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Lexapro vs Zoloft
Introduction
For individuals dealing with major depressive disorder (MDD) or other forms of depression, certain medications that modify the levels of chemicals in the brain associated with mood, known as neurotransmitters, can assist in managing symptoms and stabilizing emotional lows. Lexapro and Zoloft are two such drugs frequently prescribed for depression. Both impact serotonin levels in the brain but affect this neurotransmitter differently and thus have distinctive effects on patients' moods.
Lexapro is classified as a selective serotonin reuptake inhibitor (SSRI), specifically designed to prevent the reabsorption of serotonin into neurons, thereby increasing its availability within synaptic spaces. On the other hand, Zoloft not only prevents serotonin reuptake but also mildly affects dopamine and norepinephrine reuptake. This broad spectrum activity gives it a different profile from Lexapro which might be preferable depending upon individual patient characteristics.
Lexapro vs Zoloft Side By Side
| Attribute | Lexapro | Zoloft |
|---|---|---|
| Brand Name | Lexapro | Zoloft |
| Contraindications | Should not be used with MAO inhibitors or within 5 weeks of stopping MAOIs. Inform healthcare provider of all current medications due to potential drug interactions. | Should not be used with MAO inhibitors or within 5 weeks of stopping MAOIs. Inform healthcare provider of all current medications due to potential drug interactions. |
| Cost | Brand-name: $356 for 30 tablets of 10 mg. Generic: Ranges from $0.14 to nearly $1/day depending on dosage and purchase location. | Brand-name: $340 for 30 tablets of 50 mg. Generic: Starts at just over $.05/day up to around $.80/day based on dose and purchase point. |
| Generic Name | Escitalopram | Sertraline |
| Most Serious Side Effect | Worsening depression and increased thoughts of suicide or self-harm, serotonin syndrome symptoms, visual disturbances, cardiovascular issues, reduced sodium levels. | Signs of an allergic reaction, worsening or new onset of mood changes, anxiety, panic attacks, suicidal thoughts and behaviors, sudden dizziness and fainting, eye pain/swelling/redness with visual disturbances, unusual bleeding or bruising, seizures. |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | 10-20 mg/day, with 10 mg/day being typically adequate for treating major depressive disorder in adults. | Starts at 50 mg/day for depression and OCD, or 25 mg/day for panic disorder, PTSD, and social anxiety disorder, up to a maximum of 200 mg/day. |
What is Lexapro?
Escitalopram (the generic name for Lexapro) is one of the later drugs introduced in the SSRI class of antidepressants, which symbolized a significant progression from earlier classes like tricyclic antidepressants (TCAs). Escitalopram was first approved by the FDA in 2002. Lexapro works by boosting levels of free serotonin, preventing its reabsorption and hence "retaining" it within the brain longer than normal. It is often prescribed to treat various forms of depression and anxiety disorders. Similarly, Sertraline (Zoloft) increases serotonin levels in your brain, but also has some effect on dopamine and norepinephrine neurotransmitters albeit at a lower extent than others SSRIs. This leads to Zoloft having a broader range of applications including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder amongst others along with fewer side effects depending on individual tolerance levels.
What conditions is Lexapro approved to treat?
Lexapro is approved for the treatment of various mood and anxiety disorders, including:
- Major depressive disorder (MDD), often referred to as unipolar depression
- Generalized anxiety disorder (GAD)
- Panic disorder, which includes sudden attacks of fear and worry about these attacks Zoloft, on the other hand, has a broader range of FDA approvals that include not only MDD and panic disorder but also:
- Obsessive-compulsive Disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Social Anxiety Disorder
- Premenstrual dysphoric disorder (PMDD).
How does Lexapro help with these illnesses?
Lexapro, like Zoloft, is designed to manage depression and anxiety disorders by increasing the amount of serotonin in the brain. It accomplishes this by inhibiting its reabsorption into neurons. This process allows serotonin levels to remain elevated for extended periods of time. Serotonin is a neurotransmitter that facilitates communication within the brain and impacts various physiological functions such as mood, cognition, memory, sleep patterns, hunger cycles, and body temperature regulation. It's believed that those suffering from depression or anxiety have lower levels of serotonin than normal. By elevating these levels through medication such as Lexapro (or Zoloft), it can mitigate the negative effects associated with these conditions and help individuals stabilize their moods and better manage their mental health.
What is Zoloft?
Zoloft, a brand name for sertraline, is a selective serotonin reuptake inhibitor (SSRI) that increases the levels of serotonin in the brain by reducing its reabsorption. This action on serotonin contributes to Zoloft's effect in treating depression and other mental health disorders - it was first approved by the FDA in 1991. Unlike bupropion or Wellbutrin, Zoloft does not impact dopamine or norepinephrine levels significantly nor act as an antagonist at any known receptor sites. Sertraline has been associated with common side effects such as sedation, sexual dysfunction and weight changes which are typically seen with SSRI antidepressants like Lexapro. The therapeutic efficacy on depression management can be advantageous especially for patients who do not respond well to other types of antidepressant drugs such as those acting predominantly on neurotransmitters other than serotonin.
