxiety evaluations and treatment.

What Is Zoloft?

Zoloft is the brand name for the medication sertraline. It’s an SSRI FDA-approved to treat depression in adults, and OCD in children aged 6 to 12, adolescents aged 13 to 17, and adults 18 and over. Both the brand name and generic formula are available via prescription. Neither is approved for treating children younger than six years.  

It’s also prescribed on and off-label to treat a number of conditions that can result from a serotonin imbalance. It has less potential to cause drowsiness than other antidepressants. 

Zoloft Forms and Doses

Healthcare providers may prescribe Zoloft in two forms: tablets or liquid solution. The solution is typically given to children aged 6 to 12, while tablets are given to adolescents and adults aged 13 and older. 

Each dose of the liquid solution contains 20 mg of sertraline. It’s a clear, peppermint-flavored suspension that must be properly diluted before it’s administered. Each dose of the liquid solution contains 20 mg of sertraline. Dilution instructions come with each 60 ml bottle.

Tablets are oblong, scored down the center, and stamped with the dosage amount. Dosages are also color-coded as follows: 

  • Green indicates 25 mg
  • Blue indicates 50 mg
  • Pinkish-red indicates 100 mg

Children 6 to 12 are usually prescribed a starting dose of 25 mg, while adults are prescribed 50 mg. Patients of all ages may increase their dosage 25 mg at a time, up to 200 mg, to maintain the effectiveness of the medication.

Conditions Zoloft Treats

Zoloft is FDA-approved to treat the following conditions: 

  • Major depression
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Post-traumatic stress (PTS)
  • Premenstrual dysphoric disorder (PMDD)
  • Social anxiety disorder

Symptoms of Anxiety Zoloft Can Treat

Zoloft is often prescribed off-label as an effective treatment for generalized anxiety disorder (GAD) and on-label for related conditions like social anxiety and panic disorder. 

It’s been shown to alleviate the following symptoms of these disorders: 

  • Unwanted or intrusive thoughts
  • Intense fear
  • Panic attacks 
  • Chronic feelings of anxiety

Symptoms of Depression Zoloft Can Treat

When prescribed as an antidepressant, Zoloft can help improve many symptoms, including: 

  • Depressed, irritable, or fluctuating moods
  • Disturbed sleep
  • Irregular appetite cycles
  • Low energy levels
  • Disinterest in daily life

Off-Label Uses For Zoloft

Zoloft is often prescribed off-label to treat the following conditions: 

  • Autism (mood stabilizing)
  • Alcoholism
  • Eating disorders
  • Diabetic neuropathy
  • Dementia
  • Hot flashes
  • Generalized anxiety disorder (GAD)
  • Fibromyalgia
  • Migraines
  • Personality disorders
  • Tourette syndrome
  • Premature ejaculation

Zoloft Costs

Brand-name Zoloft can cost between $215 and $315 for a 30-day supply. Many insurances don’t cover the brand name because of these high prices. 

Fortunately, sertraline—Zoloft’s generic counterpart—is much more affordable and covered by Medicare and many major insurance companies. Depending on the dosage, a 30-day supply costs between $4.00 and $25.   

Zoloft Side Effects

Common side effects of Zoloft include: 

  • Nausea or indigestion
  • Diarrhea or loose stool
  • Tremors or twitching
  • Decreased appetite and weight loss
  • Bruising and muscle aches
  • Decreased libido/trouble orgasming
  • Excessive sweating
  • Anxiety

Rarer but more serious side effects include: 

  • Heart arrhythmia
  • Bleeding and liver injury
  • Confusion and seizures
  • Suicidal thoughts
  • Changes in behavior

SSRIs may also cause serotonin syndrome, a condition caused by too much serotonin in the body. Symptoms include diarrhea, confusion, seizures, and rapid heart rate.

Contact your health care provider immediately if you experience any severe side effects. 

Zoloft Warnings For Use

Those with the following conditions or circumstances should avoid taking Zoloft: 

  • Pregnancy or breastfeeding
  • Liver problems
  • Epilepsy and seizure disorders 
  • Glaucoma
  • Bipolar disorder
  • Thyroid disease

Zoloft Drug Interactions

The following medications and substances may have adverse interactions with Zoloft: 

  • Monoamine oxidase inhibitors (MAOIs)
  • Blood thinners
  • Antipsychotic and antiseizure medications
  • Alcohol—recreational and alcohol-based medications

What Is Prozac?

