Lexapro vs. Sertraline
See how Lexapro and Sertraline compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lexapro is FDA-approved only for depression and generalized anxiety disorder, while sertraline carries approval for six different conditions, including OCD, panic disorder, and PTSD.
In trials, sertraline caused higher rates of nausea and diarrhea than Lexapro, whose most common side effects were generally reported at lower rates.
Lexapro's dosing is simple, with just two steps, while sertraline's dosing ranges from 25 mg to 200 mg with more titration steps along the way.
Lexapro vs. Sertraline Drug Summary
Lexapro
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) approved to treat major depressive disorder in adults and adolescents ages 12 to 17, and generalized anxiety disorder in adults. It comes as a tablet or oral solution and is taken once a day, usually starting at 10 mg.
Sertraline
Sertraline (Zoloft) is an SSRI approved to treat major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD in adults, plus OCD in children ages 6 to 17. It is also taken once daily, usually starting at 25 mg or 50 mg depending on the condition being treated.
Lexapro vs. Sertraline Side Effects
Lexapro
Sertraline
Lexapro vs. Sertraline Dosage
Lexapro
Sertraline
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Lexapro
| 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 |
Sertraline
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Lexapro vs. Sertraline Indications
Lexapro
Lexapro is FDA-approved to treat major depressive disorder in adults and adolescents ages 12 to 17, along with generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety disorders in pediatric patients.
Major depressive disorder in adults
Major depressive disorder in adolescents (12-17 years)
Generalized anxiety disorder in adults
Not FDA-approved for GAD in children or adolescents
Sertraline
Sertraline carries one of the broadest FDA-approved labels of any SSRI, covering major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD in adults. It is also approved for OCD in children and adolescents ages 6 to 17.
Major depressive disorder in adults
Obsessive-compulsive disorder in adults and children (6-17 years)
Panic disorder, PTSD, and social anxiety disorder in adults
Premenstrual dysphoric disorder (PMDD) in adult women
Lexapro vs. Sertraline Pros and Cons
Lexapro
Lexapro is a well-tolerated SSRI with a simple two-step dosing schedule and a comparatively low rate of nausea in trials. Its FDA approval is narrower than sertraline's, limited to depression and generalized anxiety disorder.
Pros
Approved for major depressive disorder in adolescents ages 12 to 17, an age group sertraline is not approved to treat for depression
Simple titration with only two tablet strengths, 10 mg and 20 mg
Lower nausea rate in trials (15%) than sertraline (up to 26%)
FDA-approved for generalized anxiety disorder, a use sertraline only has off-label
Cons
Narrower FDA-approved label, covering only two conditions versus sertraline's six
Not approved for OCD, panic disorder, PTSD, social anxiety disorder, or PMDD, all on sertraline's label
Shorter track record: FDA-approved in 2002, versus sertraline's approval in 1991
Sertraline
Sertraline is one of the most prescribed antidepressants in the US, with FDA approval spanning depression, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. That broader label comes with a wider dosing range and somewhat higher rates of GI side effects in trials.
Pros
Broadest FDA-approved label among common SSRIs, covering six distinct conditions
Approved for OCD in children and adolescents ages 6 to 17, a pediatric use Lexapro lacks
Longer track record, FDA-approved since 1991, over a decade before Lexapro
Wider dosing range (25 mg to 200 mg) allows finer adjustment for symptom control
Cons
Higher rates of GI side effects in trials, including nausea (up to 26%) and diarrhea (up to 20%)
Not approved for major depressive disorder in pediatric patients, unlike Lexapro's adolescent approval
Not FDA-approved for generalized anxiety disorder, only used off-label for that condition
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.