What conditions is Zoloft approved to treat?
Zoloft is a widely used medication, and it has been approved for the treatment of various mental health conditions such as:
- Major depressive disorder (MDD)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD) This illustrates Zoloft's versatility in handling a wide array of psychological issues.
How does Zoloft help with these illnesses?
Serotonin is a neurotransmitter that has significant influence on mood, sleep patterns, and other bodily functions. It's widely understood that low levels of serotonin can contribute to depression. Zoloft works by increasing the availability of serotonin in the brain, thereby helping to alleviate some symptoms of depression and anxiety disorders. Its action doesn't only stop at boosting serotonin levels but also affects dopamine to a lesser degree which may play roles in its efficacy as an antidepressant. Since it does not majorly affect norepinephrine levels, it is often prescribed when a patient does not respond well to other SSRI antidepressants (such as Lexapro), or it may be combined with them for additive effect.
How effective are both Lexapro and Zoloft?
Both escitalopram (Lexapro) and sertraline (Zoloft) have significant success in treating patients with depression and anxiety, and both are selective serotonin reuptake inhibitors (SSRIs), meaning they primarily act on the neurotransmitter serotonin. The effectiveness of Lexapro and Zoloft was directly compared in a 2004 double-blind clinical trial; the two drugs showed similar efficacy in managing symptoms of major depressive disorder as well as comparable safety profiles. No significant differences were found in measurements evaluating improvements to depressive symptoms between patients receiving Lexapro or Zoloft.
A 2012 review of meta-analysis reports on escitalopram demonstrated it is effective at alleviating symptoms of depression from the first week of treatment, has a side effect profile favorable over many other antidepressants, including less risk for sexual dysfunction than some SSRIs such as fluoxetine or paroxetine, making it an attractive option for those who may be particularly susceptible to these side effects. Furthermore, its efficacy appears resistant to patient age variations which makes it useful across different population groups.
Sertraline shares many similarities with escitalopram but is known for its broader range of use beyond major depressive disorder – treating conditions like panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorders among others - hence why it's often considered a first-line treatment for these conditions. A 2016 review indicated that sertraline seems more effective than placebo when used alone or co-prescribed alongside other treatments depending on individual symptomatology. Despite being highly efficacious across multiple psychiatric conditions, users need careful monitoring due to potential withdrawal syndrome associated with abrupt discontinuation.
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At what dose is Lexapro typically prescribed?
Oral dosages of Lexapro range from 10-20 mg/day, but research has shown that a dose of 10 mg/day is typically adequate for treating major depressive disorder in adults. Adolescents may be started on a lower dose of 5 mg/day. In either age group, the dosage can be increased after several weeks if necessary based upon response to treatment. The maximum recommended daily dosage for any individual should not exceed 20 mg/day.
At what dose is Zoloft typically prescribed?
Zoloft treatment typically begins at a dose of 50 mg/day for depression and obsessive-compulsive disorder, or 25 mg/day for panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder. The dose can then be increased to a maximum of 200 mg/day depending on the response to treatment, usually following an interval of one week. Doses are generally taken once daily in the morning or evening and can be administered with or without food. It's important to note that some patients may not see improvement until several weeks into their Zoloft regimen. Always discuss any changes in dosing with your healthcare provider as abrupt cessation could lead to withdrawal symptoms.
What are the most common side effects for Lexapro?
Common side effects of Lexapro and Zoloft include:
- Anxiety
- Nervousness
- Difficulty sleeping (insomnia)
- Drowsiness or fatigue
- Sweating, including night sweats
- Changes in appetite or weight gain/loss
- Dry mouth
- Decreased libido (sex drive) or other changes in sexual desire/functioning
- Diarrhea or constipation
- Nausea, vomiting, upset stomach
- Tremor (involuntary trembling or shaking)
-Increased heart rate
-Dizziness and lightheadedness
-Rashes and itching skin. -Cough, cold symptoms, sinusitis.
Please note that these medications affect everyone differently. It's also important to remember that many people taking these medications may not experience all - if any - of the listed side effects. Always consult with your healthcare professional for potential risks when starting a new medication.
Are there any potential serious side effects for Lexapro?
In rare instances, taking Lexapro might lead to severe side effects, including:
- Worsening depression and increased thoughts of suicide or self-harm
- Signs of allergic reaction: hives, difficulty breathing, swelling in the face or throat
- Serotonin syndrome symptoms: restlessness, hallucinations, rapid heartbeat, fever, loss of coordination, nausea and vomiting
- Visual disturbances such as blurred vision or eye pain/swelling
- Cardiovascular issues like accelerated heartbeats or feeling faint due to sudden drops in blood pressure
- Reduced sodium levels - symptoms may include headache, confusion slurred speech severe weakness and unsteadiness
Zoloft could also potentially cause similar side-effects. If you encounter any of these alarming signs while on either medication it is important to get immediate medical attention.
