Introduction

With all the different depression and anxiety medications on the market, it can be hard to know which drug is which. Lexapro and Zoloft are two of the more commonly prescribed medications for mood disorders such as depression.

These drugs are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing levels of serotonin, a substance in your brain that helps maintain your mood. Read on to learn more about similarities and differences between Lexapro and Zoloft.

Drug features

Lexapro is prescribed to treat depression and generalized anxiety disorder. Zoloft is prescribed to treat depression, obsessive compulsive disorder, and several other mental health conditions. The table below compares the conditions each drug is approved to treat.

ConditionZoloft Lexapro
depressionXX
generalized anxiety disorder X
obsessive compulsive disorder (OCD)X
panic disorderX
post-traumatic stress disorder (PTSD)X
social anxiety disorderX
premenstrual dysphoric disorder (PMDD)X

The table below compares other key aspects of Zoloft and Lexapro.

Brand name Zoloft Lexapro
What is the generic drug?sertraline escitalopram
What forms does it come in?oral tablet, oral solutionoral tablet, oral solution
What strengths does it come in?tablet: 25 mg, 50 mg, 100 mg; solution: 20 mg/mLtablet: 5 mg, 10 mg, 20 mg; solution: 1 mg/mL
Who can take it?people 18 years and older*people 12 years and older
What is the dosage?determined by your doctordetermined by your doctor
What is the typical length of treatment?long-termlong-term
How do I store this drug?at room temperature away from excess heat or moistureat room temperature away from excess heat or moisture
Is there a risk of withdrawal with this drug?yes†yes†
*Except for treating OCD
† If you’ve been taking this drug for longer than a few weeks, don’t stop taking it without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms.

Cost, availability, and insurance

Both medications are available in most pharmacies in brand-name and generic versions. Generics are generally cheaper than brand-name products. At the time this article was written, the prices for the brand-name and generic versions of Lexapro and Zoloft were similar, according to GoodRx.com.

Health insurance plans typically cover antidepressant medications such as Lexapro and Zoloft, but prefer you to use the generic forms.

Side effects

The charts below list examples of side effects of Lexapro and Zoloft. Because Lexapro and Zoloft are both SSRIs, they share many of the same side effects.

Common side effectsLexaproZoloft
nauseaXX
sleepinessXX
weaknessXX
dizzinessXX
anxietyXX
sleeping troubleXX
sexual problemsXX
sweatingXX
shakingXX
loss of appetiteXX
dry mouthXX
constipationX
respiratory infectionsXX
yawning XX
diarrheaXX
indigestionXX
Serious side effectsLexaproZoloft
suicidal actions or thoughtsXX
serotonin syndrome*XX
severe allergic reactionsXX
abnormal bleedingXX
seizures or convulsionsXX
manic episodesXX
weight gain or lossXX
low sodium (salt) levels in the bloodXX
eye problems** XX
*Serotonin syndrome is a condition that can occur when the levels of serotonin, a chemical produced by your body, become too high. Serotonin syndrome can be life-threatening.
**Eye problems can include blurry vision, double vision, dry eyes, and pressure in the eyes.

Keep reading: Managing sexual side effects from antidepressants »

A concern that many people have about taking antidepressants is weight gain. It’s true that many antidepressants can cause weight gain, but some drugs are thought to cause less weight gain than others. Lexapro and Zoloft are two antidepressants that may cause less weight gain. If you’re concerned about this effect from taking an antidepressant, talk with your doctor.

Drug interactions

The drug interactions of Lexapro and Zoloft are very similar. Before starting Lexapro or Zoloft, tell your doctor about all medications, vitamins, or herbs you take, especially if they’re listed below. This information can help your doctor prevent possible interactions.

The chart below compares examples of drugs that can interact with Lexapro or Zoloft.

Interacting drugsLexapro Zoloft
monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzinexx
pimozidexx
blood thinners such as warfarin and aspirinxx
nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxenxx
lithiumxx
antidepressants such as amitriptyline and venlafaxinexx
anti-anxiety drugs such as buspirone and duloxetinexx
medications for mental illness such as aripiprazole and risperidonexx
antiseizure drugs such as phenytoin and carbamazepinexx
medications for migraine headaches such as sumatriptan and ergotaminexx
sleeping medications such as zolpidemxx
metoprololx
disulfiram x*
medications for irregular heartbeat such as amiodarone and sotalolxx
*interacts if you’re taking the liquid form of Zoloft

Warning information

Conditions of concern

Lexapro and Zoloft contain many of the same warnings for use with other medical conditions. For example, both medications are pregnancy category C drugs. This means that if you’re pregnant, you should only use these medications if the benefits are greater than the risk to your pregnancy.

The chart below lists other medical conditions you should discuss with your doctor before taking Lexapro or Zoloft.

Medical conditions to discuss with your doctorLexaproZoloft
liver problemsXX
seizure disorderXX
bipolar disorderXX
kidney problemsX

Risk of suicide

Both Lexapro and Zoloft raise the risk of suicidal thinking and behavior in children, adolescents, and young adults. In fact, Zoloft is not approved by the Food and Drug Administration (FDA) to treat children younger than 18 years, except for those with OCD. Lexapro is not approved for children younger than 12 years.

For more information, read about antidepressant use and the risk of suicide.

Possible withdrawal

You should not suddenly stop treatment with an SSRI such as Lexapro or Zoloft. Stopping these medications suddenly can cause withdrawal symptoms. These can include:

  • flu-like symptoms
  • agitation
  • dizziness
  • confusion
  • headache
  • anxiety
  • sleeping trouble

If you need to stop one of these medications, talk to your doctor. They will slowly decrease your dosage to help prevent withdrawal symptoms. For more information, read about the dangers of stopping an antidepressant abruptly.

Talk with your doctor

To find out more about how Lexapro and Zoloft are alike and different, talk with your doctor. They’ll be able to tell you if one of these drugs, or a different drug, could help you with your mental health condition. Some questions that might be helpful to ask your doctor include:

  • How long will it take before I feel the benefits of this medication?
  • What is the appropriate time of day for me to take this medication?
  • Which side effects should I expect from this medication, and will they go away?

Together, you and your doctor can find a medication that’s right for you. To learn about other options, check out this article on the different types of antidepressants.

Q:

Which is better for treating OCD or anxiety—Lexapro or Zoloft?

A:

Zoloft, but not Lexapro, is approved to help relieve the symptoms of obsessive-compulsive disorder, or OCD. OCD is a common and long-lasting condition. It causes uncontrollable thoughts and urges to perform certain behaviors again and again. As for anxiety, Zoloft is approved to treat social anxiety disorder, and is sometimes used off-label to treat generalized anxiety disorder (GAD). Lexapro is approved to treat GAD and can be used off-label to treat social anxiety disorder and panic disorder. If you have OCD or anxiety, talk with your doctor about what drug might be best for you.

Healthline Medical TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.