Sydney is a contributing health writer and editor who enjoys shedding light on health topics, making information available to anyone who wants it, and ending stigmas or lack of access to care and treatment.
Leann Poston, M.D.
Leann Poston, M.D. earned her medical degree from the Wright State University Boonshoft School of Medicine. She completed an MBA from Raj Soin College of Business, focusing on healthcare. She is a full-time medical communication writer and educator.
March 18, 2021
Both Lexapro and Zoloft are selective serotonin reuptake inhibitors used to treat a variety of mental health conditions. Their main difference is their primary active ingredient. Zoloft uses Sertraline as its active ingredient, while Lexapro uses Escitalopram.
According to a study done for the International Clinical Psychopharmacology Institute, “Overall, as an allosteric serotonin reuptake inhibitor that is somewhat different from classical SSRIs, escitalopram is the first choice judged by combined efficacy and tolerability.” While this might be true in certain studies, antidepressants are very personal, and one might work well for someone that doesn’t work as well for the majority of people.
Though Zoloft and Lexapro are both SSRIs (selective serotonin reuptake inhibitors), they use different active ingredients. The active ingredient in Zoloft is sertraline, while in Lexapro, it is escitalopram. This difference in active ingredients is the root cause for many of the differences between these two medications.
While Lexapro and Zoloft are both used to treat depression, only Lexapro is approved to treat generalized anxiety disorder. Zoloft, unlike Lexapro, is approved to treat:
Zoloft is not approved for usage in people under 18 years of age, while Lexapro is approved for usage in patients as young as 12 years old. Lexapro and Zoloft also have different side effects.
Some side effects of Lexapro may fade as the body adjusts, but that process usually takes a couple of weeks. Some side effects include:
Lexapro has a few potentially dangerous side effects. Lexapro can trigger suicidal thoughts, especially in younger patients. If you start to have thoughts of harming yourself, seek medical help immediately. Those who experience these side effects should contact a medical professional immediately. These side effects are:
If you are worried that Lexapro is causing too many negative side effects, speak to a doctor about getting off of it and trying a new one. It’s important not to stop taking any antidepressant on your own due to withdrawals. You can make an appointment through our partner, trusted telehealth company PlushCare, and speak to a licensed physician.
PlushCare’s board-certified physicians can write prescriptions for both Lexapro and Zoloft and will work with you to make sure the medication is helping you. They can also help you know when and how to come off the medication.
If you have suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Some of the side effects of Zoloft will diminish with time. Others won’t, depending on the user. These side effects usually take several weeks to fade, if at all. These side effects include:
Zoloft has a few dangerous side effects that, if experienced, you should contact a medical professional immediately. These side effects are:
Lexapro is approved only for generalized anxiety disorder, while Zoloft is approved for social anxiety disorder. However, Zoloft has seen off-label use for generalized anxiety, and Lexapro has seen off-label use for social anxiety disorder. So how do you know which one is right for you?
It is recommended to start with the medication that is best suited to your symptoms. Speak with your doctor about other medications you may be taking, your goals for therapy, the convenience of use, and expected medication side-effects to determine which medication is a better choice for you. There are many kinds of antidepressants. They are not one-size-fits-all.
If you begin taking Zoloft for social anxiety and are not happy with your results, talk to a doctor about trying a different medication. Your doctor may recommend Lexapro, or potentially some other medication, depending on your needs.
Weight gain is a common side effect for almost all drugs used to treat depression. While not everybody who uses antidepressants experience weight gain, it is common enough and frustrating enough that some people are hesitant to start on antidepressants because of it.
It is possible that antidepressants such as SSRIs like Lexapro and Zoloft will impact the metabolism and appetite of the user, resulting in weight gain after long periods of usage. Some patients report eating the same amount of food but are suddenly experiencing weight gain, while others report having an increased appetite due to antidepressants. For some, this increased appetite is a potential cause of weight gain, but it varies from person to person.
Because antidepressants affect everybody differently, it’s tough to say whether Zoloft vs Lexapro is better for you. For some, both SSRIs will result in weight gain, for some, neither will induce a weight gain. It all depends on what is the right fit for the patient. If you are currently taking Zoloft or Lexapro and are unhappy with your results, consult a medical professional about changing your medication.
Lexapro is a more potent medication than Zoloft. Typically, those prescribed Lexapro take a maximum dosage of 20mg per day. Zoloft dosages, on the other hand, range from 25mg per day up to 200mg per day, depending on the patient and intended use.
Zoloft treats a wider variety of illnesses and as such has a wider range of dosages, but when treating depression, Zoloft dosage is typically anywhere from twice to quadruple of Lexapro dosage.
George Alexopoulos, M.D., Professor of Psychiatry at Weill Medical College of Cornell University referred to a study in which “most patients experienced relief from depressive symptoms. Patients treated with Lexapro received 10 mg throughout the study period, while patients treated with Zoloft received dosages based on depressive symptoms and the development of side effects,” and said “Lexapro is an effective treatment for depression with simple dosing that may improve patient adherence.”
Due to the potential to experience withdrawal from both Lexapro and Zoloft, it is important to seek guidance from a medical professional when switching antidepressants.
There are many reasons to switch antidepressants. Some people are unhappy with how some medications make them feel, others would prefer to take a different dosage or dosing schedule, while others prefer the side effects of one medication over another. If you are unhappy with your current results with either Lexapro or Zoloft, talk to a doctor about how you are feeling and discuss the option of switching.
Do not try to stop or change medications on your own. It is always best to talk to your doctor when it comes to making these kinds of changes. You can make a convenient online appointment with PlushCare to talk about Lexapro vs Zoloft and other antidepressant options too.
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