Zoloft vs. Lexapro
See how Zoloft and Lexapro compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both drugs are SSRIs that treat depression similarly, but Zoloft covers more conditions, including OCD, panic disorder, PTSD, and PMDD, while Lexapro is approved only for depression and generalized anxiety disorder.
Lexapro's dosing is simpler, moving from 10 mg to one 20 mg maintenance dose, while Zoloft's dose can range from 25 mg up to 200 mg depending on what is being treated.
Zoloft tends to cause more nausea and diarrhea, while Lexapro is more associated with sexual side effects and somnolence at its approved doses.
Zoloft vs. Lexapro Drug Summary
Zoloft
Zoloft (sertraline) is a selective serotonin reuptake inhibitor approved for major depressive disorder, obsessive-compulsive disorder, panic disorder, PTSD, and PMDD. It comes as a tablet or oral solution taken once daily, with a starting dose of 25 mg or 50 mg depending on the condition being treated.
Lexapro
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor approved for major depressive disorder in adults and adolescents and for generalized anxiety disorder in adults. It is taken once daily as a tablet or oral solution, typically starting at 10 mg and moving to 20 mg after about a week if needed.
Zoloft vs. Lexapro Side Effects
Zoloft
Lexapro
Zoloft vs. Lexapro Dosage
Zoloft
Lexapro
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 50-200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| 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 |
Zoloft
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 50-200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Lexapro
| 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 |
Zoloft vs. Lexapro Indications
Zoloft
Zoloft is an SSRI with one of the broadest FDA approval lists in its class. It treats major depressive disorder, OCD, panic disorder, PTSD, and PMDD, and can be dosed differently for each.
Major depressive disorder in adults
Obsessive-compulsive disorder in adults and children 6 and up
Panic disorder
Lexapro
Lexapro is an SSRI approved for major depressive disorder and generalized anxiety disorder. It is used in adults for both conditions, and in adolescents for depression only.
Major depressive disorder in adults
Major depressive disorder in adolescents ages 12-17
Generalized anxiety disorder in adults
Zoloft vs. Lexapro Pros and Cons
Zoloft
Zoloft carries FDA approval for six conditions, more than most SSRIs, which makes it useful when anxiety, OCD, or PTSD symptoms overlap with depression. It has been prescribed since 1991, giving doctors decades of real-world safety data to draw on.
Pros
FDA-approved for OCD, panic disorder, PTSD, and PMDD, not just depression
Long track record dating back to 1991
Available as a tablet or oral solution
Dose can be fine-tuned from 25 mg up to 200 mg for harder-to-treat cases
Cons
Higher rates of nausea and diarrhea than Lexapro
More dosing steps, with different starting doses by condition
Not FDA-approved specifically for generalized anxiety disorder
Lexapro
Lexapro's narrower approval list reflects its development as a purified, single-enantiomer SSRI. Its simple two-step dosing and comparatively mild GI side effect profile make it appealing for patients who haven't tolerated other SSRIs well.
Pros
FDA-approved for generalized anxiety disorder, not just depression
Simple two-step dosing: 10 mg starting dose, then 20 mg if needed
Lower rates of nausea and GI upset than Zoloft
Approved for adolescent depression starting at age 12
Cons
Not FDA-approved for OCD, panic disorder, PTSD, or PMDD
Fewer approved uses overall than Zoloft
Notable rate of sexual side effects, including ejaculation disorder in men
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.