Prozac vs. Sertraline
See how Prozac and Sertraline compare on approved uses, dosing, side effects, and cost.
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.
Prozac's long half-life allows a once-weekly dosing option after initial treatment, while sertraline is taken every day without exception.
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
Sertraline
Prozac vs. Sertraline Dosage
Prozac
Sertraline
| 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 |
| 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
| 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
| 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.