When it comes to prescription antidepressants, patients often try different drugs before settling on one that works best for them. Lexapro and Zoloft are both prescription SSRI antidepressants prescribed to treat depression and anxiety.

They work by restoring the balance of neurotransmitters like serotonin. The difference is that Zoloft can treat several additional symptoms, but Lexapro has a faster release time. Lexapro and Zoloft also have different side effects.

Comparison chart

Lexapro versus Zoloft comparison chart
Edit this comparison chartLexaproZoloft
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Generic Name Escitalopram Sertraline
Use Antidepressant, SSRI. Treats depression and anxiety. SSRI; Treats depression, obsessive compulsive disorder, panic attacks, post-traumatic stress disorder, social anxiety disorder, premenstrual dysphoric disorder.
Prescription Required? Yes Yes
Prescription only Yes Yes
Forms Tablet, liquid Tablets, liquid
Storage Conditions Room temperature with no light or moisture. Do not flush or wash down the drain. Room temperature with no light or moisture. Do not flush or wash down the drain.
Cost Around $83.83 per month (without insurance) or $30.31 (with insurance). Around $85 a month without insurance.
Directions for Use Taken by mouth once daily, usually at the same time of day. Mix with four ounces of another liquid, measure using medicine dropper. Taken once daily orally, usually at the same time of day.
How it Works Restores balance of neurotransmitters, such as serotonin Restores balance of neurotransmitters, such as serotonin
Time Lapse One to two weeks before beginning to feel benefit. Four weeks before feeling full benefit. No significant time lapse.
Administration Oral Oral
Mild Side Effects Agitation, blurred vision, diarrhea, insomnia, drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, change in appetite, sexual dysfunction and weight change. Dizziness, drowsiness, diarrhea, dry mouth, increased sweating, insomnia, loss of appetite, nausea, upset stomach
Severe Side Effects Common: Confusion, difficulty concentrating, euphoria, suicidal thoughts, decreased sex drive & ability. Rare: aggressive behavior, high BP, heart attack, blood clots, very rapid heartbeat, slow heartbeat, hemorrhage, kidney failure, seizures. Common: suicidal thoughts, decreased sex drive, decreased sexual ability. Rare: rapid ventricular heartbeat, slow heartbeat, hemorrhage, liver failure, acute kidney disease, euphoria.
Withdrawal Symptoms Confusion, headache, insomnia, nervousness, numbness, tingling. Headache, mood swings, sleep changes, tiredness, brief sensation such as electric shock.
Warnings Medical history: Psychiatric disorders, suicide attempts, bleeding problems, liver disease, seizures, kidney disease, stomach bleeding, dehydration, low sodium in blood; Avoid alcohol, driving, operating machinery until sure of alertness. Medical history: Bleeding problems, liver disease, seizure disorders, thyroid disease; Avoid alcohol; Avoid driving or operating machinery until sure of alertness.
FDA Approval 2002 1991
Shelf Life 3 years 5 years

Usage

Lexapro (generic name Escitalopram), a Selective Serotonin Reuptake Inhibitor (SSRI), works by restoring the balance of neurotransmitters like serotonin. Doctors prescribe Lexapro to treat depression and anxiety. Lexapro has to be prescribed and is taken orally once a day, usually at the same time of day.

Zoloft (generic name Sertraline) is also an SSRI that works by restoring the balance of neurotransmitters (serotonin). Doctors prescribe Zoloft to treat depression, obsessive compulsive disorder, panic attacks, post-traumatic stress disorder, social anxiety disorder and premenstrual dysphoric disorder. Zoloft is also prescription medication and is taken once a day after dilution, usually at the same time of the day.

Dr. Pickett of Depression CAREPATH explains the use of SSRI in depression:

Side Effects

The use of Lexapro as well as Zoloft can lead to several side effects. People using Lexapro may experience dizziness, drowsiness constipation, dry mouth, increased sweating, insomnia, nausea or tiredness. Pregnant women may take Lexapro, but there is a risk of birth defects. Some of the more severe side effects may include confusion, difficulty concentrating, euphoria, suicidal thoughts, low sex drive and decreased sexual ability. Some side effects are rare, but still likely – these include aggressive behavior, high blood pressure, heart attack, blood clots, very rapid heartbeat, slow heartbeat, hemorrhage, kidney failure and seizures.

Zoloft users may experience dizziness, drowsiness, diarrhea, dry mouth, increased sweating, insomnia, loss of appetite, nausea or upset stomach. As with Lexapro, pregnant women may use the drug, but there is a risk of birth defects. Common severe side effects include suicidal thoughts, low sex drive and decreased sexual ability. Rare side effects include a rapid ventricular heartbeat, a slow heartbeat, hemorrhage, liver failure, acute kidney disease and euphoria.

Withdrawal

Doctors recommend patients cease using Lexapro or Zoloft only under medical supervision. Patients ceasing either drug may experience withdrawal symptoms.

The withdrawal symptoms from Lexapro include confusion, headache, insomnia, nervousness, numbness and tingling. Ceasing the use of Zoloft may lead to headaches, mood swings, sleep changes, tiredness or a brief sensation such as an electric shock.

Warnings

Before taking either Lexapro or Zoloft, patients need to reveal their entire medical history to their doctor. Drinking alcohol is not recommended with the use of either drug. Driving or operating machinery should also be avoided while using Lexapro or Zoloft.

Any psychiatric disorders, suicide attempts, bleeding problems, liver disease, seizures, kidney disease, stomach bleeding, dehydration and low sodium in the blood should be mentioned before deciding to use Lexapro.

Zoloft may not work well if patients have had bleeding problems, liver disease, seizure disorders and thyroid disease.

Drug Interactions

Patients need to be aware of drug interactions with both Lexapro and Zoloft. Neither works well together with MAO inhibitors such as isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline or tranylcypromine. The results can be fatal.

Both Lexapro and Zoloft increase the risk of bleeding when interacting with the following drugs: Pimozide, antiplatelet drugs, NSAIDs, blood thinners and aspirin. An increase of drowsiness occurs when either Lexapro or Zoloft interacts with antihistamines, sleep or anxiety drugs, muscle relaxants or narcotic pain relievers.

Specific drug interactions can lead to serotonin syndrome. Those drugs include dextromethorphan, lithium, St. John's wort, sibutramine, Tramadol, tryptophan, the SSRI antidepressants fluoxetine and paroxetine and the SNRIs duloxetine and venlafaxine. People suffering from serotonin syndrome experience several effects. Their mental status can change so that they experience agitation, delirium or hallucinations. They may even go into a coma. Dizziness, flushing, hyperthermia and tachycardia are signs of autonomic instability. Neuromuscular effects include incoordination, rigidity and tremors. People with serotonin syndrome can suffer from gastrointestinal issues such as diarrhea, nausea or vomiting. They may be prone to seizures.

Serotonin syndrome is a side effect of mixing either Lexapro or Zoloft with specific medications.

Storage and Shelf Life

Lexapro is the newer of the two drugs, receiving FDA approval in 2002. Zoloft received FDA approval in 1991. Both should be stored at room temperature with no light or moisture. Kept that way, Lexapro has a shelf life of three years and Zoloft five years. Neither medication should be flushed or washed down the drain.

References

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