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Key takeaways
Escitalopram is a generic prescription antidepressant that treats major depressive disorder and generalized anxiety disorder.
Other drugs that can be used instead of escitalopram include other antidepressants or anxiety medications: SSRIs, SNRIs, atypical antidepressants, tricyclic antidepressants, bupropion, buspirone, or benzodiazepines.
Top escitalopram alternatives include Zoloft, duloxetine, Effexor XR, Wellbutrin XL, and Remeron.
Changing to other psychiatric drugs may involve medical issues, such as withdrawal, and should be managed by a healthcare professional.
Looking for an alternative to escitalopram? You are not alone, and it is not because escitalopram is bad medicine. It’s more a matter of numbers. Roughly a third of the population experiences depression at some point, and escitalopram is one of the most commonly used first-line treatments. However, many people newly treated for depression or anxiety change drugs because of side effects or inadequate relief. Whatever the reason, doctors have a lot of options to choose from. Here, we will guide you through the list and highlight typical top picks.
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What can I take instead of escitalopram?
Escitalopram is better known by its brand name, Lexapro. The drug belongs to the well-regarded selective serotonin reuptake inhibitor (SSRI) class of antidepressants. By increasing the amount of serotonin in the synapse between brain cells, major depression or anxiety symptoms can hopefully be alleviated. If it does not work out, trying another SSRI could be worthwhile.
Beyond SSRIs, there are a number of options you might be interested in. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are often the next choice, offering the potential to increase synaptic levels of two neurotransmitters in the brain. In other circumstances, atypical antidepressants and serotonin modulators are two other options that could make sense. Antipsychotics are sometimes called upon for the treatment of depression, most often to augment the effects of antidepressants. Older antidepressant medications like tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are still in use, too. For anxiety alone, buspirone or a benzodiazepine can be considered. Of course, you want to know more than just the available drug classes, so let’s get to it.
| Compare escitalopram alternatives | |||
|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Lexapro (escitalopram) | $564 for 30, 10 mg tablets | $9 for 30, 10 mg tablets of generic escitalopram at Kroger | See latest prices |
| Zoloft | $544 for 30, 50 mg tablets | $9 for 30, 50 mg tablets of generic sertraline at Kroger | See latest prices |
| Celexa (citalopram) | $407 for 30, 20 mg tablets | $6 for 30, 20 mg tablets of generic citalopram at Kroger | See latest prices |
| Fluoxetine | $68 for 30, 20 mg capsules | $6 for 30, 20 mg capsules of generic fluoxetine at Kroger | See latest prices |
| Paxil | $756 for 30, 20 mg tablets | $4 for 30, 20 mg tablets of generic paroxetine at Walmart | See latest prices |
| Viibryd | $434 for 30, 40 mg tablets | $36 for 30, 40 mg tablets of generic vilazodone at CVS Pharmacy | See latest prices |
| Duloxetine | $229 for 30, 60 mg capsules | $8 for 30, 60 mg capsules of generic duloxetine at Kroger | See latest prices |
| Effexor XR (venlafaxine extended-release) | $779 for 30, 150 mg capsules | $6 for 30, 150 mg capsules of generic venlafaxine ER at Kroger | See latest prices |
| Pristiq (desvenlafaxine ER) | $543 for 30, 100 mg extended-release tablets | $18 for 30, 100 mg tablets of generic desvenlafaxine ER at Kroger | See latest prices |
| Wellbutrin XL | $3,650 for 30, 300 mg tablets | $9 for 30, 300 mg tablets of generic bupropion ER at Kroger | See latest prices |
| Remeron | $246 for 30, 15 mg tablets | $9 for 30, 15 mg tablets of generic mirtazapine at Kroger | See latest prices |
| Trazodone | $38 for 30, 50 mg tablets | $6 for 30, 50 mg tablets of generic trazodone at Kroger | See latest prices |
| Trintellix
(vortioxetine) |
$677 for 30, 20 mg tablets | $466 for 30, 20 mg tablets of brand-name Trintellix at Kroger | See latest prices |
| Amitriptyline | $27 for 30, 25 mg tablets | $4 for 30, 25 mg tablets of generic amitriptyline at Walmart | See latest prices |
| Zyprexa (olanzapine) | $639 for 30, 5 mg tablets | $13 for 30, 5 mg tablets of generic olanzapine at Kroger | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices available at the time of publication in ZIP code 23666 as of December 21, 2025. The listed price, without insurance, refers to the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.
Top 5 escitalopram alternatives
The following are some of the most common alternatives to escitalopram.
