Lexapro Vs Zoloft: Which Is Better for Anxiety & Depression?

Most people are scared of psychiatric medication because of reasons like side effects and misconceptions about the drugs.

However, studies have shown that psychiatric drugs are effective in treating and managing mental illnesses.

They work by reducing psychotic symptoms, stabilizing mood, and relieving anxiety and its related symptoms.  If you or your loved one is suffering from depression or anxiety, your doctor is likely to prescribe Lexapro or Zoloft.

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Lexapro and Zoloft are the two most commonly prescribed medications for mood disorders such as depression and anxiety.

They are antidepressants classified under selective serotonin reuptake inhibitors (SSRIs) and approved by the Food and Drug Administration (FDA).

This guide outlines everything you need to know about the two medications, ranging from usage and dosage to their unique differences and side effects to help you make informed decisions about your treatment.

1. Conditions Treated by Lexapro and Zoloft

Lexapro and Zoloft treat different mental health disorders. Escitalopram, sold under the brand name Lexapro, is used to treat the major depressive disorder in adults and adolescents.

It is also indicated for acute and maintenance treatment of the major depressive disorder (MDD) and acute treatment of generalized anxiety disorder (GAD) in adults.

On the other hand, Sertraline, sold under the brand name Zoloft, is used to treat:

• Depression
• Panic attacks
• Obsessive-compulsive disorder
• Post-traumatic stress disorder

Doctors also prescribe it for social anxiety disorder (social phobia) and premenstrual dysphoric disorder (PMDD).

Below are details of the conditions that each medication is used to treat, according to the FDA.

What Conditions Does Lexapro Treat?

The FDA approves the use of Lexapro in treating the following conditions:

• Major Depressive Disorder

To be diagnosed with major depressive disorder (MDD), you have to experience persistent low mood for at least 6 months.

The condition is characterized by difficulty controlling your mood, which causes significant interference to your daily functioning. According to studies, Lexapro is highly effective for MDD.

Lexapro is approved for acute and maintenance treatment of adult patients between ages 18 and 65 who suffer current episodes of MDD [1*] .

Treating severe and recurrent MDD episodes requires long-term medication.

If your doctor prescribes Lexapro for long-term use, your doctor will have to perform a regular evaluation to establish the effectiveness of the medication.

What Are the Differences Between Lexapro and Zoloft?

• Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) refers to excessive worry that persists for at least 6 months.

The worry may be accompanied by other symptoms such as:

• Restlessness
• Palpitations
• Fatigue
• Sleeping problems
• Nervousness

According to studies, Lexapro reduces anxiety [2*] and depressive symptoms of GAD and enhances the quality of life.

It is approved for the acute treatment of GAD in adults. However, its effectiveness in treating GAD patients with co-morbid major depression requires further research. 

For What Conditions Is Zoloft Used?

Zoloft is FDA approved for the following conditions:

• Major Depressive Disorder

Studies have shown that Zoloft is effective in treating MDD [3*] in children and adolescents. The medication is also well-tolerated.

• Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety disorder that causes patients to have repeated and unwanted thoughts (obsessions) that drive them to repetitively engage in some activities (compulsions).

A two-year study on the use of Zoloft in treating OCD validates its long-term safety and tolerability. The study also supports its efficacy in treating OCD.

• Panic disorder (PD)

Panic disorder results in panic attacks characterized by sudden feelings of terror even in the absence of real danger. If you suffer from panic disorder, you may feel like you are losing control.

It also comes with physical symptoms like:

• Palpitations
• Breathing difficulties
• Chest or stomach pain
• Sweating

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According to a clinical trial, patients treated using Zoloft showed greater improvements [4*] than their counterparts who received placebo treatment for panic attacks.

• Post-Traumatic Stress Disorder (PTSD)

PTSD occurs after experiencing or witnessing a stressful event. Symptoms include flashbacks, nightmares, severe anxiety, as well as uncontrollable thoughts about the event. According to a randomized clinical trial, Zoloft is more effective in treating the condition than PTSD placebo treatments.

• Social Anxiety Disorder (SAD)

SAD or social phobia is a type of anxiety disorder that causes extreme fear in social settings. People with SAD have trouble attending social gatherings, talking to people, meeting new people for fear of judgment or scrutiny from others.

