Think You Might Be Depressed? Take our self-quiz

Lexapro vs. Zoloft

Jill Johnson

Medically reviewed by Jill Johnson, DNP, APRN, FNP-BC

Written by Our Editorial Team

Last updated 11/7/2021

These days, there are a wide array of medications available that treat depression and anxiety. Flip through a magazine or watch television and you’re bound to see multiple ads for various options. 

Two of those options? Lexapro and Zoloft. Chances are, you’ve heard of both; they’re quite popular in anxiety and depression treatment. 

And while Zoloft and Lexapro share a number of similarities, they also have some differences. 

If you are dealing with a mental health condition like a depressive disorder or anxiety disorder, a healthcare professional will be able to tell you if either medication may be right for you. 

But if you’re curious to learn a bit more about Lexapro vs. Zoloft, keep reading. 

What to Know about Depression and Anxiety

Before diving into Lexapro and Zoloft, it’s helpful to know a bit about the disorders they treat. Both medications are most often prescribed to help with depression and anxiety.

A Word on Depression

Data from the 2017 National Survey on Drug Use and Health revealed that more than 19.4 million adults in the United States experienced at least one major depressive episode during the previous year.

Of course, depression isn’t a one-size-fits-all mood disorder, and it can vary in severity. Some may experience mild depression while others could have a severe case that lasts for years. 

One thing that is the same with depression: The disorder is often linked to low levels of certain neurotransmitters in your brain. (Neurotransmitters are chemicals that relay info between neurons.) 

Neurotransmitters thought to be connected to depression include:

  • Serotonin. This one is to thank for regulating your mood, appetite and sleep. It also helps inhibit pain. There is some research that suggests that many with depression have lower serotonin levels.

  • Norepinephrine. Also called noradrenaline, this neurotransmitter boosts your blood pressure and constricts your blood vessels. It’s also connected to feelings of motivation and reward. Norepinephrine has been shown to relate to the development of depression and anxiety.

  • Dopamine. You’ve probably heard of this one, as it can make you feel happy and affect how you perceive reality. It’s also released into your system when you expect a reward.

  • Acetylcholine. This neurotransmitter can boost memory and aids in learning. It also activates muscles and helps you focus on tasks. 

  • Gamma-aminobutyric acid (GABA). This limits certain types of brain activity.According to studies, people with depression and some anxiety disorders may have reduced levels of this neurotransmitter.

Many medications for depression, including Lexapro and Zoloft, increase levels of specific neurotransmitters to address depression.

But neurotransmitters aren’t the only thing involved in depression. Factors like nerve circuit functioning, nerve cell growth and nerve cell connections may also play a role.

Understanding Anxiety

Everyone feels anxious sometimes. Getting a case of the nerves before a blind date or when you have to present at a big meeting is totally normal. 

But if your anxiety is more frequent, it could be a sign of an anxiety disorder. 

The Anxiety and Depression Association of America says that if you feel anxiety more often than not over a six month period, you may be dealing with Generalized Anxiety Disorder (GAD). 

People with GAD may feel physical anxiety symptoms like an increased heart rate or shortness of breath.

But GAD isn’t the only anxiety disorder. Other types include obsessive compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder.

online counseling

the best way to try counseling

A Primer on Lexapro

Lexapro (along with its generic version, escitalopram) is an FDA-approved medication used to treat major depressive disorder (MDD) and generalized anxiety disorder. 

It is also prescribed off-label to treat OCD, eating disorders like bulimia nervosa, panic disorder, (PTSD and premenstrual dysphoric disorder (PMDD). 

Lexapro is in a medication class called selective serotonin reuptake inhibitors (SSRIs). These types of medications work by increasing the levels of serotonin in your brain, which helps  improve your mood. 

Lexapro comes in tablets and a liquid solution and is available in dosages from 1mg to 20 mg. A healthcare professional will work with you to determine the right dosage for you.

A healthcare provider might start you on a lower dose and then increase your dosage slowly as needed. 

You’ll need to take Lexapro at the same time of day and it can be taken with or without food.

A Primer on Zoloft

Zoloft (or the generic version sertraline) is also an SSRI

It’s also quite popular — with more than 30 million prescriptions written for it each year in the U.S. 

Like Lexapro, Zoloft is used to treat depression. In addition, it’s often prescribed to help treat a variety of anxiety disorders, like generalized anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorder and panic attacks. 

Sometimes Zoloft is also prescribed off-label to treat premature ejaculation.

Zoloft, like Lexapro, comes in both a tablet form and liquid solution, and requires a prescription. 

