5 important factors to consider when taking Lexapro vs Zoloft

Lexapro (escitalopram) and Zoloft (sertraline) are two widely prescribed medications used to treat depression and anxiety. While they share similar uses and functions, we will take an in depth look at lexapro vs zoloft. We will discuss certain differences in the side effects, conditions they treat, and how effective they are may determine the right treatment for your mental health needs.

This article serves to compare Lexapro versus Zoloft and provide you with clear, useful information to help you to make a more informed decision.

Remember, every patient is unique, and your physician will help determine the most appropriate treatment based on your specific needs and health history.

Key Takeaways

Lexapro and Zoloft are both SSRIs that help treat depression and anxiety by increasing serotonin levels in the brain.
Lexapro is FDA-approved for depression and generalized anxiety disorder (GAD), while Zoloft is approved for a wider range of conditions, including PTSD, OCD, and panic disorder.
Both medications can cause nausea, dry mouth, fatigue, and sexual dysfunction, but Lexapro is more likely to cause weight gain, while Zoloft may lead to diarrhea.
Both drugs can interact with other medications, such as MAOIs, NSAIDs, and blood thinners, increasing the risk of side effects like serotonin syndrome.
Lexapro may be better for general anxiety and depression, while Zoloft is often chosen for patients with multiple mental health conditions.
Choosing between Lexapro versus Zoloft depends on your symptoms, health history, and potential side effects, so a healthcare provider should guide your decision.

Overview of Lexapro and Zoloft

Lexapro and Zoloft are both prescription medications used to treat depression and anxiety-related conditions. They belong to a class of drugs called Selective Serotonin Reuptake Inhibitors (SSRIs), which work by increasing serotonin levels in the brain to improve mood and emotional stability.

Lexapro (Escitalopram)

Lexapro is FDA-approved for:

Major Depressive Disorder (MDD) – A condition characterized by persistent sadness, loss of interest, and difficulty functioning in daily life.
Generalized Anxiety Disorder (GAD) – A disorder marked by excessive worry and anxiety about various aspects of life, often with physical symptoms like restlessness, muscle tension, and difficulty concentrating.

Lexapro is also prescribed off-label for other conditions such as social anxiety disorder, panic disorder, and obsessive-compulsive disorder (OCD).

Zoloft (Sertraline)

Zoloft has a broader range of FDA-approved uses, including:

Major Depressive Disorder (MDD)
Social Anxiety Disorder – Intense fear of social situations, leading to avoidance and distress.
Obsessive-Compulsive Disorder (OCD) – A condition characterized by unwanted repetitive thoughts (obsessions) and behaviors (compulsions).
Post-Traumatic Stress Disorder (PTSD) – A disorder that develops after experiencing a traumatic event, leading to flashbacks, nightmares, and severe anxiety.
Panic Disorder – Sudden episodes of intense fear, rapid heartbeat, and shortness of breath.
Premenstrual Dysphoric Disorder (PMDD) – Severe mood disturbances before menstruation.

Like Lexapro, Zoloft is also used off-label for other anxiety and mood disorders.

How Do Lexapro and Zoloft Work?

Lexapro and Zoloft are both Selective Serotonin Reuptake Inhibitors (SSRIs), a class of antidepressants that help regulate mood and anxiety. They work by increasing serotonin levels in the brain, a neurotransmitter that plays a key role in mood, emotions, and mental stability.

How SSRIs Work

Normally, after serotonin is released in the brain, nerve cells absorb it back, reducing its availability. SSRIs block this reabsorption (reuptake), leaving more serotonin available in the brain.Higher serotonin levels can help reduce symptoms of depression and anxiety over time.

Lexapro vs. Zoloft: Differences in How They Work

While both medications boost serotonin levels, they have slight differences in how they function:

Feature	Lexapro (Escitalopram)	Zoloft (Sertraline)
Effect on Serotonin	More efficient at increasing serotonin levels due to additional allosteric inhibition.	Increases serotonin but less targeted compared to Lexapro.
Conditions Treated	Primarily used for depression and generalized anxiety disorder.	Used for a wider range of conditions, including PTSD, OCD, and panic disorder.
Speed of Action	May work slightly faster due to its strong serotonin uptake inhibition.	Works well but may take longer to show full effects for some conditions.

What Are Their Side Effects of Lexapro vs Zoloft?

