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Drug vs. Drug

Lexapro vs. Zoloft: Differences and similarities explained

Lexapro and Zoloft are SSRIs, but they work differently and have different indications
Karen Berger medical writer and reviewer headshot
By | Updated on Jul. 22, 2025 Medically reviewed by Chad Shaffer, MD & Karen Berger, Pharm.D.
Two Rx tablets: Lexapro vs. Zoloft drug comparison

Key takeaways

  • Lexapro (escitalopram) and Zoloft (sertraline) are SSRI antidepressants used to treat depression and anxiety. Zoloft also treats other conditions such as OCD, PTSD, and social anxiety disorder.

  • Common side effects of both drugs include nausea, tiredness, and sexual problems. Serious side effects are less rare but may include serotonin syndrome, suicidal thoughts, and allergic reactions.

  • Choosing between Lexapro and Zoloft depends on your specific medical needs and conditions. Consult your healthcare provider for medical advice for your condition and treatment.

In this article:

Lexapro and Zoloft are two brand-name medications used to treat depression and other mental health conditions. They are part of a group of drugs called selective serotonin reuptake inhibitors, or SSRIs. They work by increasing the amount of a chemical in the brain, serotonin, that regulates mood. Although both medicines are antidepressants, they are not exactly the same. The table below outlines some key information about Lexapro and Zoloft.

Compare Lexapro vs. Zoloft key differences
Lexapro Zoloft
Drug class Selective serotonin reuptake inhibitor (SSRI) Selective serotonin reuptake inhibitor (SSRI)
Brand/generic status Brand and generic Brand and generic
What is the generic name? Escitalopram Sertraline 
What form(s) does the drug come in? Oral tablet: 5 mg, 10 mg, 20 mg

Oral solution: 5 mg/5 mL

 Oral tablet: 25 mg, 50 mg, 100 mg

Oral solution: 20 mg/1 mL

Oral capsule: 150 mg, 200 mg 
What is the standard dosage? Adults: 10 or 20 mg by mouth once daily

Pediatric patients: varies by age and use

 Adults: 25 to 200 mg by mouth once daily

Pediatric patients: varies by age and use
How long is the typical treatment? Long-term  Long-term 
Who typically uses the medication? Adults and pediatric patients 7 years and older (anxiety)

Adults and pediatric patients 12 years and older (depression)

 Adults and pediatric patients 6 years and older (OCD) 

Adults (all other uses)

 

Lexapro contains the active ingredient escitalopram, which is also the generic version. It is approved by the FDA to treat anxiety (also known as generalized anxiety disorder, or GAD) and depression (also known as major depressive disorder, or MDD). Lexapro is sometimes prescribed off-label (for a non-FDA-approved use) for conditions such as panic disorder, social anxiety disorder, and irritability associated with autism. 

Zoloft’s active ingredient is sertraline, which is also available in generic form. It is FDA approved to treat MDD, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). Zoloft is sometimes prescribed off-label for other reasons, such as separation anxiety, hot flashes, premature ejaculation, and binge eating disorder. 

Compare Lexapro vs. Zoloft conditions treated
Condition Lexapro Zoloft
Anxiety (generalized) Yes  Off-label 
Depression  Yes  Yes 
OCD Off-label  Yes 
Panic disorder Off-label  Yes 
Social anxiety disorder Off-label  Yes 
PTSD Off-label Yes 
PMDD No  Yes 

Is Zoloft better than Lexapro?

One can’t say which drug is technically better, especially since they have some different FDA-approved uses. Both drugs are popularly prescribed—in 2022, generic Lexapro was the 15th most popular drug prescribed, and generic Zoloft was the 11th. 

A review of studies published in The Lancet in 2018 looked at 21 different antidepressants. All antidepressants were found to be more effective than placebo (a pill that does not contain active medicine). In terms of Zoloft and Lexapro specifically, Lexapro was considered to be one of the more effective antidepressants. Both Zoloft and Lexapro were considered to be among the better-tolerated antidepressants. 

