Lexapro vs. Zoloft: Drug Comparison

Lexapro (escitalopram) and Zoloft (sertraline) are two prescription medications that treat mood disorders. They are selective serotonin reuptake inhibitors (SSRIs), which increase the serotonin levels in the brain. While these two medications are similar, some differences are important to note.

This article will cover how Zoloft and Lexapro work and their side effects. It will also discuss conditions that these medications treat.

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Zoloft is used to treat several mental health conditions. It is in the SSRI class and blocks serotonin reuptake, causing an accumulation of serotonin in the brain.

Serotonin regulates mood, personality, and wakefulness in the central nervous system (CNS), made up of the brain and spinal cord. By blocking its reuptake and allowing for more serotonin in the brain, Zoloft can benefit certain conditions like depression.


Zoloft is approved to treat multiple conditions, including:


Zoloft commonly causes insomnia, so it is typically recommended to take it in the morning. Drowsiness occurs less commonly.

For major depressive disorder, the dose starts at 50 milligrams (mg) and can be increased to 200 mg. Other conditions start at 25 mg or 50 mg and can be as high as 200 mg.

The dosage for Zoloft varies from person to person. The dose is based on several factors, including the condition being treated, symptoms, and other medical conditions the person may have. Follow the prescribing provider's instructions on the dosage and refer to the medication label as well.


Lexapro is a prescription medication that is used to treat anxiety and depression. It is an SSRI and increases serotonin levels in the brain. The conditions, dosage, and effectiveness are discussed below.


Lexapro is indicated to treat the following conditions:


Lexapro is typically taken once per day in the morning or evening.

The dosage ranges from 10 mg to 20 mg. The dose will vary from person to person based on their diagnosis and the healthcare provider's recommendations. Follow the instructions given by the healthcare provider.


A 2017 study found that after 24 weeks on Lexapro, there was an improvement in participants' depression, anxiety, and quality of life.

Lexapro is effective in treating depression in both adolescents and adults.

Do Lexapro and Zoloft Work the Same?

Lexapro and Zoloft work in very similar ways. They are both in the SSRI class of drugs and increase serotonin in the brain. Serotonin is a neurotransmitter, a chemical messenger carrying signals between brain nerve cells (neurons). SSRIs like Lexapro and Zoloft block the serotonin from reabsorbing, allowing more serotonin to be available in the brain.

Lexapro and Zoloft Use in Adolescents

Zoloft and Lexapro are very similar medications with one key difference: their approval by the Food and Drug Administration (FDA) for use in adolescents. Zoloft is not approved to treat depression in adolescents, while Lexapro is approved to treat depression in people 12 years old and over. Zoloft is approved to treat OCD in people 6 years and older.

Side Effects

Since Lexapro and Zoloft are both SSRIs, they have similar side effects. Gastrointestinal (GI, involving the stomach and intestines) side effects are the most common. Below is a list of the common side effects:

  • Nausea
  • Diarrhea
  • Insomnia
  • Dry mouth
  • Sweating
  • Sexual changes (ejaculation failure, decreased libido)
  • Tremor

It's important to talk to a healthcare provider when side effects occur. They may change the medication and its dose or suggest ways to improve the side effects.

Drug Interactions and Warnings

SSRIs like Zoloft and Lexapro may decrease the body's ability to form clots and increase bleeding risk.

People need to be aware of this, especially if they are also on anticoagulants or blood thinners that increase bleeding risk, like Jantoven (warfarin), or aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).

People on Zoloft and Lexapro should not stop the medication abruptly. People on these medications need to be gradually weaned off. Stopping abruptly can lead to side effects such as:

  • Nausea
  • Sweating
  • Dysphoric mood
  • Irritability

Some medications—when taken with Zoloft or Lexapro—can increase the risk of certain conditions. Always have a current list of medications available so a healthcare provider can cross-reference when starting something new.

These medications also have a risk of suicidal thoughts and behaviors in children and young adults.

How Does Lexapro Differ from Zoloft?

Two major differences between Lexapro and Zoloft are their uses for anxiety and the ages they're approved for.

In addition to treating anxiety and depression, only Zoloft is also approved to treat:

Another key difference is that Zoloft is not approved to treat depression in adolescents, and Lexapro is approved to treat depression in people ages 12 years old and older. Zoloft is approved to treat OCD in children 6 years and older.

Talking to Your Healthcare Provider

Lexapro and Zoloft are two medications that are effective at treating certain mental health conditions. However, medication is not the only method for treating mental health conditions. Talk to your healthcare provider about the best way to manage symptoms.


Zoloft and Lexapro are prescription medications from the class of SSRIs. These medications are approved to treat several mental health conditions, including depression and anxiety.

As with most medications, people must be aware of potential side effects and drug interactions. Always talk to a healthcare provider before starting a new medication to ensure it is safe for your situation.

Frequently Asked Questions

  • Which has fewer side effects Zoloft or Lexapro?

    Zoloft and Lexapro both have similar side effects, and the amount of side effects will vary from person to person based on their diagnosis and dosage.

  • What is better, Zoloft or Lexapro?

    Zoloft is approved to be used for more mental health conditions. However, that does not mean it is better than Lexapro. Only a healthcare provider can decide which one is right for you.

  • Should I switch from Lexapro to Zoloft?

    Talk to your healthcare provider about your concerns. There may be reasons to switch from one medication to another, but they need to be evaluated first. Always make sure you slowly wean off Lexapro or Zoloft. Do not abruptly stop.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food & Drug Administration. Zoloft (sertraline hydrochloride) label.

  2. U.S. Food & Drug Administration. Lexapro (escitalopram oxalate) label.

  3. Jiang K, Li L, Wang X, et al. Efficacy and tolerability of escitalopram in treatment of major depressive disorder with anxiety symptoms: a 24-week, open-label, prospective study in Chinese populationNeuropsychiatr Dis Treat. 2017;13:515-526. doi:10.2147/NDT.S120190

  4. MedlinePlus. Antidepressants.

By Patty Weasler, RN, BSN
Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.