Lexapro vs. Zoloft: Differences and similarities explained

In this article:

• Lexapro vs. Zoloft: Which is better?
• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Drug interactions

In this article

• Lexapro vs. Zoloft: Which is better?
• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Drug interactions

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. 

Lexapro vs. Zoloft: Which is better?

Neither medication is universally better, but clinical guidelines and patient experience suggest different benefits for each drug. They’re both effective antidepressants, and the best choice depends on symptoms, side effects, and individual response. However, there are situations when one may be preferred over the other. 

A review of studies published in The Lancet in 2018 looked at 21 different antidepressants. All antidepressants were found to be more effective than a 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.

The table below outlines some key information about Lexapro and Zoloft.

Lexapro vs. Zoloft: Key differences
Difference/Similarity	Lexapro	Zoloft
Drug class	Selective serotonin reuptake inhibitor (SSRI)	Selective serotonin reuptake inhibitor (SSRI)
Brand/generic status	Brand and generic available	Brand and generic available
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. 

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

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 $565 for 30, 10 mg tablets. 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 $548 for 30, 50 mg tablets. But switching to generic sertraline and using a SingleCare coupon can bring the price down to as low as $9.

Lexapro vs. Zoloft: cost and insurance coverage comparison
	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 at Kroger	$9 at Kroger

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of Jan. 22, 2026. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.

Lexapro vs. Zoloft: 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. 

RELATED: Zoloft side effects to expect in the first week

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. 

RELATED: Zoloft side effects in men and how to avoid them

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

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 Zoloft notes 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. 

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jan. 22, 2026. Prices vary by pharmacy. Check Lexapro and Zoloft prices at pharmacies near you.