Table of ContentsView AllTable of ContentsDifferencesUsesContraindicationsSide EffectsDosageInteractions
Table of ContentsView All
View All
Table of Contents
Differences
Uses
Contraindications
Side Effects
Dosage
Interactions
Prozac contains the active ingredientfluoxetine, while Lexapro contains the active ingredientescitalopram. In addition to treating depression, both drugs can treat other mood disorders, includinganxiety.
This article will compare Prozac and Lexapro, including their uses and side effects. It also covers dosages, interactions, and how well they work,
Getty Images / Evgeniia Siiankovskaia.
Prozac vs. Lexapro: How Are They Different?
The FDA-approved uses of Prozac and Lexapro are described at follows:
ProzacMajor depressive disorder (MDD)Obsessive-compulsive disorder (OCD)Bulimia nervosaPanic disorderLexaproMajor depressive disorder (MDD)Generalized anxiety disorder (GAD)
ProzacMajor depressive disorder (MDD)Obsessive-compulsive disorder (OCD)Bulimia nervosaPanic disorder
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Bulimia nervosa
Panic disorder
LexaproMajor depressive disorder (MDD)Generalized anxiety disorder (GAD)
Generalized anxiety disorder (GAD)
Lexapro is sometimes used off-label to treat SAD, panic disorder, and irritability associated withautism.
What Are Selective Serotonin Reuptake Inhibitors (SSRIs)?
Which Drug Lasts Longer?
By comparison:
It’s important to note that it can take several weeks for either drug to reach a therapeutic concentration in your bloodstream and up to several months to feel the full effects of treatment.
Which Is More Effective?
SSRIs like Prozac or Lexapro are often the first medications used for depression as they are considered safe and effective. They are also better tolerated than other types of antidepressants.
With that said, there is no evidence that one antidepressant is inherently superior to another, including SSRIs. Arguably, the only differentiating factor is the discontinuation of treatment due to drug intolerability.
In this regard,selective serotonin and norepinephrine reuptake inhibitors (SNRIs)likeEffexor XR (venlafaxine)may be less effective than SSRIs like Prozac and Lexapro which have lower rates of treatment discontinuation.
With respect to SSRIs, a recent study in the journalHealthcarereported that Prozac, Lexapro, and an SSRI calledZoloft (sertraline)were equally effective in treating depression symptoms.
Healthcare providers will prescribe an antidepressant based on the drug’s safety profile along with your age, diagnosis, symptoms, medical history, and individual preferences.
How Do SSRIs Work?
Serotonin is a chemical messenger called aneurotransmitterinvolved in the elevation of moods, appetite, memory, and sexual desire.
SSRIs vs. SNRIs: Similarities and Differences
Who Shouldn’t Use Prozac or Lexapro?
Prozac or Lexapro have similar contraindications (meaning conditions in which the drugs should never be used). Absolute contraindications for Prozac and Lexapro include:
Prozac and Lexapro may used with caution with the following conditions if the benefits of treatment are seen to outweigh the risks:
If pregnant or breastfeeding, consult with your healthcare provider before taking Prozac or Lexapro to better understand the potential risks and benefits.
Taking Lexapro? Here’s What to Expect in the First Week
Common Side Effects of Prozac vs. Lexapro
As with all drugs, Prozac and Lexapro can cause side effects. The side effects tend to be milder than other classes of antidepressants but can still be significant enough to require a change in treatment.
Common side effects include:
ProzacAbnormal dreamsErectile dysfunctionLow sex driveLoss of appetiteAnxietyDry mouthNauseaWeaknessIndigestionFlu-like symptomsRashSinus infectionExcessive sweatingSleepinessTremorsLexaproTrouble sleepingErectile dysfunctionDelayed ejaculationLow sex driveAnorgasmia (inablity to orgasm)NauseaExcessive sweatingFatigueSleepiness
ProzacAbnormal dreamsErectile dysfunctionLow sex driveLoss of appetiteAnxietyDry mouthNauseaWeaknessIndigestionFlu-like symptomsRashSinus infectionExcessive sweatingSleepinessTremors
Abnormal dreams
Erectile dysfunction
Low sex drive
Loss of appetite
Anxiety
Dry mouth
Nausea
Weakness
Indigestion
Flu-like symptoms
Rash
Sinus infection
Excessive sweating
Sleepiness
Tremors
LexaproTrouble sleepingErectile dysfunctionDelayed ejaculationLow sex driveAnorgasmia (inablity to orgasm)NauseaExcessive sweatingFatigueSleepiness
Trouble sleeping
Delayed ejaculation
Anorgasmia (inablity to orgasm)
Fatigue
Severe Side Effects
While uncommon, Prozac and Lexapro can cause potentially serious side effects, including:
You can also experience withdrawal symptoms if the medicine is abruptly stopped.