Like all medications, Lexapro and Zoloft can cause side effects. Some are mild and temporary, while others are more serious. The severity and type of side effects vary from person to person.

Common Side Effects

Most people experience mild side effects when starting Lexapro or Zoloft. These often improve as the body adjusts to the medication.

Side Effect	Lexapro (Escitalopram)	Zoloft (Sertraline)
Nausea	Common	Common
Dry mouth	Common	Common
Sexual dysfunction	Common	Common
Weight gain	Possible	Less common
Fatigue	Common	Common
Excessive sweating	Common	Common

Rare But Serious Side Effects

While uncommon, some people may experience more serious side effects.

Rare Side Effect	Lexapro	Zoloft
QT prolongation (irregular heartbeat)	Possible	Rare
Dizziness	Possible	Common
Diarrhea	Rare	Common
Fatigue	Common	Common

Suicidal Thoughts Risk

Both Lexapro and Zoloft carry an FDA black box warning for increased risk of suicidal thoughts and behaviors, especially in young adults, teenagers, and children. Anyone starting these medications should be closely monitored, particularly during the first few weeks of treatment.

Individual Response to Side Effects

Individual responses to side effects can vary depending on factors such as dosage, personal health, and body chemistry. While some people tolerate one medication better than the other, others may experience stronger side effects. In cases where side effects become too bothersome, adjusting the dose or switching to a different medication may help. However, you should always consult a doctor before making any changes to ensure safe and effective treatment.

Common Drug Interactions

Lexapro and Zoloft can interact with certain medications and supplements, which may increase side effects or reduce effectiveness. Ensure you discuss all medications with a doctor before starting treatment.

Lexapro Interactions

Monoamine Oxidase Inhibitors (MAOIs): Combining Lexapro with MAOIs can cause dangerous increases in serotonin levels.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen and aspirin may increase the risk of bleeding.
St. John’s Wort: This herbal supplement can raise serotonin levels too much, increasing the risk of side effects.

Zoloft Interactions

Antipsychotics: Some medications used for schizophrenia and bipolar disorder can increase side effects like drowsiness and dizziness.
MAOIs: Like Lexapro, taking Zoloft with MAOIs can lead to a dangerous condition called serotonin syndrome.
NSAIDs and Blood Thinners: Combining Zoloft with aspirin, warfarin, or other blood thinners can increase bleeding risk.

Both medications can cause serotonin syndrome when taken with other drugs that boost serotonin levels, such as other antidepressants, migraine medications, or illicit drugs like MDMA. Symptoms of serotonin syndrome include confusion, rapid heart rate, sweating, and muscle stiffness, requiring immediate medical attention. Always inform your doctor of all medications and supplements you take to avoid harmful interactions.

Lexapro Versus Zoloft: Which Is Better?

The choice between Lexapro and Zoloft depends on individual needs, as both are effective antidepressants but treat slightly different conditions.

Lexapro is often preferred for depression and generalized anxiety disorder (GAD) because it may have fewer side effects at lower doses and a smoother onset. Some people find it more tolerable and experience fewer digestive issues compared to Zoloft.

Zoloft, on the other hand, is a better option for a wider range of conditions, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder. Its broader approval makes it a more versatile medication for people with multiple mental health conditions.

Since everyone responds differently to medication, what works best for one person may not be ideal for another. Factors such as side effects, personal health history, and how well the medication controls symptoms all play a role. Consulting a doctor will help you determine which option is safest and most effective for your needs.

If you're considering starting or switching antidepressants, Telapsychiatry is here to help. Our team of experienced psychiatrists can provide a thorough evaluation and guide you in selecting the best treatment. We offer convenient virtual appointments that allow you to receive the care you need from the comfort of your home.

FAQs

What are the similarities between Zoloft and Lexapro?

Both are SSRIs that help treat depression, anxiety, and other mental health conditions by increasing serotonin levels in the brain.

Does Lexapro or Zoloft cause more weight gain?

Lexapro is more likely to cause weight gain than Zoloft, but individual responses vary. Some people may not experience any weight changes on either medication.

What are other antidepressant medications?

Other types of antidepressants include SNRIs (e.g., Effexor, Cymbalta), MAOIs (e.g., Nardil, Parnate), and TCAs (e.g., Amitriptyline, Nortriptyline). These work differently from SSRIs and may be prescribed in specific cases.