Lexapro vs. Escitalopram

See how Lexapro and Escitalopram compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lexapro and escitalopram are the same SSRI medication, escitalopram oxalate, just sold under different names.

  • Both treat major depressive disorder in adults and teens 12 and older, and generalized anxiety disorder in adults.

  • Generic escitalopram typically costs a small fraction of brand-name Lexapro, since price is the main practical difference between them.

Lexapro vs. Escitalopram Drug Summary

Lexapro

Lexapro is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and generalized anxiety disorder. It works by increasing serotonin levels in the brain and is taken as one tablet or dose of oral solution each day. Lexapro is the brand-name version of escitalopram oxalate.

Escitalopram

Escitalopram is the generic form of the SSRI sold under the brand name Lexapro, used for major depressive disorder and generalized anxiety disorder. It works the same way, by increasing serotonin levels in the brain, and is taken once daily as a tablet or oral solution. Escitalopram is available from multiple manufacturers at a much lower cost than the brand.

Lexapro vs. Escitalopram Side Effects

Lexapro

Most common
nausea (up to 15%)
ejaculation disorder (up to 9%)
insomnia (up to 9%)
somnolence (up to 6%)

Escitalopram

Most common
nausea (up to 15%)
ejaculation disorder (up to 9%)
insomnia (up to 9%)
somnolence (up to 7%)

Lexapro vs. Escitalopram Dosage

Lexapro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily Week 1
Maximum dose 20 mg once daily Week 2 onward
Dose changes 1 increase Every week

Escitalopram

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily Week 1
Maximum dose 20 mg once daily Week 2 onward
Dose changes 1 increase Every week

Lexapro vs. Escitalopram Indications

Lexapro

Lexapro is FDA-approved for major depressive disorder in adults and adolescents ages 12 to 17, and for generalized anxiety disorder in adults. It is not approved for treating depression in children under 12 or for anxiety in pediatric patients.

  • Treats major depressive disorder in adults and teens 12-17

  • Treats generalized anxiety disorder in adults

  • Not approved for depression in children under 12

  • Not approved for anxiety disorders in children or teens

Escitalopram

Escitalopram carries the same FDA approvals as Lexapro: major depressive disorder in adults and adolescents 12 to 17, and generalized anxiety disorder in adults. It is not approved for bipolar depression or for major depressive disorder in children under 12.

  • Treats major depressive disorder in adults and teens 12-17

  • Treats generalized anxiety disorder in adults

  • Not approved for bipolar depression

  • Not approved for major depression under age 12

Lexapro vs. Escitalopram Pros and Cons

Lexapro

Lexapro and generic escitalopram are clinically identical, since Lexapro is simply the brand-name version of escitalopram oxalate. Insurance plans typically favor the generic, and many require patients to try it first before covering the brand. Choosing Lexapro over escitalopram usually comes down to formulation preference, not medical necessity.

Pros

  • Same well-studied active ingredient as generic escitalopram

  • Oral solution available directly from the original manufacturer

  • Consistent tablet appearance and inactive ingredients every refill

Cons

  • Roughly $440 to $603 per month without insurance, much pricier than generic

  • Most insurance plans require trying the generic first

  • No clinical advantage over generic escitalopram

Escitalopram

Escitalopram delivers the exact same active ingredient as Lexapro, since it is the generic form of the same molecule. It is stocked at nearly every pharmacy and preferred by most insurance formularies, making it the default choice for patients and prescribers. The main tradeoff is that appearance and inactive ingredients can vary between generic manufacturers.

Pros

  • Roughly $8 to $56 per month without insurance, far cheaper than brand

  • Preferred or covered outright by most insurance formularies

  • Widely stocked at pharmacies from multiple manufacturers

Cons

  • Appearance and inactive ingredients can vary by manufacturer

  • No brand-name oral solution option from every generic maker

  • Some patients notice differences switching between manufacturers

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