Prozac vs. Sertraline

See how Prozac and Sertraline compare on approved uses, dosing, side effects, and cost.

Andre Stone | MD

Medically reviewed by Andre Stone | MD, University of Pittsburgh School of Medicine on September 8th, 2026.

Key Takeaways

  • Prozac and sertraline are both SSRIs for depression, but Prozac also has FDA approval for bulimia nervosa and bipolar depression with olanzapine.

  • Sertraline is FDA-approved for PTSD, social anxiety disorder, and PMDD, uses that are not on Prozac's label.

  • A once-weekly form of Prozac may be prescribed for some adults with major depression who have responded to daily treatment. Sertraline is usually taken once daily. Take either medicine exactly as prescribed, and ask your prescriber what to do about a missed dose.

Prozac vs. Sertraline Drug Summary

Prozac

Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat major depression, OCD, panic disorder, and bulimia nervosa. It comes as a daily capsule, tablet, or liquid, and also as a once-weekly capsule once a stable daily dose is reached.

Sertraline

Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat major depression, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It is taken as a tablet, capsule, or liquid once a day, usually in the morning or evening.

Prozac vs. Sertraline Side Effects

Prozac

Most common
nausea (up to 21%)
diarrhea (up to 12%)
insomnia (33%, bulimia trials)
anxiety/nervousness (up to 15%)

Sertraline

Most common
nausea (up to 26%)
diarrhea (up to 20%)
tremor (up to 11%)
dyspepsia (up to 8%)

Prozac vs. Sertraline Dosage

Prozac

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 90 mg once weekly If needed
Dose changes 2 increases As tolerated

Sertraline

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25-50 mg once daily At the start
Maximum dose 200 mg once daily If needed
Dose changes 3 increases As tolerated

Prozac vs. Sertraline Indications

Prozac

Prozac is FDA-approved for major depression, OCD, panic disorder, and bulimia nervosa, plus bipolar depression and treatment-resistant depression when combined with olanzapine. Doctors also prescribe it off-label for premenstrual dysphoric disorder and binge eating disorder.

  • Major depressive disorder (MDD)

  • Obsessive-compulsive disorder (OCD)

  • Bulimia nervosa

  • Panic disorder

  • Bipolar I depression (with olanzapine)

Sertraline

Sertraline is FDA-approved for major depression, OCD, panic disorder, PTSD, social anxiety disorder, and premenstrual dysphoric disorder (PMDD). It is sometimes used off-label to treat premature ejaculation in men.

  • Major depressive disorder (MDD)

  • Obsessive-compulsive disorder (OCD)

  • Panic disorder

  • Post-traumatic stress disorder (PTSD)

  • Social anxiety disorder (SAD)

Prozac vs. Sertraline Pros and Cons

Prozac

Prozac has one of the broadest FDA-approval lists among SSRIs, covering eating disorders and treatment-resistant depression that sertraline is not approved for. Its long-acting metabolite means milder symptoms if a dose is missed, but it can also make Prozac more activating for some people.

Pros

  • FDA-approved for bulimia nervosa and bipolar depression

  • Once-weekly dosing option after initial daily treatment

  • Long half-life causes milder withdrawal if a dose is missed

  • Available since 1987, with decades of clinical use data

Cons

  • Not FDA-approved for PTSD or social anxiety disorder

  • Can be more activating, causing more insomnia and anxiety

  • Long half-life means a longer wait before starting an MAOI

  • No approved use for premenstrual dysphoric disorder on label

Sertraline

Sertraline covers more anxiety-related conditions on its FDA label, including PTSD and social anxiety disorder, along with PMDD. Its shorter half-life clears the body faster, which can mean quicker relief from side effects but more noticeable symptoms if a dose is missed.

Pros

  • FDA-approved for PTSD, social anxiety disorder, and PMDD

  • Shorter half-life allows faster switching to other medications

  • Widely used off-label for premature ejaculation

  • Flexible daily dosing lets doctors adjust doses quickly

Cons

  • Not FDA-approved for bulimia nervosa or bipolar depression

  • No once-weekly dosing option available

  • Shorter half-life can cause more noticeable withdrawal symptoms

  • GI side effects like diarrhea tend to be more common

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.

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