Zoloft vs. Prozac
See how Zoloft and Prozac compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both drugs are SSRIs for depression and related conditions, but Zoloft is FDA-approved for PTSD and social anxiety disorder while Prozac is not.
Prozac's long-acting metabolite lowers the risk of withdrawal symptoms if a dose is missed, while Zoloft's shorter half-life means doses must be taken more consistently.
Zoloft is dosed once daily within a 25-200 mg range, while Prozac offers daily dosing plus a once-weekly maintenance option after stabilization.
Zoloft vs. Prozac Drug Summary
Zoloft
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used for major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It is a once-daily tablet or oral solution, usually starting at 25-50 mg and increasing weekly up to 200 mg.
Prozac
Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used for major depressive disorder, OCD, bulimia nervosa, panic disorder, and treatment-resistant or bipolar depression when combined with olanzapine. It is a once-daily capsule, tablet, or oral solution, with a once-weekly capsule option after stabilizing on the daily dose.
Zoloft vs. Prozac Side Effects
Zoloft
Prozac
Zoloft vs. Prozac Dosage
Zoloft
Prozac
| STAGE | DOSE | WHEN |
| Starting dose | 25-50 mg once daily | At the start |
| Maximum dose | 50-200 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| 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 |
Zoloft
| STAGE | DOSE | WHEN |
| Starting dose | 25-50 mg once daily | At the start |
| Maximum dose | 50-200 mg once daily | If needed |
| Dose changes | 2 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 |
Zoloft vs. Prozac Indications
Zoloft
Zoloft is FDA-approved for major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and premenstrual dysphoric disorder. Some doctors also prescribe it off-label for generalized anxiety disorder.
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Panic disorder
Post-traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)
Prozac
Prozac is FDA-approved for major depressive disorder, OCD, bulimia nervosa, panic disorder, and, combined with olanzapine, bipolar I depression or treatment-resistant depression. It is also used off-label for premenstrual symptoms and binge eating disorder.
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Bulimia nervosa
Panic disorder
Bipolar I depression (with olanzapine)
Zoloft vs. Prozac Pros and Cons
Zoloft
Zoloft covers a broader range of FDA-approved anxiety indications than Prozac, including PTSD and social anxiety disorder, alongside its own approval for PMDD. Its shorter half-life allows faster dose adjustments but requires strict daily dosing to avoid withdrawal symptoms.
Pros
FDA-approved for PTSD and social anxiety disorder, indications not on fluoxetine's label
Approved specifically for PMDD, with continuous or luteal-phase-only dosing options
Shorter half-life clears the body faster, simplifying switches to other medications or an MAOI
Reaches steady state in about a week, so dose changes can happen faster than with fluoxetine
Cons
Carries a moderate risk of discontinuation symptoms if doses are missed, due to its shorter half-life
Not approved for bulimia nervosa or as an add-on for treatment-resistant depression, unlike fluoxetine-olanzapine
No once-weekly maintenance dosing option; requires daily dosing without exception
Reports a higher rate of diarrhea in trials (up to 20%) than fluoxetine (up to 12%)
Prozac
Prozac's long half-life makes it more forgiving of missed doses and is the only SSRI approved with olanzapine for treatment-resistant and bipolar I depression. It also carries a specific approval for bulimia nervosa that sertraline does not have.
Pros
Long-acting metabolite gives one of the lowest risks of withdrawal symptoms among SSRIs if a dose is missed
Only SSRI approved in combination with olanzapine for treatment-resistant depression and bipolar I depression
Approved specifically for bulimia nervosa, an indication sertraline does not carry
Offers a once-weekly maintenance dosing option after stabilizing on the daily dose
Cons
Not approved for PTSD or social anxiety disorder, indications carried by sertraline
Takes about a month to reach steady state, making dose changes slower than with sertraline
Long half-life means it takes weeks to fully clear the body, complicating switches to other medications or an MAOI
PMDD treatment with Prozac is off-label; sertraline carries a specific FDA approval for that use
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.