A study about multidimensional effects of Zoloft for social anxiety disorder [5*] confirms the efficacy in the treatment of SAD with a selective serotonin reuptake inhibitor (SSRI), Zoloft.

• Premenstrual Dysphoric Disorder (PMDD)

PMDD is a severe form of PMS that usually occurs a week or two before your period. It is a result of dwindling hormone levels that happen after ovulation. Symptoms include severe depression, tension, and irritability. A study on the recognition and treatment of PMDD [6*] confirms Zoloft as an effective treatment option for PMDD.

2. Lexapro VS. Zoloft: How Do They Work?

Knowing how Zoloft and Lexapro work helps you understand how the medications affect your body so you can establish their safety. Since both Lexapro and Zoloft are selective serotonin reuptake inhibitors, they have a similar mechanism of action.

Read on for more information on how antidepressants work.

Understanding SSRIs and How They Work to Treat Depression

Selective serotonin reuptake inhibitors (SSRIs) are a result of the serotonin hypothesis of depression.

According to the hypothesis, depression results from low levels of the neurotransmitter serotonin. While SSRIs are the most popular depression drugs, most of them are also approved for anxiety treatment.

Serotonin is a chemical messenger (neurotransmitter) that carries information throughout your brain and body. SSRIs function by inhibiting the reuptake of serotonin.

They are known as selective serotonin reuptake inhibitors as they only target serotonin. Note that inhibition of serotonin reuptake affects brain chemistry by slowing the reabsorption of serotonin, which is necessary for mood and regulation.

If you struggle with anxiety or depressions, the parts of your brain that regulate mood and communicate using serotonin may be dysfunctional.

SSRIs help boost the availability of serotonin by suppressing the reuptake process, causing serotonin to accumulate between the neurons to facilitate proper communication within the body.

• How Does Lexapro Work?

While Lexapro’s exact mechanism of action is unclear, experts believe that its effectiveness comes from the drug’s ability to suppress serotonin reuptake from the nerves.

The results are increased serotonin concentrations in the space between two nerves (nerve synapse). Serotonin (also called ‘5HT’) plays a crucial role in areas of the brain responsible for regulating mood and thinking.

• How Long Do You Need to Take Lexapro?

Before beginning your treatment with Lexapro, your doctor will advise you on how long you need to use the medicine. However, most people continue taking the medication up to 6 months after getting better to protect themselves from recurring symptoms.

Lexapro and Zoloft Drug Interaction

• How Does Zoloft Work?

Zoloft works by increasing the brain’s serotonin levels, which in turn:

• Prevents panic attacks
• Boosts your mood
• Reduces obsessive-compulsive behavior

Since Zoloft also alleviates anxiety symptoms, people with social anxiety disorder can also benefit from the medication.

• How Long Do You Need to Take Zoloft?

Zoloft is a prescription drug ideal for daily use to help treat depression and anxiety, among other illnesses. Therefore, you need to speak to your doctor for a prescription before using Zoloft for mental illness.

While it may take a few weeks before it can start working effectively, most people experience relief shortly after beginning treatment with Zoloft.

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3. Lexapro Vs. Zoloft: Dosage, Availability, and Cost

To get the best out of Lexapro and Zoloft, you need to use the right dosage. Your ideal Lexapro and Zoloft dosages will vary depending on factors like the severity of your condition, age, and existing medical conditions.

The medications come with patient information inserts with instructions that you should read carefully. In case of any concerns or questions, don’t hesitate to consult your doctor.

Read on for an overview of the dosage, cost, and availability of Lexapro. Note that the below dosage information refers to average dosage recommendations. In case your dose differs from the below information, don’t change it without your doctor’s prescription.

1. Lexapro Dosage and Administration

The FDA recommends the daily administration of Lexapro. The medication is available in the form of tablets and solutions, and you can take them with or without food.

Below is Lexapro’s recommended dosage depending on illness:

• Major Depressive Disorder

The recommended dose for adolescents and adults is 10 mg daily. Your doctor may increase your dosage to 20 mg if necessary. However, doctors can only increase the dosage after 3 weeks when treating adolescents and one week when treating adults.

• Generalized Anxiety Disorder

The recommended initial dose for adults with GAD is 10 mg. Your doctor may increase your dosage to 20 mg after a week if necessary.

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2. Zoloft Dosage and Administration

It is advisable to take Zoloft daily as per your doctor’s recommendation. Zoloft comes in tablet and oral solutions forms and can treat multiple conditions.

