Lexapro vs Prozac

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For individuals suffering from major depressive disorder (MDD) or other forms of depression, there are specific medications that modify the concentrations of neurotransmitters in the brain associated with mood. This can aid in stabilizing depressive lows and managing symptoms. Lexapro and Prozac are two such drugs commonly prescribed for these conditions. Both impact different neurotransmitters within the brain, but they share a common effect: they stabilize mood in patients suffering from depression. Lexapro is an SSRI--Selective Serotonin Reuptake Inhibitor--that primarily affects serotonin levels. On the other hand, Prozac is also an SSRI and it impacts serotonin levels as well; however, its effects tend to kick off more slowly compared to those of Lexapro which offers quicker relief for acute cases.

What is Lexapro?

Escitalopram (the generic name for Lexapro) is a newer drug of the SSRI class of antidepressants, which was a significant advancement following the development of fluoxetine or Prozac. Escitalopram was first approved by the FDA in 2002. Like Prozac, Lexapro works by increasing levels of free serotonin in the brain and preventing it from being reabsorbed - effectively boosting its availability for longer periods than usual. It's prescribed mainly for treating different forms of depression and generalized anxiety disorder. Similar to Prozac, Lexapro primarily influences serotonin with only minor effects on dopamine and norepinephrine; this results in fewer side effects as compared to other antidepressants that have stronger impacts on these two other neurotransmitters. However, it's worth noting that every individual can respond differently to these medications due to their unique chemistry.

What conditions is Lexapro approved to treat?

Lexapro is approved for the treatment of various forms of depression and anxiety including:

  • Major depressive disorder (MDD), also known as unipolar depression
  • Generalized Anxiety Disorder (GAD)
  • Panic disorder with or without agoraphobia.

How does Lexapro help with these illnesses?

Lexapro assists in managing depression by enhancing the amount of serotonin present in the brain's synapses. Similar to Prozac, Lexapro prevents reabsorption of serotonin into neurons, allowing for increased levels over extended periods. Serotonin is a neurotransmitter that acts as a messenger throughout both the brain and body and plays significant roles in mood regulation, cognitive function, memory formation, sleep patterns and appetite control among other things. It's believed that those suffering from depression may have relatively lower levels of serotonin. Therefore, by boosting these levels with Lexapro usage can alleviate depressive symptoms and aid patients in stabilizing their mood more effectively.

What is Prozac?

Prozac, also known as fluoxetine, is a Selective Serotonin Reuptake Inhibitor (SSRI), meaning it increases the levels of serotonin in the brain by reducing its reabsorption. Prozac was first approved by the FDA in 1987 and has since been used extensively for treating depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. As an SSRI antidepressant, unlike Lexapro which is an SRI, Prozac does not only inhibit the reuptake of serotonin but it also acts on other neurotransmitters to a certain extent. This can result in a different side-effect profile for some patients: while both drugs may cause nausea and sexual dysfunction among others, Prozac might lead to more sleep disturbances compared to Lexapro due to its activating effect. Its influence on multiple neurotransmitters could potentially be beneficial for patients who do not respond well just to increased serotonin levels offered by "typical" SSRIs like Lexapro.

What conditions is Prozac approved to treat?

Prozac, also known as fluoxetine, is a well-known antidepressant that has been approved by the FDA for several indications. These include:

  • Major depressive disorder (MDD)
  • Obsessive-compulsive disorder (OCD)
  • Bulimia nervosa
  • Panic disorder As with any medication, it's important to discuss your individual health circumstances with your healthcare provider before starting treatment.

How does Prozac help with these illnesses?

Serotonin is a neurotransmitter that has numerous functions in the body, influencing mood, sexual function, sleep, and appetite. It also plays a significant role in several mental health disorders including depression. Prozac works by increasing levels of serotonin available in the brain thus helping to improve mood and reduce anxiety. This medication belongs to a class known as selective serotonin reuptake inhibitors (SSRIs). While Lexapro also increases serotonin levels and falls under SSRIs category like Prozac does, it is often noted for its potential fewer side effects due to its more selective interaction with certain receptor sites compared to other SSRI antidepressants. However, since everybody's neurochemistry differs slightly, there are patients who might respond better or tolerate one medication over another which makes Prozac an important option within this therapeutic class.

How effective are both Lexapro and Prozac?

Both escitalopram (Lexapro) and fluoxetine (Prozac) have proven histories of success in treating patients with depression, they were initially approved by the FDA several years apart, with Prozac being the older drug. Both are selective serotonin reuptake inhibitors (SSRIs), so they work on the same neurotransmitter system but may be prescribed under different circumstances due to their differing side effect profiles. A 2004 study directly compared escitalopram to fluoxetine; both drugs demonstrated similar efficacy in managing symptoms of depression as well as showing promising safety profiles.

