Lexapro vs Zoloft: Compare Differences & Prices

When it comes to side effects, both Lexapro (escitalopram) and Zoloft (sertraline) have many similarities because they belong to the same family of medications known as selective serotonin reuptake inhibitors (SSRIs). This means they generally act in similar ways within the body, but each can also have unique effects and may be better suited for different individuals based on how their bodies respond. Understanding these side effects can help you know what to expect and when to speak with your doctor about concerns.

Both medications share a range of common side effects. It’s important to know that while some people may experience several of these, others may have very few or none at all. The most frequent side effects for both Lexapro and Zoloft include:

• Nausea

• Sleepiness or fatigue

• Dizziness

• Sexual problems, such as decreased libido or difficulty reaching orgasm

• Sweating

• Dry mouth

• Difficulty sleeping

• Changes in appetite

Some differences can emerge in how these side effects present. For example, Lexapro is more likely to cause drowsiness or sedation, which might be helpful for those with anxiety-related insomnia but could be bothersome if you need to stay alert during the day. Zoloft is typically less sedating and may lead to more “activating” effects, which can cause restlessness in some people. Zoloft is also somewhat more likely to cause gastrointestinal side effects such as diarrhea or upset stomach, while Lexapro may lead to constipation or dry mouth.

Beyond these common reactions, there are some more serious side effects that require attention. Both Lexapro and Zoloft may increase the risk of suicidal thoughts and behaviors, especially in children, adolescents, and young adults. This is a key reason why you and your loved ones should stay alert for any changes in mood or behavior, especially in the early weeks of treatment or when adjusting the dose. Both medications may also cause serotonin syndrome, a rare but potentially life-threatening condition with symptoms such as agitation, high fever, fast heartbeat, and muscle stiffness. If you notice any of these signs, seek immediate medical help.

Other uncommon but serious side effects can include abnormal bleeding (especially if taken with blood thinners), seizures, severe allergic reactions, low sodium levels in the blood, and in rare cases, changes in heart rhythm. Lexapro, in particular, may rarely cause a heart issue known as QT prolongation, which leads to an irregular heartbeat.

Because everyone responds differently, the best way to manage side effects is to maintain open communication with your healthcare provider. They can help you decide whether a side effect is likely to fade as your body gets used to the medication, or if you need to try something else. If side effects interfere with your daily life, or if you have any concerns, do not stop taking your medication suddenly—always speak with your doctor, as stopping either Lexapro or Zoloft on your own can result in withdrawal symptoms such as dizziness, mood changes, anxiety, or flu-like feelings. Your healthcare provider will usually suggest gradually reducing the dose to help avoid these effects.

When considering treatments for mental health conditions, Lexapro (Escitalopram) and Zoloft (Sertraline) are both widely used medications from the group called selective serotonin reuptake inhibitors, or SSRIs. Both medicines are primarily prescribed to help with mood disorders like depression and various forms of anxiety, but there are important differences in the specific conditions they are approved to treat by the Food and Drug Administration (FDA), as well as how doctors might use them in other situations.

Lexapro is officially approved by the FDA to treat major depressive disorder and generalized anxiety disorder. For depression, Lexapro can be prescribed to adults and adolescents ages 12 and older, and for generalized anxiety disorder, it may be given to children as young as 7 years old. While these are the main uses for Lexapro, doctors sometimes prescribe it for other conditions based on evidence and clinical judgment, even though these uses are not specifically approved by the FDA. These off-label uses can include social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), as well as managing certain symptoms related to menopause.

Zoloft, on the other hand, has a broader set of FDA-approved uses. It is approved to treat major depressive disorder in adults, as well as several anxiety and related disorders in adults, including OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. A key difference to note, especially for parents of younger patients, is that Zoloft is only FDA-approved to treat OCD in children and adolescents who are at least 6 years old. It is not approved by the FDA for treating depression in people under 18, though doctors may sometimes use it in this way off-label if they believe it would be helpful for a particular patient.

Here is a summary of FDA-approved uses for each medication:

• Lexapro is FDA-approved for:

  • Major depressive disorder (for adults and adolescents 12 and older)

  • Generalized anxiety disorder (for adults and children 7 and older)

• Zoloft is FDA-approved for:

  • Major depressive disorder (adults only)

  • Obsessive-compulsive disorder (adults, and children/adolescents 6 and older)

  • Panic disorder, PTSD, social anxiety disorder, and PMDD (adults only)

Doctors may also use both Lexapro and Zoloft off-label for other conditions when they believe it is appropriate. For Lexapro, these off-label uses can include other types of anxiety disorders, OCD, panic disorder, PTSD, and PMDD. For Zoloft, common off-label uses might include binge eating disorder, bulimia nervosa, certain sexual health conditions, and in some cases, generalized anxiety disorder.

The choice between Lexapro and Zoloft often depends on your individual symptoms, specific diagnosis, age, and other unique health factors. Lexapro is usually preferred when treatment is needed for generalized anxiety disorder, especially in children or adolescents, due to its approval status and dosing range. Zoloft may be favored if you are dealing with not just depression but also OCD, PTSD, panic disorder, or social anxiety disorder, particularly if more than one of these conditions is present.

It’s always important to have a conversation with your doctor about your symptoms, medical history, and personal goals. They can help you determine which medication, if any, is likely to be most helpful for your situation—and make sure that the treatment plan addresses all of the conditions you’re experiencing, whether it’s depression, anxiety, or other mental health challenges.