Prozac and Zoloft are powerful prescription medications used to treat depression and other issues. They’re both brand-name drugs. The generic version of Prozac is fluoxetine, while the generic version of Zoloft is sertraline hydrochloride.
Both drugs are selective serotonin reuptake inhibitors (SSRIs). Serotonin is a naturally occurring chemical that produces a feeling of well-being. These drugs work by influencing serotonin levels in your brain. By balancing chemicals in your brain, these drugs will likely improve your mood and appetite. They can also enhance your energy levels and help you sleep better. Both medications can reduce anxiety, fear, and compulsive behaviors. For people who have major depression, they can dramatically improve quality of life.
However, these drugs do have some differences, including who they’re used for.
What they treat
Prozac and Zoloft have slightly different uses. The table below lists the conditions each drug is approved to treat.
|Both||Prozac only||Zoloft only|
|major depression||bulimia nervosa||post-traumatic stress disorder (PTSD)|
|obsessive-compulsive disorder (OCD)||premenstrual dysphoric disorder (PMDD)|
|panic disorder||social anxiety disorder or social phobia|
These medications can also be prescribed for other off-label uses. These may include eating disorders and sleep disorders.
Off-label drug use means that a doctor has prescribed a drug that’s been approved by the U.S. Food and Drug Administration (FDA) for a purpose that it hasn’t been approved for. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.
Who they treat
Prozac is the only drug approved by the FDA for treating depression in children who are 8 years or older. It’s also used to treat OCD in children who are 7 years or older. Additionally, it treats adults for all of its uses.
Zoloft is approved to treat adults and children who are 6 years or older for OCD. Otherwise, for its other uses, Zoloft is only approved to treat adults.
The table below compares other features of Prozac and Zoloft.
|What is the generic name?||fluoxetine||sertraline|
|Is a generic version available?||yes||yes|
|What form(s) does it come in?||oral capsules||oral capsules, oral liquid concentrate solution|
|What strengths does it come in?||10 mg, 20 mg, 40 mg, 90 mg||oral capsules: 25 mg, 50 mg, 100 mg; oral solution: 20 mg/mL|
|Is it a controlled substance*?||no||no|
|Is there a risk of withdrawal† with this drug?||yes||yes|
|Does this drug have potential for misuse¥?||no||no|
† If you’ve been taking this drug for longer than a few weeks, do not stop taking it without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as anxiety, sweating, nausea, and sleeping trouble.
¥ This drug has a high misuse potential. This means you can get addicted to it. Be sure to take this drug exactly as your doctor tells you to. If you have questions or concerns, talk with your doctor.
To lower your chance of side effects, your doctor will start you on the lowest possible dosage. If your symptoms don’t improve at this dosage, your doctor may increase it. It may take some time to find the correct dosage and the best medication for you.
Both drugs cause many similar side effects. Common side effects can include:
- nausea and vomiting
- nervousness and anxiousness
- sexual problems, such as erectile dysfunction (trouble getting or keeping an erection)
- insomnia (trouble falling or staying asleep)
- weight gain
- weight loss
- dry mouth
When it comes to side effect specifics, Zoloft is more likely than Prozac to cause diarrhea. Prozac is more likely to cause dry mouth and sleep problems. Neither drug causes drowsiness, and both medications are less likely to cause weight gain than older antidepressant drugs.
Antidepressants can also cause serious side effects. Prozac and Zoloft may cause suicidal thoughts in children, teenagers, and young adults. Talk to your doctor or your child’s doctor if this risk applies to you.
Both Prozac and Zoloft can interact with other drugs. Be sure to tell your doctor about all drugs and supplements you take, both prescription and over-the-counter. These include:
- monoamine oxidase inhibitors (MAOIs)
- methylene blue injection
Prozac or Zoloft can also cause problems if you’re pregnant or breastfeeding. In general, you should only use these medications in these cases if the potential benefit justifies the potential risk.
Both medications are available in most pharmacies. At the time this article was written, a 30-day supply of Prozac was about $100 more than a similar supply of Zoloft. To check the most current pricing, though, you can visit GoodRx.com.
Most health insurance plans likely won’t cover brand-name Prozac or Zoloft. This is because both drugs are also available as generic medications, and generics tend to cost less than their brand-name counterparts. Before covering the brand-name product, your health insurance company may need prior authorization from your doctor.
Prozac and Zoloft are both effective drugs. They work in the same way in your body and cause similar side effects. They treat some different conditions, though, so the drug your doctor chooses for you may depend largely on your diagnosis.
Talk to your doctor to learn which medication may be the best choice for you. Many people react differently to these types of medications. It’s hard to predict if one drug will work better for you than the other. It’s also impossible to know ahead of time which side effects you may have or how severe they will be. There are also other options available. To learn more, check out Healthline’s depression medication list.