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.[1][2]
| Condition | Lexapro | Zoloft |
|---|---|---|
| Depression | X | X |
| 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.[1][2]
| Question | Lexapro | Zoloft |
|---|---|---|
| What types of antidepressants are they? | Selective serotonin reuptake inhibitor (SSRI) | Selective serotonin reuptake inhibitor (SSRI) |
| What is the generic drug name? | escitalopram | sertraline |
| What form does the drug come in? | oral tablet, oral solution | oral tablet, oral solution |
| Who can take it? | people 12 years and older | people 18 years and older |
| What dosage does it come in? | tablet: 5 mg, 10 mg, 20 mg; solution: 1 mg/mL | tablet: 25 mg, 50 mg, 100 mg; solution: 20 mg/mL |
| How long is a typical course of treatment? | Long-term | Long-term |
| is there a risk of withdrawal? | Yes | Yes |
| How should it be stored? | room temperature away from excess heat or moisture | room 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.[1][2]
| Common side effects | Lexapro | Zoloft |
|---|---|---|
| nausea | X | X |
| sleepiness | X | X |
| weakness | X | X |
| dizziness | X | X |
| anxiety | X | X |
| sleeping trouble | X | X |
| sexual problems | X | X |
| sweating | X | X |
| shaking | X | X |
| loss of appetite | X | X |
| dry mouth | X | X |
| constipation | X | |
| respiratory infections | X | X |
| yawning | X | X |
| diarrhea | X | X |
| indigestion | X | X |
| Serious side effects | Lexapro | Zoloft |
|---|---|---|
| suicidal actions or thoughts | X | X |
| serotonin syndrome | X | X |
| severe allergic reactions | X | X |
| abnormal bleeding | X | X |
| seizures or convulsions | X | X |
| manic episodes | X | X |
| weight gain or loss | X | X |
| low sodium (salt) levels in the blood | X | X |
| eye problems | X | X |
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.[5]
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.[3][4]
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.[3][4]
| Interacting drugs | Lexapro | Zoloft |
|---|---|---|
| monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine | X | X |
| pimozide | X | X |
| blood thinners such as warfarin and aspirin | X | X |
| nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen | X | X |
| lithium | X | X |
| antidepressants such as amitriptyline and venlafaxine | X | X |
| anti-anxiety drugs such as buspirone and duloxetine | X | X |
| medications for mental illness such as aripiprazole and risperidone | X | X |
| antiseizure drugs such as phenytoin and carbamazepine | X | X |
| medications for migraine headaches such as sumatriptan and ergotamine | X | X |
| sleeping medications such as zolpidem | X | X |
| metoprolol | X | X |
| disulfiram | X | |
| medications for irregular heartbeat such as amiodarone and sotalol | X | X |
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:[1][2]
| Withdrawal Symptoms | Lexapro | Zoloft |
|---|---|---|
| Anxiety | X | X |
| Flu-like symptoms | X | X |
| Agitation | X | X |
| Headache | X | X |
| Confusion | X | X |
| Trouble sleeping | X | X |
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:[3][4]
- Liver conditions
- Kidney conditions
- Seizure disorders