Below is the FDA’s dosage recommendation for Zoloft depending on the condition.

The dose recommendation for women with PMDD is 50 mg. You can take the medication daily throughout your menstrual cycle or only intermittently (during your menstrual cycle’s luteal phase) as per your doctor’s instructions.

3. Availability and Cost

Lexapro and Zoloft are both available in generic and brand forms. The generic versions cost less than their counterparts and are covered by insurance. They are also cheaper to co-pay.

Lexapro brand form costs around $37 for 30 tablets of 10 mg pills. The cost for 30 tablets of 10 mg generic Lexapro is between $0 and $30. Depending on the pharmacy, you can expect to pay between $9 and $45 with a single care card.

Zoloft costs around $365 for 30 tablets of 100 mg (brand form). You can expect to pay between $9 and $31 with a single care card.

Lexapro and Zoloft Withdrawal Symptoms

4. Differences and Effectiveness of Lexapro and Zoloft

Although Lexapro and Zoloft both belong to the same pharmacological class (SSRI) and have a similar mechanism of action, they have their differences. The differences may range from dosage, availability, and costs.

However, the most important factor that most people consider when comparing medication is its effectiveness and suitability.

Below are details of the differences between Lexapro and Zoloft to help you establish their effectiveness and suitability for your specific mental health condition.

• Differences Between Lexapro and Zoloft

The comparison table below simplifies the differences between Lexapro and Zoloft:

• Which Antidepressant Is Better: Lexapro Or Zoloft?

Since Lexapro and Zoloft both treat major depressive disorder, studies about their effectiveness are based on their ability to treat the condition.

Some of these studies show that Lexapro is more effective and tolerable for treating MDD [7*] due to the low incidence of side effects in most patients.

However, other studies maintain that Zoloft is equally effective as Lexapro in treating MDD [8*] , and does not have a higher incidence of side effects.

From the mixed results, it is clear that antidepressants work differently for every person. What works for one person may not produce the same results for another, and some antidepressants are more effective for some patients than others.

Therefore, the only way to establish the most effective medication for you is through your doctor.

Your doctor will recommend the best option after a thorough evaluation that takes into account various factors, including your medical condition, medical history, and any medications you may be taking.

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5. Side Effects of Lexapro Vs. Zoloft

While depression and anxiety medications can effectively treat and manage the conditions, they may also result in side effects. Most common side effects go away once your body starts getting used to the medication.

However, in some cases, the side effects may continue for longer, become bothersome, or cause discomfort.

In case of severe side effects, you may need to change your dosage or switch your medications to other tolerable alternatives. In case of adverse side effects, inform your doctor for professional advice.

Below are the various side effects of Lexapro and Zoloft that you can use to keep track when using the medications or consulting your doctor.

• Common Side Effects of Lexapro and Zoloft

• Possible Serious Side Effects of Lexapro and Zoloft

• Sexual Side Effects

Sexual dysfunction is a typical adverse effect of all SSRI antidepressant medications. The side effects vary by drug and may range from 20% to 70%. The risk of sexual dysfunction [9*] also increases with increases in your SSRIs dosage.

According to the FDA, Lexapro and Zoloft can induce erectile dysfunction in men (delayed ejaculation, reduced sex drive, and impotence). It may also lower women’s libido.

If you experience any sexual side effects while taking either Lexapro or Zoloft, inform your doctor.

Your doctor can prescribe alternative medications such as:

• Bupropion
• Mirtazapine
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) like:
  • Duloxetine (Cymbalta) 
  • Venlafaxine

6. Drug Interactions of Lexapro and Zoloft

Substances like food, drugs, and herbs may interact with medication when taken together and change the effect of the drugs in the body. Drug interactions may make your medication more or less effective or trigger unexpected side effects.

While Lexapro and Zoloft can effectively treat and manage depression and anxiety, they are not suitable for everyone. The medications may not be ideal for individuals with certain mental or medical conditions.

Before taking Lexapro or Zoloft, discuss with your doctor all prescription and non-prescription medicines, herbs, and supplements you may be taking before the time of consultation.

Also, disclose any existing health conditions, if any, to help you avoid adverse drug interactions.

Conditions That Lexapro and Zoloft Treat

Read on for more information about Lexapro and Zoloft drug interactions. Note that the below list of interactions is not exhaustive and only includes interactions based on significance.