Prozac is the brand name for the medication fluoxetine. It’s an SSRI FDA-approved to treat depression in adults and children eight years or older. It’s also approved to treat OCD in adults and children seven years or older. Both the brand name and generic formula are available via prescription. Neither form is approved for treating children under 7. 

It’s also prescribed on and off-label to treat various conditions resulting from low serotonin.  

Prozac Forms and Doses

Healthcare providers may prescribe Prozac as a capsule or liquid suspension. Each capsule contains a 20 mg dose of the medication. They’re smooth, oblong pills that are half white and half green. The liquid is a mint-flavored suspension that can be measured in 10 mg doses. It’s usually prescribed for children under 13 years of age. 

Adult patients usually take 20 mg daily, gradually increasing the amount to between 60 mg and 80 mg, depending on their condition. Children may start with 10 mg or 20 mg daily and gradually raise the dosage to 60 mg if needed.

Conditions Prozac Treats

Prozac has been FDA-approved to treat the following conditions: 

  • Anxiety and stress
  • Major depression
  • Bulimia nervosa
  • Premenstrual dysphoric disorder (PMDD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Postpartum depression
  • Schizoaffective disorder

Symptoms of Anxiety Prozac Can Treat

Individuals taking Prozac for anxiety most frequently experience relief from the following symptoms: 

  • Fear
  • Chronic anxiety
  • Intrusive or unwanted thoughts
  • Frequent panic attacks

Symptoms of Depression Prozac Can Treat

Those taking Prozac for depression often experience relief from the following symptoms: 

  • Irritable, listless, or fluctuating moods
  • Disturbed sleep
  • Irregular appetite
  • Low energy levels
  • Disinterest in daily life

Off-Label Uses For Prozac

Prozac can be prescribed off-label to treat: 

  • Anorexia nervosa
  • Premature ejaculation
  • Various anxiety disorders

Prozac Costs

Depending on the dosage, brand-name Prozac can cost between $460 and nearly $1000 for a 30-day supply. Many insurances don’t cover the brand-name product because it’s too expensive. 

However, fluoxetine—Prozac’s generic name—is much less expensive. Medicare and many major insurance companies cover it. On average, a 30-day supply of capsules costs between $3 and $4, while the solution costs around $12. Fluoxetine tablets may cost up to $100 for those requiring a high dosage.

Prozac Side Effects

Common side effects of Prozac include: 

  • Nausea
  • Diarrhea or constipation
  • Changes in appetite
  • Headache and fatigue
  • Increased sweating
  • Trouble sleeping
  • Impotence/sexual dysfunction

Rarer but more serious side effects include: 

  • Fever
  • High blood pressure
  • Rigid muscles
  • Seizures
  • Kidney or respiratory failure
  • Disorientation or delirium

Like Zoloft, Prozac may also cause serotonin syndrome. 

If you experience severe side effects, contact your health care provider immediately.

Prozac Warnings For Use

Those with the following conditions should avoid taking Prozac: 

  • Diabetes
  • Liver disease
  • Alcohol use disorder
  • History of bipolar disorder
  • History of suicide attempts
  • Low blood sodium or dehydration
  • Seizures
  • Gastrointestinal ulcers
  • Glaucoma

Prozac Drug Interactions

The following medications and substances are contraindicated for use with Prozac: 

  • 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
  • Alcohol—recreational and alcohol-based medications

Frequently Asked Questions About Prozac and Zoloft

Does Zoloft Make You Gain Weight? Does Prozac?

Most SSRIs—including Zoloft and Prozac—can contribute to weight gain. Those who lack appetite due to a serotonin imbalance may gain weight on Zoloft or Prozac because they eat more regularly. 

These medications may also cause shifts in metabolism while your body adapts to them. Some individuals find the weight gain tapers off after several months. 

Is Zoloft or Prozac Better for Anxiety?

Both medications are FDA-approved to treat anxiety-related conditions, such as panic disorder. Which is better for you largely depends on potential contraindications from other drugs or medical conditions. Additionally, individual body and brain chemistry affect how well these medications work. 

