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Prozac vs. Lexapro: What to Know About Each

Introduction

If you suffer from depression, you’ve likely heard of the drugs Prozac and Lexapro. Prozac is the brand name for the drug fluoxetine. Lexapro is the brand name for the drug escitalopram. Both medications are used to treat depression and other mental conditions, and they’re only available with a prescription from your doctor.

These medications work somewhat similarly in your brain, but there are some important differences you should understand before you start taking either one. Here’s what to know about these drugs to see if either may be a good fit for you.

Drug features at a glance

Research

Prozac and Lexapro are antidepressant medications. They belong to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). They help treat depression by boosting the activity of the chemical serotonin. Serotonin is made in both your brain and intestines. It’s linked with mood control and other functions of your body. By enhancing serotonin, these drugs treat symptoms of depression.

The table below outlines some features of Prozac and Lexapro at a glance.

Brand nameProzacLexapro
What is the generic drug?fluoxetineescitalopram
Is a generic version available?yesyes
What does it treat?major depressive disorder

obsessive-compulsive disorder

panic disorder

depressive symptoms of bipolar disorder

bulimia nervosa
depression

generalized anxiety disorder
What forms does it come in?oral tablet

oral capsule

delayed-release oral capsule

oral solution
oral tablet

oral solution
What strengths does it come in?oral tablet: 10 mg, 20 mg, 60 mg

oral capsule: 10 mg, 20 mg, 40 mg

delayed-release oral capsule: 90 mg

oral solution: 20 mg/5 mL
oral tablet: 5 mg, 10 mg, 20 mg

oral solution: 5 mg/5 mL
What is the typical length of treatment?short-term or long-termshort-term or long-term
How do I store this drug?at room temperature from 59°F to 86°F (15°C to 30°C)at room temperature of 77°F (25°C)
Is this a controlled substance?nono
Is there a risk of withdrawal?yes†yes†
Does this drug have potential for misuse?nono
 
† If you need to stop taking the drug, your doctor will slowly reduce your dosage to keep symptoms from coming back.

Cost, availability, and insurance

cost

Prozac and Lexapro are each available as generic drugs. In general, generic drugs cost less than their brand-name counterparts.

Most health insurance companies cover both drugs. As brand-name drugs, Prozac and Lexapro cost about the same. However, your out-of-pocket costs will depend on your health insurance plan. Both medications are available at most pharmacies.

Side effects

Warning

The side effects of Prozac and Lexapro are fairly similar. However, Lexapro’s side effects tend to be more mild. For example, Prozac is linked with more nausea and diarrhea, especially when you first start taking it. Sleeping problems also tend to be more intense with Prozac.

Common side effects of both drugs can include:

  • sexual problems
  • vivid dreams
  • dry mouth and sore throat
  • sweating
  • shaking
  • loss of appetite
  • nausea
  • diarrhea

Serious side effects of Prozac and Lexapro can include:

  • suicidal thoughts or actions
  • worse symptoms of anxiety
  • unpredictable mood changes

Because Prozac’s half-life is longer than Lexapro’s, it takes longer to go through your body. Seniors tend to process drugs more slowly. A drug that goes through the body more quickly, such as Lexapro, may cause fewer side effects. This means that Lexapro may be a better choice for older adults.

Some antidepressants are not safe for younger people, but both Prozac and Lexapro are approved for use in children and adolescents. Young people who use Prozac or Lexapro may have side effects, such as extreme thirst. Girls may have heavier menstrual periods. Young people who take Lexapro may also have trouble urinating, while young people who take Prozac may need to urinate more often.

It’s important that you understand the many side effects that these drugs may cause. If you talk to your doctor about these drugs, be sure to factor in how the side effects may affect you.

Drug interactions

Complications

These drugs can interact with other medications. These include monoamine oxidase inhibitors (MAOIs) and other drugs. Be sure to tell your healthcare provider about all of the medications and supplements you currently take. Lexapro is a newer drug than Prozac, and it also has fewer interactions than Prozac does.

Learn more: Combining Prozac and alcohol »

Use with other medical conditions

Risk Factors

Certain medical issues can change the ways these drugs work in your body. You should discuss your safety with your doctor before taking Prozac or Lexapro if you have any of the following conditions:

  • liver problems
  • kidney problems
  • heart problems
  • seizures or convulsions
  • bipolar disorder or mania
  • low sodium levels
  • a history of a stroke
  • high blood pressure
  • bleeding problems
  • pregnancy or plans to become pregnant
  • breastfeeding or plans to breastfeed

Talk with your doctor

Talk therapy

Lexapro and Prozac are powerful drugs that have been shown to help many people. The drug that’s right for you will depend on many factors. Be honest with your doctor when you talk about your health history and your current mental and physical health.

You should take Prozac or Lexapro exactly as prescribed by your doctor to treat your mental health problem. Usually, medications for mental health conditions are part of an overall treatment program that includes counseling and other therapies.

Talk with your doctor about how long it may take for Prozac or Lexapro to begin making a difference in how you feel. If it seems like the drug isn’t working, tell your doctor. There may be other options to treat your condition.

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