1. Zoloft (sertraline)
If escitalopram has been ineffective, it does not necessarily mean that another SSRI like Zoloft will not help. Celexa (citalopram), generic Prozac (fluoxetine), Paxil (paroxetine, and Viibryd (vilazodone) are other SSRIs. In fact, clinical studies have shown that changing to a different SSRI may have just as much chance of success as changing to a different category. Sertraline is also FDA-approved for other mental health conditions, including panic disorder, social anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). If these are relevant diagnoses, switching to sertraline or another SSRI may help. Sertraline may avoid the potential for QT-prolongation—a change in electrical conduction in the heart that could be problematic with some other SSRIs, such as citalopram and escitalopram. It does not avoid other common adverse effects of SSRIs, such as weight gain and sexual dysfunction.
RELATED: Zoloft side effects: What to expect in the first week of taking Zoloft
2. Duloxetine
SNRIs, such as duloxetine, Effexor XR (venlafaxine ER), and Pristiq (desvenlafaxine ER), offer some potential additional benefits over SSRIs, like escitalopram. The Food and Drug Administration (FDA) has approved duloxetine for other health conditions besides depression or anxiety, including diabetic neuropathy pain, fibromyalgia, and chronic musculoskeletal pain. If you have another of these health conditions in addition to depression or anxiety, then there is a possibility of getting dual benefits.
3. Effexor XR (venlafaxine ER)
Over half of people with chronic daily headaches have depression, demonstrating how commonly comorbid these conditions are. The SNRI Effexor XR may provide both relief of depression symptoms and prevention of migraine. Effexor XR can be used off-label for migraine headache prophylaxis at times.
4. Wellbutrin XL (bupropion ER)
Sexual dysfunction can plague users of SSRIs like escitalopram. Reduced libido, difficulty achieving orgasm, and erectile dysfunction can all be problems. Weight gain is another concern associated with SSRIs. Wellbutrin XL is a norepinephrine and dopamine reuptake inhibitor, so it bolsters synaptic levels of these neurotransmitters in the brain. Based on its ability to avoid sexual side effects and weight gain, Wellbutrin XL may be a good pick if these adverse effects are compelling you to change meds.
5. Remeron (mirtazapine)
Remeron is a tetracyclic antidepressant that is an option if changing antidepressant categories away from SSRIs makes sense. When it is chosen, it is usually because of its side effects, namely sedation and increased appetite. These effects can be beneficial for individuals who have insomnia and those seeking weight loss.
Over-the-counter depression or anxiety medications
There are no effective over-the-counter medications for clinical depression or anxiety. However, some dietary and herbal supplements may help improve mood. Some limited evidence exists for using carnitine, creatinine, glycyrrhizic acid, omega-3 fatty acids, and zinc, mostly as adjuncts added to antidepressants. St. John’s Wort is an herbal drug for depression with proof to back it, but unfortunately, the lack of standardization in potency has led the American Psychiatric Association (APA) guidelines to caution against it. You should be aware that St. John’s Wort and other supplements can have important drug interactions with other medications, so be sure to check with your healthcare provider for medical advice before starting or stopping any OTC remedy. Remember: these over-the-counter remedies might help with temporary mood changes or boost antidepressant or anxiolytic treatment, but they are not sufficient to resolve major depressive disorder or generalized anxiety.
Natural alternatives to escitalopram
Antidepressants are effective and often necessary for treating major depressive symptoms. Natural alternatives can help improve mood, but should not take the place of prescription medications in people diagnosed with major depressive disorder or generalized anxiety disorder. For people with either mental health condition, the most effective nonpharmaceutical treatment is cognitive behavioral therapy (CBT), a form of psychotherapy that helps people change the way they think and react. According to the APA guidelines, exercise also has some proof behind it, as well as diets high in omega-3 fats and tryptophan (e.g., fish, nuts, poultry, and whole grains). Light therapy has less support but still some interest and mention in the APA guidelines. Before adopting any natural method to improve your mood, consult a healthcare professional first.
How to switch to an escitalopram alternative
Getting an appointment with the healthcare professional prescribing your escitalopram is likely your next step in seeking new medication treatment. You have learned about the alternatives, and now you need to share your ideas. The provider will review your list of over-the-counter and prescription medications, as well as your health history, to avoid potential drug interactions and contraindications. Additionally, they will look for any compelling additional benefits that a new treatment choice could offer you. When the appointment is over, you should be able to walk out with a clear plan of action, whether that means continuing escitalopram, adding another agent, or switching to a different option.
Choosing the right path for depression treatment
Always consult with a doctor or other mental health professional about what types of drugs and treatments are best to resolve the symptoms of depression or anxiety. Medical management of depression doesn’t always work, particularly if other treatments such as psychotherapy or lifestyle changes are not also pursued. Common side effects of antidepressants can be a significant problem, leading many patients to quit taking their drugs. In fact, failure to comply with treatment is a common reason most people don’t get better. Always consult with a mental health professional about the drugs you’re taking, possible side effects, and any adjunctive therapies. Above all, be ready to invest time. Successful treatment of depression and anxiety takes months, so keep at it.