It’s also worth noting that Zoloft is FDA-approved for social anxiety, while Prozac is approved for general anxiety.

Can I Replace Zoloft with Prozac?

Most medical practitioners agree that—under medical supervision—it’s safe to switch from one SSRI to another using either the cross-taper or direct switch method. 

With the cross taper method, you’ll gradually decrease the Zoloft while simultaneously starting a low dose of Prozac. You’ll then continue reducing the Zoloft and increasing the Prozac until you’re only taking Prozac.

With the direct switch method, you simply stop taking the Zoloft and begin taking a low dose of Prozac immediately. Since the medications are similar, the chances of experiencing withdrawal are low.

Is Zoloft Energizing or Sedating? What About Prozac?

Though SSRI drugs affect everyone differently, Prozac and Zoloft have a reputation for increasing individuals’ energy levels. Prozac is reportedly more energizing than Zoloft, and some patients may experience drowsiness on either medication.

Does Zoloft Cause Brain Fog? Does Prozac?

Both Zoloft and Prozac can cause brain fog, though Zoloft seems to cause it more often than Prozac. Though SSRIs increase the serotonin available in the brain, they reduce the number of firing neurotransmitters. This process can make your thoughts feel hazy and make concentrating difficult. 

Can I Drink Alcohol On Prozac? On Zoloft?

It’s not safe to drink alcohol when taking either Prozac or Zoloft. Alcohol amplifies the effects of SSRI drugs, which can cause dizziness, sudden fatigue, and other symptoms of serotonin syndrome. Drinking while taking SSRIs may also worsen symptoms of depression or cause suicidal thoughts.

Can I Drink Caffeine When I’m on Prozac? How About Zoloft?

It’s considered safe to mix caffeine with SSRI medications, including Prozac and Zoloft. However, caffeine raises the amount of serotonin and serotonin receptors in the brain, so your consumption should be fairly limited to reduce the risk of developing serotonin syndrome.  

What Is Better For Depression—Prozac or Zoloft?

Which medication is right for you depends on several factors, including:

  • Medical history
  • Other medications and supplements
  • Coinciding conditions (anxiety, OCD, etc.)
  • Body chemistry

These factors help determine the best option since they’re both approved to treat various types of depression. 

Finding the right antidepressant can sometimes take a little experimentation due to personal body chemistry. Some people react better to different medications than others. Your best option is to speak to a qualified healthcare professional.

How Klarity Helps You Discover the Right Medication

If you’re still unsure which medication is right for you, book an appointment with a licensed mental health specialist on Klarity today. As your one-stop care center for anxiety and depression evaluation and treatment, healthcare providers on our platform are qualified to confirm your diagnosis, recommend a treatment plan, and prescribe an appropriate medication. 

No insurance? No problem—providers on Klarity deliver professional ADHD care starting at just $25 per month. That fee includes regular appointments, unlimited messaging with your provider, and your prescription. Plus, all appointments are via telehealth, so you can get the care you need when you need it. 

Sources: 

https://psychologenie.com/most-energizing-antidepressant

https://www.webmd.com/drugs/2/drug-6997/prozac-oral/details

https://www.neurosection9.com/prozac-brain-fog/
https://www.neurosection9.com/zoloft-brain-fog/#:~:text=There%20is%20no%20clear%20answer%2C%20as%20brain%20fog,fog%20because%20of%20its%20effects%20on%20serotonin%20levels.

https://walrus.com/questions/switching-from-zoloft-sertraline-to-prozac-fluoxetine

https://www.medicalnewstoday.com/articles/325684

https://www.drugs.com/compare/prozac-vs-zoloft

https://www.rxlist.com/prozac-drug.htm#overdosage

https://www.healthline.com/health/depression/prozac-zoloft

https://www.verywellhealth.com/prozac-fluoxetine-oral-uses-side-effects-dosages-5207729#toc-dosage-how-much-prozac-should-i-take

https://www.verywellhealth.com/zoloft-5077993#:~:text=Zoloft%20(sertraline)%20is%20an%20antidepressant,certain%20types%20of%20sexual%20dysfunction.

https://www.rxlist.com/zoloft-drug.htm#description

https://www.webmd.com/drugs/2/drug-35/zoloft-oral/details

https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

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