It comes in doses that range from 25mg to 200mg and takes about a month of daily use before you might notice it working. 

Side Effects of Lexapro and Zoloft

Because both Lexapro and Zoloft are SSRIs, they can cause many of the same side effects. 

The most common mild side effects of SSRIs include:

  • Nausea

  • Tiredness

  • Weakness

  • Dizziness

  • Trouble sleeping

  • Dry mouth

  • Diarrhea 

  • Loss of appetite 

  • Sexual side effects (like low sex drive)

More severe SSRI side effects include:

  • Seizures 

  • Allergic reactions

  • Manic episodes

  • Abnormal bleeding

  • Serotonin syndrome (which can involve confusion, shivering, agitation, rapid heart rate, elevated blood pressure, dilated pupils and muscle rigidity and twitching.) 

Along with seizures and serotonin syndrome, there is another serious side effect you should know about: Both Lexapro and Zoloft come with an FDA Black Box warning. 

These warnings are required by the FDA because, although rare, severe side effects like risk of suicide or suicidal thoughts can occur.

It’s important to note that you should never suddenly stop taking Lexapro or Zoloft. Doing so can cause withdrawal symptoms and adverse effects.

Instead, consult your healthcare provider about a plan to safely wean off either medication if that is warranted. 

Also important: Before starting either one of these medications to treat depression, you should let your healthcare provider know if you are taking anything else (such as blood thinners), as there are potential drug interactions that can be dangerous. 

It’s also important to disclose any medical conditions you may have.

online psychiatry

it’s never been easier to talk to a psychiatry provider about treatments

Lexapro vs. Zoloft: Which Is Right for You?

Both Lexapro and Zoloft are commonly prescribed medications to help treat depressive disorder or one of the various types of anxiety disorders. 

They are in a class of medications called SSRIs, which work by increasing serotonin production in the brain.

Both are considered antidepressant and anxiolytic medications, and come in tablet or liquid form. 

Zoloft is generally prescribed in higher doses than Lexapro. 

Because both medications are SSRIs, they can cause similar common side effects. 

Mild side effects include things like dry mouth and loss of appetite, while severe side effects include allergic reactions, manic episodes and more. 

You’ll need to consult with a healthcare professional before taking either of these medications, and let your provider know about any medical conditions you have or other medications you’re taking. Both Lexapro and Zoloft can have negative drug interactions with other meds. 

As far as Lexapro vs. Zoloft and which one might be best for you: Consult with an online psychiatrist. They’ll be able to walk you through which medication can best help you. 

14 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Major Depression. (2019, February). Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml
  2. Hyman, S.E. (2005, March 8). Neurotransmitters. Current Biology. 15 (5), PR154-R158. Retrieved from https://www.cell.com/current-biology/comments/S0960-9822(05)00208-3
  3. What causes depression? (2019, June 24). Retrieved from https://www.health.harvard.edu/mind-and-mood/what-causes-depression
  4. Higley, M.J. & Picciotto, M.R. (2014, December). Neuromodulation by Acetylcholine: Examples from Schizophrenia and Depression. Current Opinion in Neurobiology. 29, 88–95. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268065/
  5. Luscher, B., Shen, Q. & Sahir, N. (2011, April). The GABAergic Deficit Hypothesis of Major Depressive Disorder. Molecular Psychiatry. 16 (4), 383–406. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412149/
  6. Generalized Anxiety Disorder (GAD). Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
  7. What are the five types of anxiety disorders? U.S. Department of Health and Human Services. Retrieved from https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html
  8. Escitalopram (Lexapro). National Alliance of Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro)
  9. Overview Selective serotonin reuptake inhibitors (SSRIs). NHS. Retrieved from https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/overview/
  10. Sertraline. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a697048.html
  11. Number of sertraline hydrochloride prescriptions in the U.S. from 2004 to 2018. Statista. Retrieved from https://www.statista.com/statistics/781658/sertraline-hydrochloride-prescriptions-number-in-the-us/
  12. Arafa, M., Shamloul, R., (2006, March 23). Efficacy of sertraline hydrochloride in treatment of premature ejaculation: a placebo-controlled study using a validated questionnaire. International Journal of Impotence Research, 18: 534-538. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16554853/
  13. Sertraline. NHS. Retrieved from https://www.nhs.uk/medicines/sertraline/#:~:text=Sertraline%20is%20one%20of%20a,called%20serotonin%20in%20the%20brain.
  14. Side Effects Selective Serotonin Reuptake Inhibitors (SSRIs). NHS. Retrieved from https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/side-effects/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

📫 Get updates from hims

Insider tips, early access and more.