A review from 2011 reports that escitalopram is effective at reducing symptoms of anxiety within the first week or two of treatment, and that its side effect profile is generally favorable over many other antidepressants. The dose associated with optimal efficacy varies between individuals but is often around 10 mg/day. Beyond alleviating symptoms of depression and generalized anxiety disorder, it also appears to reduce panic attack frequency in those suffering from panic disorder.

Fluoxetine has a long-established history as an effective antidepressant treatment option since it was one of the first SSRIs developed. According to a meta-analysis conducted in 2015, fluoxetine seems about as efficacious as most other commonly prescribed antidepressants for treating major depressive disorder while also appearing more tolerated than tricyclics. Fluoxetine typically serves as a primary line treatment choice for various mood disorders due to its extensive research backing and generic availability making it cost-effective.

abstract image of a researcher studying a bottle of drug.

At what dose is Lexapro typically prescribed?

Oral dosages of Lexapro typically range from 10–20 mg/day, but research has shown that 10 mg/day is generally enough to treat major depressive disorder in most adults. Adolescents and the elderly may be started on a lower dose of 5 mg/day. For either age group, if there's no improvement seen after a few weeks, the dosage can be increased gradually under medical supervision. However, it should not exceed the maximum limit of 20 mg/day for any reason to avoid potential side effects or overdose risks.

At what dose is Prozac typically prescribed?

Prozac therapy typically begins with a dosage of 20 mg/day taken once in the morning. If necessary, after several weeks, the dose may be increased to a maximum of 60 mg/day. The increase should be made gradually; an increase to two doses per day can occur after one week at 20 mg/day if needed, then upping it to three doses per day (totaling 60mg) spaced out over the course of the day if there is no response to treatment at lower dosages. Always remember that any changes in dosage should only be done under medical supervision.

What are the most common side effects for Lexapro?

Commonly reported side effects of Lexapro, which can also be found in Prozac users, include:

  • Anxiety and nervousness
  • Difficulty with sleeping or insomnia
  • Sleepiness or drowsiness (somnolence)
  • General weakness and fatigue (asthenia)
  • Unintentional trembling or shaking (tremor)
  • Lack of appetite (anorexia)
  • Nausea
  • Discomfort in the digestive tract (dyspepsia)
  • Diarrhea
  • Dry mouth -Increased perspiration(sweating)

Sexual side effects are quite common with this type of medication, leading to decreased libido, abnormal ejaculation and impotence. Other less common side effects may include rash, unusual dreams, symptoms resembling those of influenza (flu syndrome), inflammation at the back of the throat(pharyngitis), inflamed sinus cavities(sinusitis), as well as yawning. If any such symptom arises after starting Lexapro treatment it is important to consult your healthcare provider for guidance.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Lexapro?

In comparison to Prozac, Lexapro also carries the potential for significant side effects. These include:

  • Heightened risk of suicidal thoughts or tendencies, particularly in younger individuals
  • Signs of an allergic reaction such as hives, difficulty breathing or swallowing, and swelling in your face, lips, tongue or throat
  • Changes in vision including blurred sight and eye pain
  • Rapid heartbeat accompanied by shortness of breath and a sensation of light-headedness akin to fainting
  • Significant drop in sodium levels which could lead to headache, confusion, slurred speech, severe weakness and unsteadiness
  • Adverse nervous system response resulting in extremely rigid muscles along with high fever; this may be accompanied by sweating heavily even when it's cold. Other symptoms include tremors and feeling like you might lose consciousness.
  • Possible occurrence of serotonin syndrome characterized by agitation or restlessness; hallucinations (seeing things that aren't there); fast heart rate; fluctuating body temperature leading to profuse sweat or shivering; muscle stiffness or twitching.

Please seek immediate medical attention if you experience any such symptoms while on Lexapro.

What are the most common side effects for Prozac?

Prozac, a commonly prescribed antidepressant, has several potential side effects to be aware of:

  • Dry mouth or sore throat
  • Sweating and nervousness
  • Insomnia or sleep problems
  • Nausea, stomach upset, loss of appetite
  • Weight changes - it could lead to weight loss in some individuals
  • Tremors or feeling shaky
  • A fast heartbeat may occur in rare cases.
  • Some might experience blurred vision and ringing in the ears.
  • It may cause increased urination.
  • In certain situations, confusion or agitation can occur.
    -Possible skin reactions like rash. -Prozac users could also encounter dizziness and headaches. -Muscle pain or joint pain is another possible adverse effect.

