Lexapro vs Zoloft: What Antidepressant Will You Take?

Lexapro (Escitalopram) and Zoloft (Setraline) are antidepressants classified under a group of drugs known as selective serotonin reuptake inhibitors (SSRIs). These are prescriptions medicines for the treatment of various types of anxiety and depression complications. Doctors may sometimes prescribe Zoloft to manage symptoms of other disorders, such as panic disorder, panic disorders, generalized anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder (PTSD), as well as premenstrual dysphoric disorder (PMDD). Lexapro, on the other hand, does not have the approval to treat the above.

The two drugs exhibit some common side effects, such as nausea, drowsiness, tremor, headache, reduced appetite, insomnia, and diarrhea, dry mouth, weight loss/gain, reduced sexual desires, and stomach upset or indigestion. Like other SSRIs, these two medicines may also result in withdrawal effects, such as tingling, dizziness, vivid dreams, mood changes, irritability, and feeling of tiredness.


As mentioned earlier, withdrawal symptoms are common when you discontinue the SSRI treatment. The same applies to Lexapro, which normally exhibit common symptoms, such as tingling, mood changes, dizziness and irritability, among others. Gradual reduction of the dosage is recommended to avoid these side effects. The following are common adverse reactions of the drug that patients are encouraged to watch out for:

  • Drowsiness and sleeping difficulties;
  • Blurred vision and restlessness;
  • Dry mouth, diarrhea and fever;
  • Regular urination, headache and ingestion;
  • Nausea and change in appetited (can increase or drop);
  • Reduced libido;
  • Change in weight.

Some patients have reported pain on their shoulders and neck, as well influenza-like symptoms. Kindly bear in mind that depression alone may affect your sexual desire, but taking Lexapro can worsen the situation. Most male patients have experienced difficulties ejaculating. These side effects are likely to disappear upon discontinuation of treatment and shouldn't really be any cause for alarm.

There are however some known side effects that are considered severe that must be reported to the nearest medical health provider for attention. They include, but not limited to seizures, serotonin syndrome, having suicidal thoughts, low sodium, abnormal bleeding, and angle closure glaucoma.


Zoloft tends to exhibit other unique side effects compared to Lexapro, such as dizziness, constipation, and nervousness. The drug is however associated with adverse reactions, such as sleepiness, insomnia, nausea, tremor, nervousness, constipation, loss of appetite, diaphoresis, low libido, dizziness, and loss of weight. The above side effects may in most cases not be severe and might disappear after sometimes. However, there are some serious ones that require urgent medical attention. They include:

  • Having suicidal thoughts;
  • Reduced functioning of the liver;
  • Changed heartbeats;
  • Patients suffering from bipolar disorder may experience mania;
  • Increased depression;
  • Hyponatremia;
  • Priapism;
  • Severe allergic reactions;
  • Abnormal bleeding.

The Zoloft therapy requires close monitoring of the patients, especially on how they react to the treatment. This drug shouldn't be discontinued without properly consulting the medical practitioner since it might result in side effects, such as vomiting, diarrhea, headaches, flu, sweating, lightheadedness, vomiting, disrupted sleep, reduced appetite, and possible impairment of memory.

Dosage: Lexapro vs Zoloft

The dosage of any of these drugs varies. In most cases, the doctor will evaluate and consider a lot of factors before giving dosage instructions, such as the age of patient, other medical conditions the person might be suffering from, other drugs being used at that time, previous experience with the drug, among others. Each is however prescribed different despite similarity in their mechanism.

Lexapro: A patient may be prescribed an initial dose of 10mg taken once per day for managing depression, normally in the evenings or mornings. This may be adjusted to a maximum of 20mg once per day after sometime, normally a week. Note that the effect of this drug is not instant, and may take up to 4 weeks, and higher dosage doesn't necessarily boost the drug's effectiveness. For generalized anxiety disorder, a 10mg daily dose taken once is recommended, with or without food.

Zoloft: The Zoloft dosage varies depending on various factors, including the severity of the condition. Normally, a dosage of between 25mg and 200mg taken once daily, taken with or without food, may be prescribed for treating OCD, depression, PTSD, panic disorder, and social anxiety disorder. The starting dose is however pegged at 25mg-50mg taken once per day. The initial dose is then reviewed upward over time, especially after every week depending on how the patient responds to the therapy until a suitable dose is reached. For PMDD, doctors normally prescribe between 50mg and 150mg each menstrual cycle day or approximately two weeks (14 days) before menstruation.

Drug Interactions: Lexapro vs Zoloft

A combination of any SSRI drug, Lexapro and Zoloft included, with monoamine oxidase inhibitors (MAOIs) such as Isocarboxazid (Marplan) and Phenelzine (Nardil) is highly discouraged. Any such combination is likely to result in high blood pressure, confusion, hyperactivity, tremor, possible coma and even result in death. To avoid that from happening, a period of not less than 14 days should be given before or after using MAOIs before you can use SSRIs.

A combination of any of these two drugs with other drugs, such as Tryptophan, Meperidine (Demerol, Meperitab), and Tramadol (ConZip, Synapryn FusePaq, Ultram), that are known to increase serotonin levels in the brain is equally discouraged when using Zoloft. The drug is also associated with increasing levels of pimozide in the blood that might affect the heart's electrical conduction, a situation that can be fatal.

Pregnancy: Lexapro vs Zoloft

Use of Zoloft during pregnancy is highly discouraged, especially at the third trimester, because it is feared the drug can harm the unborn baby. Even though the effect of Lexapro on pregnancy and breastfeeding mothers has not been established sufficiently, patients are encouraged to inform their doctors for professional guidance. However, it is safer to keep off the drugs during pregnancy.


Related to the drug's effectiveness, both medicines are considered highly effective for the medical conditions they are prescribed for. Even though they are both selective serotonin reuptake inhibitors (SSRIs) used for treating anxiety and depression disorders, Zoloft has other approved uses, such as management of post-traumatic disorder (PTSD), premarital dysphoric disorder (PMDD), and obsessive compulsive disorder (OCD).