What are the most common side effects for Zoloft?
Zoloft, similar to Lexapro, can have several side effects. These may include:
- Dry mouth and increased sweating
- Insomnia or drowsiness
- Nausea, diarrhea or constipation
- Loss of appetite leading to weight loss
- Nervousness and restlessness
- Dizziness or light-headedness
- Tremors or muscle spasms
- Fast heartbeat in some cases
Are there any potential serious side effects for Zoloft?
When taking Zoloft, it's important to be vigilant for any adverse side effects. If you experience any of the following symptoms, seek immediate medical attention:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Any worsening or new onset of mood changes, anxiety, panic attacks or suicidal thoughts and behaviors
- Changes in sleep patterns (insomnia) or signs of a manic episode including racing thoughts and recklessness
- Sudden dizziness and fainting which may indicate abnormal heart rhythm
- Eye pain/swelling/redness accompanied by visual disturbances like blurred vision and seeing halos around lights
- Unusual bleeding (such as nosebleeds) or bruising under the skin
- Seizures (convulsions)
Remember that this list is not exhaustive. Always consult with your doctor about potential side effects when starting a new medication.
Contraindications for Lexapro and Zoloft?
Both Lexapro and Zoloft, as with most other antidepressant medications, may exacerbate symptoms of depression in some individuals. If you notice your depression intensifying or an increase in suicidal ideation, thoughts, or behavior while taking these medications, it is critical to seek immediate medical attention.
Neither Lexapro nor Zoloft should be used if you are currently on medication with monoamine oxidase (MAO) inhibitors or have taken them recently. Always inform your healthcare provider about any medications you're presently consuming; MAOIs require a period of approximately 5 weeks to be completely eliminated from the system to avoid hazardous interactions with both Lexapro and Zoloft. Furthermore, due to potential drug interactions, always consult your doctor before initiating treatment with either Lexapro or Zoloft if you are already taking other prescription drugs.
How much do Lexapro and Zoloft cost?
For the brand-name versions of Lexapro and Zoloft:
- The price for 30 tablets of Lexapro (10 mg) averages around $356, which works out to approximately $11.87/day.
- The cost for 30 tablets of Zoloft (50 mg) is about $340, equating to roughly $11.33/day.
Therefore, if you are in the higher dosage range for Lexapro (i.e., 20 mg/day), then brand-name Zoloft may be less expensive on a per-day treatment basis. Please keep in mind that cost should not be your sole determining factor when choosing between these two medications.
In terms of generic versions; escitalopram (generic name for Lexapro) and sertraline (generic name for Zoloft):
- Escitalopram is available in packs ranging from 5 to 500 tablets with costs varying from as low as $0.14 up to nearly a dollar a day depending on your dosage and where you purchase it.
- Sertraline comes in similar pack sizes with prices starting at just over $.05/day if purchased in larger quantities but can go up to around $.80 per day based on dose and point of purchase.
Popularity of Lexapro and Zoloft
Escitalopram, under the brand name Lexapro, was estimated to have been prescribed to about 27.7 million people in the US in 2020. Escitalopram accounted for approximately 14% of SSRI prescriptions and around 6% of overall antidepressant prescriptions. This medication has generally seen a steady growth since its introduction.
Sertraline, also known by its brand name Zoloft, was prescribed to an estimated 38.8 million individuals in the USA during that same year. Sertraline accounts for just over 20% of SSRI prescriptions and nearly 10% of all antidepressants dispensed within America's borders. The prevalence of Sertraline has been on a gradual increase over the last decade.
Conclusion
Lexapro (escitalopram) and Zoloft (sertraline) are both well-established options in the treatment of depression and anxiety disorders, with numerous clinical trials indicating their efficacy over placebo treatments. In some scenarios, these medications may be used concurrently; however, this must be under the strict guidance of a healthcare professional due to potential interactions. Both Lexapro and Zoloft primarily work by increasing serotonin levels in the brain but they differ slightly in their pharmacological properties which can influence how they are prescribed.
Lexapro tends to cause fewer side effects related to sleep and weight compared to other SSRIs including Zoloft. However, both drugs carry risks associated with sexual dysfunction - a common concern for many patients taking antidepressants.
Both Lexapro and Zoloft have generic forms available that offer significant cost savings for those paying out-of-pocket. It's worth noting that as with all SSRIs, it may take several weeks before benefits become noticeable.
The safety profiles of both Lexapro and Zoloft are similar; they're generally well-tolerated but require careful monitoring especially during initial stages of treatment or dosage adjustments. Any intensification of depressive symptoms or emergence of suicidal thoughts should prompt immediate medical attention.
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Refrences
- Wade, A. G., Crawford, G. M., & Yellowlees, A. (2011, March 16). Efficacy, safety and tolerability of escitalopram in doses up to 50 mg in Major Depressive Disorder (MDD): an open-label, pilot study. BMC Psychiatry. Springer Science and Business Media LLC.http://doi.org/10.1186/1471-244x-11-42
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