Lexapro vs. Luvox

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

Key Takeaways

  • Lexapro is FDA-approved for depression and generalized anxiety disorder, while Luvox is approved specifically for obsessive-compulsive disorder in both adults and children.

  • Luvox's FDA label shows notably higher rates of nausea, headache, and insomnia than Lexapro's label, though the drugs are not tested head to head.

  • Both carry the same boxed warning about increased suicide risk in young people, but brand-name Lexapro's list price runs far higher than generic fluvoxamine, the only form Luvox is sold in.

Lexapro vs. Luvox Drug Summary

Lexapro

Lexapro (escitalopram) is an SSRI antidepressant approved for major depressive disorder in adults and adolescents ages 12 to 17, and for generalized anxiety disorder in adults. It's taken as a single daily tablet or oral solution, typically starting at 10 mg and increasing to 20 mg after one week if needed.

Luvox

Luvox (fluvoxamine) is an SSRI approved specifically for obsessive-compulsive disorder in adults and children ages 8 and older. It's taken as a tablet, usually starting at 50 mg daily and increased gradually to a typical maintenance dose of up to 300 mg per day, often split into two doses.

Lexapro vs. Luvox Side Effects

Lexapro

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

Luvox

Most common
nausea (up to 40%)
insomnia (up to 35%)
somnolence (up to 27%)
headache (up to 35%)

Lexapro vs. Luvox Dosage

Lexapro

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

Luvox

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once daily At the start
Maximum dose 300 mg/day If needed
Dose changes 4 increases As tolerated

Lexapro vs. Luvox Indications

Lexapro

Lexapro is FDA-approved for major depressive disorder in adults and adolescents, and for generalized anxiety disorder in adults. Its approved uses cover two of the most common conditions treated with antidepressants in primary care. It is not approved for GAD in children or for depression in kids under 12.

  • Major depressive disorder in adults

  • Major depressive disorder in adolescents ages 12-17

  • Generalized anxiety disorder in adults

Luvox

Luvox is FDA-approved only for obsessive-compulsive disorder in both adults and children age 8 and older. It does not carry an FDA-approved indication for depression or anxiety, though doctors often prescribe it off-label for those conditions. Its main off-label uses include major depressive disorder, social anxiety disorder, and panic disorder.

  • Obsessive-compulsive disorder in adults

  • Obsessive-compulsive disorder in children ages 8-17

  • Off-label: major depressive disorder

Lexapro vs. Luvox Pros and Cons

Lexapro

Lexapro's broad FDA approval for both depression and anxiety, plus its simple once-daily dosing, makes it a common first-line SSRI choice. Generic escitalopram is widely available and inexpensive, though the brand-name version carries a much higher list price.

Pros

  • Approved for both depression and generalized anxiety disorder

  • Simple two-step titration to a once-daily dose

  • Lower reported rates of nausea and GI side effects than Luvox

Cons

  • Brand-name Lexapro costs roughly $440 to $603 per month without insurance

  • Sexual side effects, including ejaculation disorder, reported in up to 9% of patients

  • Not approved for obsessive-compulsive disorder

Luvox

Luvox's narrow FDA approval for OCD, including pediatric OCD, makes it a specialized choice rather than a general-purpose antidepressant. Its potent CYP1A2 inhibition creates more drug interaction risks than many other SSRIs, and its overall side effect rates tend to run higher.

Pros

  • Only SSRI FDA-approved for OCD in children as young as 8

  • Sold only as generic fluvoxamine, typically $15 to $170 per month without insurance

  • Extended-release generic option available for less frequent dosing

Cons

  • Higher reported rates of nausea, headache, and insomnia than Lexapro

  • Strong CYP1A2 inhibitor, raising interaction risk with caffeine, theophylline, and clozapine

  • No FDA-approved indication for depression or anxiety

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