Always consult with your healthcare provider for personalized advice about the potential risks and benefits associated with Prozac use.

Are there any potential serious side effects for Prozac?

Prozac, like any other medication, may cause adverse reactions in some individuals. It is crucial to be aware of these potential side effects and seek immediate medical attention if you experience:

  • Signs of a severe allergic reaction or skin response: hives, itching, fever, swollen glands, difficulty breathing, swelling in your face or throat, sore throat, burning eyes, skin pain accompanied by a red or purple skin rash that blisters and peels.
  • Elevated suicidal thoughts or an increase in thoughts about self-harm
  • Seizures (convulsions)
  • Unusual changes in mood or behavior leading to confusion
  • Vision problems such as blurred vision; tunnel vision; eye pain; swelling around the eyes; seeing halos around lights
  • Fast-paced heartbeats which can also become irregular
  • Symptoms suggestive of a manic episode: racing thoughts fuelled with increased energy levels leading to reckless behaviour. This could manifest as feeling extremely happy one moment followed by irritability. Increased talkativeness and severe sleep disturbances are also indicative signs.

If you notice any such symptoms while on Prozac therapy promptly contact your healthcare provider for evaluation and management.

Contraindications for Lexapro and Prozac?

Just like Prozac, Lexapro and most other antidepressant medications may exacerbate symptoms of depression in certain individuals. If you observe your depression becoming worse, or if there's an uptick in suicidal ideation, thoughts or behavior while taking these drugs, please seek immediate medical help.

Neither Lexapro nor Prozac should be taken if you are on monoamine oxidase (MAO) inhibitors or have recently stopped using them. Always disclose to your doctor any medications that you're currently taking; MAOIs will require a clearance period of approximately 5 weeks to avoid harmful interactions with Lexapro and Prozac.

How much do Lexapro and Prozac cost?

For the brand name versions of these drugs:

  • The price for 30 tablets of Lexapro (10 mg) averages around $378, which works out to about $12.60/day.
  • The price for 30 capsules of Prozac (20 mg) is approximately $570, which translates to nearly $19/day.

Thus, if you are on a typical dosage regimen, brand-name Lexapro tends to be less expensive on a per-day treatment basis compared to Prozac. Please bear in mind that cost should not be your primary consideration when choosing between these medications; efficacy and side effects also play vital roles.

Regarding generic versions of Lexapro (escitalopram) and Prozac (fluoxetine), costs are significantly lower:

  • Escitalopram can be purchased in packs as small as 5 up to 500 tablets with prices ranging from about $0.15 - $0.50 per day.
  • Fluoxetine comes in packs varying from 15 up to 1000 capsules with daily costs starting as low as just over a nickel ($0.05/day), but not exceeding around ninety cents ($0.90/day).

Popularity of Lexapro and Prozac

Escitalopram, commonly known by its brand name Lexapro, was prescribed to approximately 12.9 million people in the USA in 2020. This accounted for nearly 21% of SSRI prescriptions and a little over 14% of overall antidepressant prescriptions, making it one of the most popular choices among SSRIs. The use of escitalopram has been generally increasing since its introduction.

Fluoxetine, with popular brand versions such as Prozac, was prescribed to about 4.7 million people in the USA during the same year (2020). In terms of SSRI prescriptions within the United States, fluoxetine accounts for just under 20%, and slightly less than 10% when considering all antidepressants on a whole. Over recent years - specifically around last decade - prevalence rates for fluoxetine have remained relatively stable without significant change.


Both Lexapro (escitalopram) and Prozac (fluoxetine) are well-established in the treatment of depression and anxiety, with a wealth of clinical trials supporting their efficacy over placebo. In certain scenarios, these medications may be used together under careful physician oversight since they can interact with each other. Both drugs primarily act on serotonin but differ subtly; Lexapro is an SSRI that works by increasing levels of serotonin in the brain while Prozac also affects norepinephrine to some extent.

Prozac has been around longer than Lexapro and is often considered as a first-line treatment for major depressive disorder. However, Lexapro might be preferred if patients have not responded suitably to initial SSRI therapy or need to avoid some side effects linked with Prozac like sexual dysfunction or weight gain.

Both medications are available in generic forms which can lead to substantial cost savings for those who must pay out-of-pocket expenses. It's important for patients starting either medication to understand that there may be an adjustment period before noticing any therapeutic effect.

The side-effects profiles of both drugs bear similarities; however, compared to Prozac, Lexapro typically causes fewer unwanted effects related to sexual performance and weight changes. Regardless of chosen drug therapy, it remains vital for individuals initiating treatment to closely monitor their mood shifts and seek immediate medical attention if symptoms worsen or suicidal thoughts emerge.