Lexapro vs Zoloft

Edmund Murphy
Dr. Jenni Jacobsen
Written by Edmund Murphy on 19 April 2023
Medically reviewed by Dr. Jenni Jacobsen on 23 August 2024

With so many psychiatric medications available on the market, it may be difficult to know whether Zoloft or Lexapro is right for you. It is also useful to know the potential risks of both and whether there are any harmful drug interactions. This guide looks at the difference between Lexapro and Zoloft including key questions, side effects, and drug interactions.

What conditions do they treat?

Lexapro (escitalopram) and Zoloft (sertraline) are both forms of SSRI antidepressant used to treat a wide range of mental health issues including depression. Zoloft is used to treat numerous conditions, ranging from post-traumatic stress disorder to panic disorder, while Lexapro is primarily used to treat major depressive disorder and generalized anxiety disorder.

ConditionLexaproZoloft
DepressionXX
Generalized anxiety disorder (GAD)X 
Obsessive-compulsive disorder (OCD) X
Panic disorders X
Post-traumatic stress disorder (PTSD) X
premenstrual dysphoric disorder (PMDD) X
social anxiety disorder X

Key information

There are several specific differences between Zoloft and Lexapro that may sway your choice to use one versus another as a course of treatment. These are some of the most common questions and key facts about these two drugs.

QuestionLexaproZoloft
What types of antidepressants are they?Selective serotonin reuptake inhibitor (SSRI)Selective serotonin reuptake inhibitor (SSRI)
What is the generic drug name?escitalopramsertraline
What form does the drug come in?oral tablet, oral solutionoral tablet, oral solution
Who can take it?people 12 years and olderpeople 18 years and older
What dosage does it come in?tablet: 5 mg, 10 mg, 20 mg; solution: 1 mg/mLtablet: 25 mg, 50 mg, 100 mg; solution: 20 mg/mL
How long is a typical course of treatment?Long-termLong-term
is there a risk of withdrawal?YesYes
How should it be stored?room temperature away from excess heat or moistureroom temperature away from excess heat or moisture

Side effects (serious and common)

Zoloft side effects and Lexapro's side effects are similar due to them both being SSRIs. The common effects of both medications may cause discomfort, and you should inform your doctor if you experience any of the below symptoms. 

Common side effectsLexaproZoloft
nauseaXX
sleepinessXX
weaknessXX
dizzinessXX
anxietyXX
sleeping troubleXX
sexual problemsXX
sweatingXX
shakingXX
loss of appetiteXX
dry mouthXX
constipationX 
respiratory infectionsXX
yawningXX
diarrheaXX
indigestionXX
Serious side effectsLexaproZoloft
suicidal actions or thoughtsXX
serotonin syndromeXX
severe allergic reactionsXX
abnormal bleedingXX
seizures or convulsionsXX
manic episodesXX
weight gain or lossXX
low sodium (salt) levels in the bloodXX
eye problemsXX

Serotonin syndrome is a condition that occurs when the levels of serotonin in the body become dangerously high. This side effect can occur with both Lexapro and Zoloft. Serotonin syndrome can be life-threatening, and you should contact your doctor if you display any of the symptoms, which include sweating, high blood pressure, elevated heart rate, tremor, and agitation. In severe cases, patients may develop seizures and hyperthermia. 

Another side effect not listed is weight gain or loss. Fluctuating weight is common with all forms of antidepressants, though is less prominent in people taking SSRIs like Lexapro or Zoloft. 

Both medications have the risk of raising suicidal ideation in children and young people. Zoloft is therefore not FDA-approved for young people under 18 and Lexapro for people under 12.

Drug interactions

As both Lexapro and Zoloft are SSRIs, they have very similar interactions with other drugs. You should tell your doctor or psychiatrist if you are on any of the below medications (and any others) before starting a course of either medication. 

Interacting drugsLexaproZoloft
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
metoprololXX
disulfiram X
medications for irregular heartbeat such as amiodarone and sotalolXX

Withdrawal symptoms

Suddenly stopping a course of any antidepressants may cause withdrawal symptoms, and this is true of both Lexapro and Zoloft. Potential withdrawal from these medications may include:

Withdrawal SymptomsLexaproZoloft
AnxietyXX
Flu-like symptomsXX
AgitationXX
HeadacheXX
ConfusionXX
Trouble sleepingXX

Health risks

Both drugs may exacerbate pre-existing medical conditions and impact certain health scenarios.

For example, Lexapro and Zoloft may cause complications with pregnancy, and you should consult your doctor if you are planning on becoming or have recently become pregnant and are on these medications.

Other medical conditions that may be complicated by these medications include:

  • Liver conditions
  • Kidney conditions
  • Seizure disorders
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Resources:

  1. Landy K, et al. (2022). Escitalopram.
  2. Singh HK, et al. (2022). Sertraline.
  3. Lexapro (escitalopram oxalate) tablets; Lexapro (escitalopram oxalate) oral solution. (2017).
  4. Zoloft (sertraline hydrochloride) tablets, for oral use; Zoloft (sertraline hydrochloride) oral solution. (2016).

Activity History - Last updated: 23 August 2024, Published date:


Reviewer

Dr. Jenni Jacobsen has a PhD in psychology, and she teaches courses on mental health and addiction at the university level and has written content on mental health and addiction for over 10 years.

Activity History - Medically Reviewed on 17 April 2023 and last checked on 23 August 2024

Medically reviewed by
Dr. Jenni Jacobsen

PhD

Dr. Jenni Jacobsen

Reviewer

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