However, various studies have found different results, and people often have unique experiences with medications. Some individuals prefer Zoloft, while others find Lexapro works better for them. The best way to determine which treatment is most suitable for you is to consult with your healthcare provider. They can give you individualized medical advice based on considerations such as your symptoms, medical conditions, and medical and family history.

Lexapro vs. Zoloft: Insurance coverage and cost comparison

Commercial insurance plans, Medicare prescription plans, and Medicaid plans often cover these drugs in their generic forms. If you would prefer the brand name, your insurance may charge a higher price, or may not provide coverage for the brand. You can check with your specific plan for the most up-to-date coverage and cost information. 

If you are paying out of pocket, a one-month supply of brand-name Lexapro costs about $550. You can switch to generic escitalopram, though, and apply a SingleCare coupon to pay as low as $9. 

If you are paying without insurance for brand-name Zoloft, a one-month supply would cost about $502. But switching to generic sertraline and using a SingleCare coupon can bring the price down to as low as $9.

Compare Lexapro vs. Zoloft cost and coverage
Lexapro Zoloft
Typically covered by insurance? Generic usually covered; brand name coverage varies by plan Generic usually covered; brand name coverage varies by plan
Typically covered by Medicare Part D? Generic usually covered; brand name coverage varies by plan Generic usually covered; brand name coverage varies by plan
Typically covered by Medicaid? Generic usually covered; brand name coverage varies by plan and by state Generic usually covered; brand name coverage varies by plan and by state
Quantity 30, 10 mg tablets 30, 50 mg tablets
SingleCare cost* $9 $9
*Cost at time of publication. Drug prices fluctuate and vary by pharmacy and location.

Zoloft vs. Lexapro side effects

If you are considering taking Zoloft or Lexapro, you’ll want to know what kind of side effects to expect. With Zoloft, common side effects may include fatigue, appetite loss, nausea, diarrhea, sweating, shaking, sexual problems, and changes in sleep habits. Lexapro’s common side effects include tiredness, nausea, sweating, sexual problems, and trouble sleeping. 

In rare cases, Zoloft or Lexapro can cause an allergic reaction. Get emergency medical help if you have hives, trouble breathing, or swelling around the face, lips, tongue, or throat. 

Other serious side effects can occur with either drug, but are not common. These include hyponatremia (low sodium levels), seizures, serotonin syndrome, increased risk of bleeding, sexual problems, and vision problems. Both drugs have a black box warning about suicidal thoughts and behaviors. 

Another important consideration is that you should not stop taking Zoloft or Lexapro abruptly—doing so can cause withdrawal symptoms. If you are taking one of these medicines and wish to stop, consult your healthcare provider. They can give you a schedule so that you can slowly and safely taper off the medicine. 

You can talk with your healthcare provider about the possible side effects of Zoloft and Lexapro, as this is not a full list of every possible side effect.

Lexapro and Zoloft drug interactions and warnings

Lexapro and Zoloft are both SSRIs, and have many of the same drug interactions, such as: 

  • Monoamine oxidase inhibitors (MAOIs), which should not be taken with an SSRI
  • Other drugs that can increase serotonin levels (which could result in serotonin syndrome), such as other SSRIs, SNRIs, tricyclic antidepressants, opioid pain medicines, triptans for migraine, the cough suppressant dextromethorphan, and the supplement St. John’s wort
  • Drugs that increase the risk of bleeding, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners 

This is not a full list of drug interactions, so be sure to tell your healthcare provider about all the medicines you take—including Rx and OTC drugs, vitamins, and supplements. Your provider can check for drug interactions.  

You should also tell your healthcare provider about any medical conditions you have, including seizures, mental health conditions, bleeding problems, glaucoma, low sodium levels, liver, kidney, or heart problems, high blood pressure, or if you are pregnant or breastfeeding. 

The prescribing information for Lexapro and for Zoloft note that these medicines can harm an unborn baby, especially later in pregnancy. However, untreated depression has risks, too. Consult your healthcare provider for medical advice if you are pregnant or planning to become pregnant. If you are breastfeeding, talk with your healthcare provider before taking Lexapro or Zoloft. 

Choosing between Lexapro and Zoloft can involve various considerations. Your healthcare provider can consider your medical conditions and medical history to help you find the best treatment for you.