1. Lexapro and Zoloft Drug Interactions

Since Lexapro and Zoloft are antidepressants and belong in the same SSRIs category, they have drug interactions with similar medications.

Drug categories that can cause drug interaction with the antidepressants are:

• Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

They are antidepressant drugs that increase the amount of serotonin and norepinephrine in the brain. The medications may cause problems for patients with SSRIs in their systems.

• Tricyclic Antidepressants (TCAs)

Most doctors don’t prescribe TCAs as they have more side effects than SSRIs. Since they regulate the brain’s serotonin cycle, they may result in serotonin overflow if you combine them with other medications like SSRIs.

• Monoamine Oxidase Inhibitors (MAOIs)

MAOIs target monoamine oxidase, an enzyme responsible for breaking down serotonin. Since MAOIs reduce the amount of the enzyme in the body, they cause the brain to receive more serotonin than normal.

MAOIs are not commonly prescribed as some like selegiline increase the risk of serotonin syndrome. Serotonin syndrome is a fatal medical emergency that occurs from serotonin buildup. Therefore, you should not use MAOIs within 14 days of using Lexapro or Zoloft.

Additionally, you should not use triptans ( medications for treating migraines) such as Imitrex (sumatriptan) and antidepressants like Elavil or Cymbalta when using Lexapro or Zoloft. Doing so puts you at risk of serotonin syndrome.

Other medications that may interact with Lexapro or Zoloft include macrolide antibiotics such as Zithromax, NSAIDs (non-steroidal anti-inflammatory drugs) like Mobic, and painkillers such as Ultram.

Below is a list of drugs that can interact with Lexapro and Zoloft. Remember, the list is not exhaustive, and you should always consult your doctor.

• Parnate (tranylcypromine)
• Imitrex (sumatriptan)
• Coumadin (warfarin) 
• Motrin (ibuprofen)
• Naproxen
• Mobic (meloxicam)   
• Elavil (amitriptyline)
• Pamelor (nortriptyline)         
• Effexor (venlafaxine)
• Cymbalta (duloxetine)
• Pristiq (desvenlafaxine)        

2. Alcohol and Food Interactions

Avoid drinking alcohol when taking Lexapro or Zoloft as alcohol worsens nervous system side effects like dizziness, difficulty concentrating, and drowsiness. It may also result in poor judgment and thinking impairment.

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Besides alcohol, some types of food may also lead to adverse side effects when taken with Lexapro or Zoloft.

Inform your doctor if you regularly use the following herbs or food items:

• Grape juice
• St John’s wort
• Green tea
• Cannabis Sativa
• Foods rich in Tyramine, such as:
  • Aged cheese
  • Pepperoni
  • Salami

Remember, never use more than the recommended dose of Lexapro or Zoloft. Also, avoid activities that require mental alertness, such as driving or operating heavy machinery, until you establish how the medications affect you.

7. Warnings for Lexapro and Zoloft

Generally, the benefits of antidepressants outweigh the potential side effects. Regardless, it is crucial to understand any precautions or warnings for any medication before starting your treatment.

To ensure you are on the safe side when seeking the right treatment for depression or anxiety, below are warnings and precautions to be aware of before taking Lexapro or Zoloft.

• Withdrawal Symptoms

If you abruptly stop taking Lexapro or Zoloft, you risk experiencing withdrawal symptoms such as:

• Nausea
• Dizziness
• Nightmare
• Vomiting
• Irritability

The withdrawal symptoms usually occur a week after discontinuing the medication and may last for up to 3 weeks.

To avoid withdrawal symptoms, work with your doctor to help you stop your medication by gradually reducing your dosage.

• Indications for Lexapro and Zoloft

FDA provides a black box warning for suicide risks following the use of Lexapro and Zoloft. The precaution states that the medications increase the risk of suicidal thoughts and behaviors among children, adolescents, and young adults up to ages 24.

Therefore, individuals using antidepressants require close monitoring.