Seek immediate medical treatment if you experience signs or symptoms of any of these medical conditions.
Boxed WarningAboxed warningis the FDA’s highest level of warning to consumers about the dangers of a drug. With SSRIs like Prozac and Lexapro, there is a risk ofsuicidal thoughts and behaviorsin children, adolescents, and young adults. People in these age groups should be closely monitored for any changes in behavior or mood while on treatment.
Boxed Warning
Aboxed warningis the FDA’s highest level of warning to consumers about the dangers of a drug. With SSRIs like Prozac and Lexapro, there is a risk ofsuicidal thoughts and behaviorsin children, adolescents, and young adults. People in these age groups should be closely monitored for any changes in behavior or mood while on treatment.
Lexapro: What to Expect in the First Week
Dosage: How to Take These Medications
Prozac is available as an oral tablet, capsule, and liquid solution for adults and children 7 years and older.Lexapro is available as a tablet and liquid solution for adults and children 12 years and older.Both can be taken with or without food.
For either medication, your healthcare provider will start at a lower dose and slowly increase the dose, if needed, to achieve the desired effect. If you need to stop taking Prozac or Lexapro, the dosage would be gradually tapered (decreased) to preventwithdrawal symptoms.
Prozac is prescribed in the following dosages in milligrams (mg):
Lexapro is prescribed in the following dosages in milligrams (mg):
Lexapro Recommended DosagesConditionAge groupDosageMaximum doseMajor depressive disorder (MDD)Adults10 mg once daily20 mg per dayChildren 12 to 1710 mg once daily20 mg per dayGeneralized anxiety disorder (GAD)Adults10 mg once daily10 mg per dayDrug Interactions: Prozac vs. LexaproProzac or Lexapro can interact with certain drugs. Some of these interactions can be significant. leading to increased side effects or reduced drug efficacy.Advise your healthcare provider if you take any of the following before starting treatment:MAOI antidepressantsTriptans (used to treat migraines)St. John’s wortAnticoagulants(blood thinners)Opioid drugs painDecongestantscontaining dextromethorphanAntibioticslike erythromycin or Zithromax (azithromycin)Nonsteroidal anti-inflammatories (NSAIDs), such as Advil (ibuprofen) or Aleve (naproxen)SNRI antidepressantsBenzodiazepinessuch as Xanax (alprazolam)Effexor XR vs. Lexapro: Similarities and DifferencesSummaryProzac and Lexapro are prescription drugs classified as SSRI antidepressants. Prozac is approved to treat major depressive disorder (MDD), obsessive-compulsive disorder (OCD). bulimia nervosa, and panic disorder. Lexapro is approved to treat MDD and generalized anxiety disorder (GAD).Prozac can be used in adults and children 7 years and over. Lexapro can be used in adults and children 12 and older. Both carry a black box warning advising consumers that the drugs may lead to suicidal thoughts and behaviors in some children, adolescents, teens, or young adults.
Drug Interactions: Prozac vs. Lexapro
Prozac or Lexapro can interact with certain drugs. Some of these interactions can be significant. leading to increased side effects or reduced drug efficacy.
Advise your healthcare provider if you take any of the following before starting treatment:
Effexor XR vs. Lexapro: Similarities and Differences
Summary
Prozac and Lexapro are prescription drugs classified as SSRI antidepressants. Prozac is approved to treat major depressive disorder (MDD), obsessive-compulsive disorder (OCD). bulimia nervosa, and panic disorder. Lexapro is approved to treat MDD and generalized anxiety disorder (GAD).
