Sep 20, 2022

Lexapro vs. Zoloft: What you need to know

It's no secret that mental health disorders are on the rise. The Centers for Disease Control and Prevention reports (CDC) that roughly 1 in 5 Americans lives with a mental illness. 

The two most common mental health diagnoses are anxiety and depression, accounting for 30% of all mental illnesses in America.

There are treatments available, including psychotherapy and medications. Selective serotonin reuptake inhibitors (SSRIs) are the most popular class of FDA-approved drugs for anxiety and depression. Lexapro and Zoloft are some of the most popular SSRIs prescribed nationwide. 

So what sets these two antidepressants apart? What similarities are there? What is the best drug for treating anxiety and depression? We put together this guide to help compare Lexapro and Zoloft medications. 

What are anxiety and depression?

To understand these medications, it's best first to understand the illnesses they treat. It's important to note that it's not unusual for a person with an anxiety disorder to suffer from depression and vice versa. 

Anxiety

Anxiety can make you feel uneasy, fearful, and worried. It's our body's response to stress, and it's normal to feel anxious from time to time. Many experience it from time to time, whether before speaking in front of a group or having to make a big decision. 

However, when these conditions don't go away or worsen over time, they may result from an anxiety disorder. There are several types of anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, and phobias. 

Signs and symptoms of an anxiety disorder include but are not limited to:

Depression

Also referred to as major depressive disorder or clinical depression, this mood disorder causes feelings of sadness and a loss of interest in activities. Depression often leads to various emotional and physical problems.

There are different types of depression, such as seasonal affective disorder (SAD), persistent depressive disorder (dysthymia), perinatal depression, postpartum depression, and depression with symptoms of psychosis. 

Symptoms of depression can vary from person to person but may include:

  • anxiety

  • feelings of emptiness, guilt, and worthlessness 

  • angry outbursts

  • easily irritable or frustrated

  • loss of interest in usual hobbies and activities

  • withdrawn for family and friends 

  • lack of energy, even with the most simple tasks 

  • trouble focusing, making decisions, and remembering things

  • difficulty falling and/or staying sleeping

  • oversleeping

  • changes in appetite

  • unplanned weight gain or loss 

  • unexplained aches or pains 

  • digestive problems 

  • suicidal thoughts or attempts*

If you or someone you know has suicidal thoughts, please dial 988 immediately. If you are in immediate danger, please call 911. 

Like anxiety, it's normal to feel sad or down from time to time. People diagnosed with clinical depression have ongoing or worsening symptoms for at least two weeks.

Overview of SSRIs

As stated above, Lexapro and Zoloft are SSRIs, a type of antidepressant medication also used to treat anxiety.

SSRIs improve the serotonin levels in your brain by blocking the reuptake process, the reabsorption of serotonin by brain cells. Serotonin regulates mood, digestion, and sleep. It also plays a significant part in feeling happiness, optimism, and fulfillment. 

Lexapro vs. Zoloft

While Lexapro and Zoloft are in the same class of medicines and thus share similarities, they also have differences. 

Mental health disorders treated

Lexapro is used to treat depression and anxiety. In addition to depression, Zoloft is also used to treat obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and social anxiety disorder. 

Who can take these medications?

Lexapro and Zoloft are both available by prescription only. 

Lexapro can be taken by anyone 12 years or older, while Zoloft is recommended for adults ages 18 and up. 

Dosage

Lexapro and Zoloft are available in oral tablets and solutions. They also are taken once a day, with or without food. 

However, their dosing is quite different from one another:

Lexapro comes in 5 mg, 10 mg, 20 mg tablets and 1 mg/ml in liquid. 

Zoloft comes in 25 mg, 50 mg, 100 mg tablets and 20mg/ml liquid. 

Most healthcare professionals will start you on a lower dose of either medication and increase it over time if needed. The max dosage for Lexapro is 20 mg, and Zoloft is 200 mg. 

Side effects 

Because they are both SSRIs, Lexapro and Zoloft have similar side effects.

The most common of these antidepressants include:

  • nausea

  • drowsiness

  • weakness

  • dizziness

  • anxiety

  • trouble sleeping 

  • decrease in sex drive

  • sweating

  • trembling

  • loss of appetite

  • dry mouth

  • constipation or diarrhea

  • indigestion  

Lexapro does contain a black box warning due to an increased risk of suicidal thoughts and behaviors, occurring primarily in children, adolescents, and young adults when just beginning medication or during adjusted dosage. 

Costs

Both medications are available in most pharmacies nationwide. The cost will depend on your health insurance drug coverage. Many plans will cover much of the costs of the generic versions of antidepressants. (Escitalopram is the generic for Lexapro and Sertraline for Zoloft.)

If you don't have drug coverage or want to compare the costs of Lexapro(Escitalopram) and Zoloft(Sertraline), use Carecard.com for a pharmacy discount card.

Time it takes to see improvements

Many people will start to notice improvements in sleep, appetite, and energy levels within the first two weeks of beginning Lexapro or Zoloft. It can take up to 8 weeks to see and feel the full effectiveness of these medicines. 

The time will also depend on the condition the medication is treating and the dosage amount. It may take some time for your healthcare provider to find the correct dose for you. 

Drug interactions 

Zoloft and Lexapro both have potential adverse effects when combined with other medicines. Before starting either, talk to your doctor about your current medications, vitamins, supplements, or herbs you take to help prevent drug interactions

Withdrawal risks

You shouldn't suddenly stop taking an SSRI, including Lexapro and Zoloft. Doing so can cause withdrawal symptoms such as:

Consult with your doctor if you do need to stop. They will help you taper off your antidepressant to reduce negative side effects. 

Which is a better medication for me, Lexapro or Zoloft?

When it comes to treating anxiety and depression, only you and your physician can determine which medication is best. 

Working with your healthcare provider, you can weigh the pros and cons of both SSRIs and factor in your current symptoms, medical conditions, mental health goals, and risk factors. 

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