Sertraline vs. Escitalopram
See how Sertraline and Escitalopram compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Sertraline is FDA-approved for six conditions, including OCD, panic disorder, and PTSD, while escitalopram covers only depression and generalized anxiety disorder.
Escitalopram uses a simpler two-step dosing schedule, while sertraline involves more gradual increases on the way to its higher maximum dose.
Both drugs carry the same boxed warning for suicidal thinking in children, teens, and young adults, and both are available as low-cost generics.
Sertraline vs. Escitalopram Drug Summary
Sertraline
Sertraline is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It is taken once daily by mouth, usually starting at 50 mg and increasing over several weeks up to a maximum of 200 mg.
Escitalopram
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder in adults and adolescents 12 and older, and for generalized anxiety disorder in adults. It is taken once daily, starting at 10 mg and moving to a 20 mg maintenance dose after one week.
Sertraline vs. Escitalopram Side Effects
Sertraline
Escitalopram
Sertraline vs. Escitalopram Dosage
Sertraline
Escitalopram
| 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 |
| 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 |
Escitalopram
| 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 vs. Escitalopram Indications
Sertraline
Sertraline is FDA-approved for six psychiatric conditions: major depressive disorder, obsessive-compulsive disorder, panic disorder, PTSD, social anxiety disorder, and premenstrual dysphoric disorder. This makes it one of the more broadly approved SSRIs, often used when anxiety-spectrum symptoms overlap with depression.
Major depressive disorder in adults
Obsessive-compulsive disorder in adults and children age 6+
Panic disorder, with or without agoraphobia
Post-traumatic stress disorder (PTSD)
Escitalopram
Escitalopram 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 bipolar depression or for depression in children under 12, and any other use is considered off-label.
Major depressive disorder in adults
Major depressive disorder in adolescents ages 12-17
Generalized anxiety disorder in adults
Off-label: sometimes used for OCD, panic disorder, or PTSD
Sertraline vs. Escitalopram Pros and Cons
Sertraline
Sertraline covers more FDA-approved conditions than escitalopram, making it a common choice when anxiety disorders overlap with depression. It generally requires a longer titration process and tends to cause more gastrointestinal side effects.
Pros
FDA-approved for six conditions, including OCD, panic disorder, PTSD, and social anxiety disorder
More dosing flexibility, with steps up to 200 mg for patients who need it
Approved for pediatric OCD in children age 6 and older
Cons
Higher rates of nausea and diarrhea than escitalopram in trials
Requires more titration steps to reach an effective dose
Not FDA-approved for pediatric depression
Escitalopram
Escitalopram has a simpler dosing schedule and generally milder gastrointestinal side effects than sertraline. Its FDA approval is narrower, limited to depression and generalized anxiety disorder rather than a wider range of anxiety-spectrum conditions.
Pros
Simpler two-step dosing schedule, usually complete within two weeks
Lower rates of nausea and insomnia in clinical trials
FDA-approved for adolescent depression, ages 12-17
Cons
Narrower FDA approval, limited to depression and generalized anxiety disorder
Using it for OCD, panic disorder, PTSD, or social anxiety disorder is off-label
No FDA approval for pediatric OCD, unlike sertraline
Common Symptoms and Related Diseases You Can Explore
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