Prozac can be used in adults and children 7 years and over. Lexapro can be used in adults and children 12 and older. Both carry a black box warning advising consumers that the drugs may lead to suicidal thoughts and behaviors in some children, adolescents, teens, or young adults.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adjei K, Adunlin G, Ali AA.Impact of sertraline, fluoxetine, and escitalopram on psychological distress among United States adult outpatients with a major depressive disorder.Healthcare (Basel). 2023;11(5):740. doi:10.3390/healthcare11050740DailyMed.Prozac - fluoxetine hydrochloride capsule.DailyMed.Lexapro - escitalopram tablet, film coated. Lexapro - escitalopram solution.National Alliance on Mental Illness.Fluoxetine (Prozac).National Alliance on Mental Illness.Escitalopram (Lexapro).Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int.2021 Sep;13(3):387–401. doi:10.3390/neurolint13030038Buelt A, McQuaid JR.Comparing clinical guidelines for the management of major depressive disorder.Am Fam Physician. 2023;107(2):123-124.Kendrick T, Taylor D, Johnson CF.Which first-line antidepressant?Br J Gen Pract. 2019;69(680):114-115. doi:10.3399/bjgp19X701405Henssler J. Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C.Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis.Lancet Psychiat.2024 Jul;11(7):P526-535. doi:10.1016/S2215-0366(24)00133-0MedlinePlus.Antidepressants.Jones LA, Sun EW, Martin AM, Keating DJ.The ever-changing roles of serotonin.Int J Biochem Cell Biol. 2020;125:105776. doi:10.1016/j.biocel.2020.105776
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adjei K, Adunlin G, Ali AA.Impact of sertraline, fluoxetine, and escitalopram on psychological distress among United States adult outpatients with a major depressive disorder.Healthcare (Basel). 2023;11(5):740. doi:10.3390/healthcare11050740DailyMed.Prozac - fluoxetine hydrochloride capsule.DailyMed.Lexapro - escitalopram tablet, film coated. Lexapro - escitalopram solution.National Alliance on Mental Illness.Fluoxetine (Prozac).National Alliance on Mental Illness.Escitalopram (Lexapro).Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int.2021 Sep;13(3):387–401. doi:10.3390/neurolint13030038Buelt A, McQuaid JR.Comparing clinical guidelines for the management of major depressive disorder.Am Fam Physician. 2023;107(2):123-124.Kendrick T, Taylor D, Johnson CF.Which first-line antidepressant?Br J Gen Pract. 2019;69(680):114-115. doi:10.3399/bjgp19X701405Henssler J. Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C.Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis.Lancet Psychiat.2024 Jul;11(7):P526-535. doi:10.1016/S2215-0366(24)00133-0MedlinePlus.Antidepressants.Jones LA, Sun EW, Martin AM, Keating DJ.The ever-changing roles of serotonin.Int J Biochem Cell Biol. 2020;125:105776. doi:10.1016/j.biocel.2020.105776
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Adjei K, Adunlin G, Ali AA.Impact of sertraline, fluoxetine, and escitalopram on psychological distress among United States adult outpatients with a major depressive disorder.Healthcare (Basel). 2023;11(5):740. doi:10.3390/healthcare11050740DailyMed.Prozac - fluoxetine hydrochloride capsule.DailyMed.Lexapro - escitalopram tablet, film coated. Lexapro - escitalopram solution.National Alliance on Mental Illness.Fluoxetine (Prozac).National Alliance on Mental Illness.Escitalopram (Lexapro).Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int.2021 Sep;13(3):387–401. doi:10.3390/neurolint13030038Buelt A, McQuaid JR.Comparing clinical guidelines for the management of major depressive disorder.Am Fam Physician. 2023;107(2):123-124.Kendrick T, Taylor D, Johnson CF.Which first-line antidepressant?Br J Gen Pract. 2019;69(680):114-115. doi:10.3399/bjgp19X701405Henssler J. Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C.Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis.Lancet Psychiat.2024 Jul;11(7):P526-535. doi:10.1016/S2215-0366(24)00133-0MedlinePlus.Antidepressants.Jones LA, Sun EW, Martin AM, Keating DJ.The ever-changing roles of serotonin.Int J Biochem Cell Biol. 2020;125:105776. doi:10.1016/j.biocel.2020.105776
Adjei K, Adunlin G, Ali AA.Impact of sertraline, fluoxetine, and escitalopram on psychological distress among United States adult outpatients with a major depressive disorder.Healthcare (Basel). 2023;11(5):740. doi:10.3390/healthcare11050740
DailyMed.Prozac - fluoxetine hydrochloride capsule.
DailyMed.Lexapro - escitalopram tablet, film coated. Lexapro - escitalopram solution.
National Alliance on Mental Illness.Fluoxetine (Prozac).
National Alliance on Mental Illness.Escitalopram (Lexapro).
Edinoff AN, Akuly HA, Hanna TA, et al.Selective serotonin reuptake inhibitors and adverse effects: a narrative review.Neurol Int.2021 Sep;13(3):387–401. doi:10.3390/neurolint13030038
Buelt A, McQuaid JR.Comparing clinical guidelines for the management of major depressive disorder.Am Fam Physician. 2023;107(2):123-124.
Kendrick T, Taylor D, Johnson CF.Which first-line antidepressant?Br J Gen Pract. 2019;69(680):114-115. doi:10.3399/bjgp19X701405
Henssler J. Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C.Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis.Lancet Psychiat.2024 Jul;11(7):P526-535. doi:10.1016/S2215-0366(24)00133-0
MedlinePlus.Antidepressants.
Jones LA, Sun EW, Martin AM, Keating DJ.The ever-changing roles of serotonin.Int J Biochem Cell Biol. 2020;125:105776. doi:10.1016/j.biocel.2020.105776
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