Drug vs. Drug

Lexapro vs Xanax: Main Differences and Similarities

SingleCare Logo for author page By | April 3, 2019

Lexapro (escitalopram) and Xanax (alprazolam) are prescription medications that can treat anxiety disorders. While they both treat similar conditions, both medications work in different ways. Lexapro is a selective serotonin reuptake inhibitor (SSRI) and Xanax is a benzodiazepine that can produce different effects. Their similarities and differences will be explored further here.

Lexapro

Lexapro is the brand name for escitalopram. It works as an SSRI antidepressant which alters the availability of serotonin in the brain. Lexapro is FDA approved for depression and anxiety disorders.

Lexapro comes as an oral tablet in strengths of 5 mg, 10 mg, or 20 mg. It is usually started as 10 mg once daily with a maximum of 20 mg per day. As an SSRI, Lexapro may take 1 to 4 weeks to start improving anxiety and depression.

Lexapro should be monitored in those with kidney or liver problems. It should not be used with other drugs that can increase serotonin levels. This is because there is an increased risk of serotonin syndrome which may require prompt medical attention.

Xanax

Xanax is also known by its generic name, alprazolam. As a benzodiazepine, its exact mechanism of action is unknown. However, its binding with GABA receptors produces inhibitory effects to slow down activity in the brain. Xanax is FDA approved for anxiety and panic disorders.

Xanax can be taken as an oral tablet with strengths of 0.25 mg, 0.5 mg, 1 mg, and 2 mg. An extended-release tablet, orally disintegrating tablet, and oral solution are also available. It is usually taken multiple times throughout the day depending on your doctor’s prescription.

Like Lexapro, Xanax may need to be monitored in those with liver and kidney problems. Because it is primarily metabolized in the liver, it should not be taken with other drugs that can affect certain liver enzymes.

Lexapro vs Xanax Side by Side Comparison

Lexapro and Xanax are different drugs that can produce similar effects. Their similarities and differences are outlined below.

Lexapro Xanax
Prescribed For
  • Major Depressive Disorder (MDD)
  • Generalized Anxiety Disorder (GAD)
  • Generalized Anxiety Disorder (GAD)
  • Panic Disorder
Drug Classification
  • Selective Serotonin Reuptake Inhibitor (SSRI)
  • Benzodiazepine
Manufacturer
Common Side Effects
  • Insomnia
  • Nausea
  • Increased sweating
  • Fatigue
  • Somnolence
  • Decreased libido
  • Ejaculation Disorder
  • Anorgasmia
  • Dizziness
  • Headache
  • Indigestion
  • Agitation
  • Shaking
  • Diarrhea
  • Confusion
  • Drowsiness
  • Lightheadedness
  • Constipation
  • Restlessness
  • Extreme fatigue
  • Slow heartbeat
  • Trouble breathing
  • Changes in appetite or weight
Is there a generic?
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Oral solution
  • Oral tablet
  • Oral concentrate
  • Oral tablet, extended release
  • Oral tablet, orally disintegrating
Average Cash Price
  • $379 per 30 tablets
  • $42.89 per 90 tablets
SingleCare Discount Price
Drug Interactions
  • MAO inhibitors
  • Tricyclic antidepressants
  • Other SSRIs
  • SNRIs
  • Triptans
  • NSAIDs
  • Amphetamines
  • Pimozide
  • Amiodarone
  • Fentanyl
  • Lithium
  • Tramadol
  • Buspirone
  • St. John’s Wort
  • Aspirin
  • Warfarin
  • Cimetidine
  • Ginkgo
  • Lamotrigine
  • Phenytoin
  • Carbamazepine
  • Zolpidem
  • Ketoconazole
  • Itraconazole
  • Clarithromycin
  • Cimetidine
  • Cyclosporine
  • Desipramine
  • Diltiazem
  • Ergotamine
  • Erythromycin
  • Fluconazole
  • Fluoxetine
  • Fluvoxamine
  • Imipramine
  • Nefazodone
  • Nicardipine
  • Nifedipine
  • Sertraline
  • Theophylline
  • Birth control pills
  • Seizure medications
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Lexapro is Pregnancy Category C. Animal studies have shown adverse effects to the fetus. Adequate studies have not been performed in humans. Lexapro is not expected to harm breastfed infants. Consult a doctor regarding steps to take while pregnant and breastfeeding.
  • Xanax is in Pregnancy Category D. Therefore, it should not be taken during pregnancy. Consult a doctor regarding steps to take while planning pregnancy. Xanax should not be taken while breastfeeding.

Summary

Lexapro (escitalopram) and Xanax (alprazolam) are two medications that can treat anxiety associated with depression. Although they treat similar disorders, they affect different neurotransmitters in the brain. Lexapro is an SSRI that regulates serotonin while Xanax is a benzodiazepine that binds to GABA receptors.

Both drugs are not usually recommended for long-term use due to potential side effects. Xanax is a Schedule IV drug which means that it has a relatively high potential for abuse and dependence compared to Lexapro which is a Schedule V drug.

As a benzodiazepine, Xanax may produce more drowsiness and sedation compared to Lexapro. Xanax also produces effects within 1 to 2 hours of taking it. This is faster than Lexapro which might take 1 to 4 weeks to feel noticeable improvements.

Both Lexapro and Xanax should only be used with a prescription. Because of their potential side effects and drug interactions, it is important to discuss these medications with a doctor. One medication may be better than the other depending on your overall condition.