• Other Warnings 

• Serotonin syndrome. It occurs due to serotonin buildup.
• Symptoms to watch out for include:
  • Hallucination
  • Seizures
  • Agitation
• Individuals with seizures should be careful when using Lexapro or Zoloft.
• The risk of hyponatremia, which is characterized by:
  • Headaches
  • Concentration difficulties
  • Memory loss
  • Confusion
  • Weakness
  • Unsteadiness
• It may also result in falls. If you notice the above symptoms, seek medical attention immediately. The symptoms call for discontinuation of the medication.
• SSRIs may increase bleeding risk. The risk of bleeding when using Lexapro or Zoloft increases with the concomitant use of warfarin, aspirin, or NSAIDs.
• Activation of mania or hypomania in patients with bipolar disorder as the antidepressants may cause mixed or manic episodes.
• You may use Lexapro or Zoloft during pregnancy only if the benefits to the mother outweigh the risks to the baby.
• Discontinuing the medication may cause depression or anxiety to recur. Therefore, every patient requires individual assessment.
• Breastfeeding mothers should use Lexapro and Zoloft oral solutions with caution. Also, check the baby for any adverse effects. Zoloft oral solutions containing 12% alcohol are not recommended for use during pregnancy or breastfeeding due to the alcohol content.

Warning of Lexapro and Zoloft

8. Challenging Misconceptions About Antidepressants

Most people have concerns and reservations against antidepressants from what they read and hear. In the age of technology and lots of readily available information, it can be difficult to differentiate between inaccurate information and facts.

Inaccurate and false information discourages patients from seeking treatment and getting the help they need. Therefore, it is crucial to debunk the myths and misconceptions surrounding antidepressants so that patients can comfortably seek the help they need.

If you have any concerns about antidepressants, including Lexapro and Zoloft, the information below will give you the answers you need to put your mind at ease. Below are some of the common misconceptions and questions about antidepressants.

• Antidepressants (Including Zoloft or Lexapro) Cause Weight Gain

Although weight gain may occur when taking antidepressants, it is less common and does not apply to all antidepressants. Also, every individual is unique, and weight gain varies from one person to another.

Lexapro and Zoloft have weight gain as one of the possible side effects. However, it does not mean that everyone who takes them will gain weight.

What’s more, you can always counter the side effects by watching your diet and exercising to keep your weight in check when under medication.

• Antidepressants Lead to Suicidal Thoughts

Antidepressants function to alleviate symptoms of mood disorders and depression. As such, they are more likely to reduce suicidal thoughts than cause them.

Only a small proportion of patients (children, adolescents, and young adults) taking antidepressants may experience suicidal thoughts or agitation. Therefore, communication between the patient (or parents) and the doctor is crucial in the early stages of treatment, especially when treating children.

• Is Lexapro Stronger Than Zoloft?

The strength or efficacy of any medication depends on the condition you use it for. Lexapro and Zoloft are equally effective for generalized anxiety disorder and depression.

However, Zoloft has proven to be more effective in treating anxiety disorders like:

• SAD
• PTSD
• PMDD

• You Will Become Addicted to Antidepressants

Antidepressants like SSRIs and SNRIs are not addictive compared to substances like alcohol, nicotine, and opiates.

But, you may experience withdrawal symptoms if you discontinue the medications abruptly or after prolonged use. Fortunately, you can manage the symptoms with your doctor’s help.

• Can You Switch from Lexapro to Zoloft?

Not all antidepressants work the same way for each patient. Therefore, if one medication does not provide satisfactory results, your doctor may switch your prescription to a suitable alternative. With this in mind, you can switch from Lexapro to Zoloft.

Your doctor may switch your medication by entirely replacing Lexapro with Zoloft. Alternatively, they can gradually reduce your Lexapro dosage while starting you on Zoloft medication and gradually increasing the dosage.

• Antidepressants Change Your Personality

No medication can change your personality. Psychiatric medication will not alter your brain’s chemicals and change who you are if you use them. Antidepressants only work to reduce symptoms of your mental health condition and help you regain mental wellbeing.

They, therefore, restore you to the original level of functioning before the onset of depression.

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The Final Takeaway

According to research and clinical use, both Lexapro and Zoloft have proven efficacy and tolerability. Also, the two medications have their differences despite belonging to the same class (SSRIs) and exhibiting therapeutic efficacy in dealing with depression and anxiety.

While this guide gives you ample information about the two medications, it does not cover all possible outcomes of taking the medication. Therefore, if you have a prescription for the drugs, it is advisable to follow your doctor’s instructions regarding their use. In case of any questions or concerns, don’t hesitate to consult your doctor.