Lexapro vs Zoloft: How do they compare?

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 7, 2023.

Official answer

by drugclasses.com

Both Lexapro and Zoloft belong to the class of medicines called selective serotonin reuptake inhibitors (SSRIs) and are both FDA approved to treat anxiety and depression. Both are available in tablet and liquid forms. The main differences between Lexapro and Zoloft are:

Lexapro is a branded version of escitalopram and Zoloft is a branded version of sertraline
Zoloft is also FDA approved to treat OCD (obsessive-compulsive disorder), panic disorder, PTSD (post-traumatic stress disorder), social phobia, and premenstrual dysphoric disorder (PDD)
There are some differences in their side effects with Lexapro being more likely to cause sleep problems and taste disturbances, and Zoloft is more likely to cause skin rash or diarrhea.
There is some evidence that Lexapro may be more effective than other SSRIs, including Zoloft, in the treatment of depression
Lexapro was FDA approved in 2002 and Zoloft was FDA approved in 1991.

Because both drugs are SSRIs, they have many similarities, such as:

They both work by preventing the reuptake of serotonin, a chemical in the brain that acts as a messenger between nerve cells. SSRIs increase levels of serotonin in the nerve synapse and this has been associated with a reduction in depressive symptoms
Side effects, such as headache, nausea and vomiting, nervousness and anxiousness, dizziness, sexual problems (eg, erectile dysfunction), tremor, and weight gain (although this tends to be less than with other antidepressants) or weight loss are common to both Lexapro and Zoloft.
Both have been associated with withdrawal symptoms when discontinued
Both are branded drugs; however, generics are available for each drug which makes costs similar
Both are prescription medicines, and neither is a controlled drug
The likelihood of interactions with other drugs (such as monoamine oxidase inhibitors, pimozide, tramadol, St John’s wort) is similar.

How long does it take for Lexapro to work?

Even though it takes Lexapro only a few hours to increase serotonin levels within the brain, it may take several weeks to start working. Signs that Lexapro has started working include an improvement in your sleep, energy, or appetite. In some, this may happen in as little as 1 to 2 weeks. Relief from symptoms, such as a depressed mood or a lack of interest in activities you used to enjoy, may take up to 6 to 8 weeks to fully improve. Continue reading

Does Lexapro cause night sweats?

Lexapro can cause night sweats and increased sweating overall (night and day) was one of the most common side effects reported with Lexapro, reported by 3% to 8% (depending on the dose) of people. Although night sweats can be worrisome, they usually diminish with time as your body and brain adjust to the medication. Continue reading

How long does Zoloft (sertraline) withdrawal last?

Sertraline (Zoloft) withdrawal symptoms typically last up to 1 to 2 weeks, but may last even longer in some people. You should avoid abruptly stopping sertraline treatment unless otherwise directed by your healthcare provider. Gradually reducing the dose over 2 to 4 weeks can help to prevent severe withdrawal symptoms in most people. Continue reading

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