Lexapro vs. Prozac: Comparing medications

Lexapro vs. Prozac: Comparing medications

Lexapro and Prozac are both SSRIs that can effective help with anxiety and depression. Which one is better depends on how you respond to each specific medication and their side effects.

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Austin Lin, MD
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May 9, 2024
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If you’re prescribed medication for depression or anxiety, you may have heard of Lexapro or Prozac mentioned among your options. These are two commonly prescribed antidepressants that work in similar ways and have similar results when it comes to helping you find relief from your symptoms. But there are important differences between them, too.

In this article we’ll talk about their distinctions, including what they treat and their side effects. Remember that you don’t have to decide whether you take Lexapro or Prozac on your own—your doctor will help figure out a treatment option that’s suited to your needs.

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Are Lexapro and Prozac the same?

Lexapro and Prozac work in a similar way within the body (more on that later), but they are not the same medication.

What is Lexapro?  

Lexapro is the brand name for escitalopram. When it comes to treating depression and anxiety, it’s one of psychiatrists’ first-choice medications. Lexapro is usually taken once a day , and is available as both a tablet and a liquid. Some people notice an improvement in their symptoms after two weeksafter only at week of taking it, but it typically takes a longer to feel the full benefits.  

What is Prozac?  

Prozac is the brand name for fluoxetine. Like Lexapro, Prozac helps treat depression and anxiety, and is also approved for other conditions, like panic disorder. Prozac comes in the form of an immediate-release pill, a delayed-release pill, or a liquid. While the immediate-release pill and liquid are  typically taken once or twice daily, the delayed-release pill is taken weekly and is approved only for depression. (You  must also be taking fluoxetine 20 mg/day steadily prior to switching to the delayed-release.) It also usually takes a few weeks to work.  

What conditions do they treat?

While Prozac is approved to treat depression and several other mental health conditions, Lexapro is only approved for depression and anxiety.  The following list also includes off-label uses—meaning the FDA has not approved the medication to treat this condition, but doctors may prescribe it based on scientific evidence. These are indicated with an asterisk*.

Prozac is approved by the FDA to treat:  

  • Premenstrual dysphoric disorder (PMDD)
  • Bulimia  
  • Depression from bipolar I (in conjunction with a mood stabilizer)
  • Social anxiety disorder
  • Generalized anxiety disorder (GAD)*
  • Posttraumatic stress disorder (PTSD)*

Lexapro is approved by the FDA to treat:  

How do Lexapro and Prozac work?

Both Prozac and Lexapro are medications that belong to a class of drugs called SSRIs or selective serotonin reuptake inhibitors. SSRIs can treat depression symptoms by raising the levels of serotonin in the brain. Though many different factors lead to anxiety and depression, having low serotonin levels is one of them.  

As SSRIs, both Lexapro and Prozac help ensure there is more of the neurotransmitter serotonin available for your brain, and each has been found to be more effective than placebos at treating both anxiety and depression.  

No medication is guaranteed to work the same for everyone, and which one works best for you will depend on your situation, what you’re using it for, and any potential side effects. For example, Prozac can make some people feel more energetic, which can intensify symptoms of anxiety That means  Lexapro may have less risk for worsening your anxiety, but there are other SSRIs that may be just as effective.. Treatment is personalized, and your doctor will help come up with a plan.

Related article: Lexapro vs Wellbutrin

Common side effects

Both Lexapro and Prozac share some common side effects. Many side effects are mild and go away over time once your body gets used to the medication. Before you are prescribed either Lexapro or Prozac, your doctor will walk you through potential side effects. If you’re worried about a specific effect or reaction, let your doctor know. They’ll address your concerns when deciding which medication to prescribe you.

Side effects of Prozac

  • Nervousness
  • Anxiety
  • Headache, confusion, weakness  
  • Difficulty concentrating, or memory problems
  • Unusual dreams
  • Excessive sweating

Side effects of Lexapro

  • Constipation
  • Drowsiness
  • Shaking
  • Dizziness
  • Increased sweating

Side effects of both  

  • Sexual problems, including decreased libido in men and women
  • Nausea
  • Diarrhea
  • Dry mouth
  • Difficulty falling asleep or staying asleep
  • Heartburn

Prozac has a half-life that is longer than Lexapro’s, which means it takes longer for Prozac to go through your body. Lexapro's half-life, while shorter than Prozac, is still moderate and you may not necessarily feel uncomfortable effects from missing a dose.  

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What to know before taking Lexapro or Prozac

Prozac and Lexapro may not be for everyone. Your doctor will review your health history before prescribing you any antidepressant to determine which medication will be best for you.  

Here are some medical conditions and medications that your doctor will keep in mind and ask you about:  

  • Bipolar disorder  
  • Type 1 diabetes or type 2 diabetes  
  • Epilepsy and seizures
  • Kidney disease
  • Pregnancy and breastfeeding (there are risks and benefits to taking antidepressants during pregnancy, which your doctor will be able to walk you through)  
  • Medications you take that increase the risk of bleeding, including NSAIDs
  • Medications and supplements you take that affect serotonin levels, including St. John’s Wort (this can lead to serotonin syndrome)

Is Lexapro or Prozac better?

Deciding between Lexapro and Prozac depends on your individual situation and needs. Your doctor will consider your symptoms and the possible side effects before recommending one over the other. No single SSRI is superior than another in terms of treating anxiety and depression; where they differ are in their costs and side effects.  If one or the other doesn't work for you, there may be another option to try. It can take trying multiple antidepressants before finding the right fit for you, but don’t let that stop you from getting help or treatment. The sooner you start, the sooner you can start feeling better.

If you have depression or anxiety and are wondering what treatment options are available, consider Talkiatry. We’re a national psychiatry practice that treats mental health conditions like anxiety and depression. You can take this quick online assessment to get matched with a psychiatrist and schedule your first virtual visit.  


Here are more answers to your questions about how Prozac and Lexapro compare.

What are the similarities between Prozac and Lexapro?

Both Prozac and Lexapro are antidepressant medications that belong to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. They work in the same way in the body and are proven effective for reducing symptoms of depression and anxiety.  

What are the differences?

Lexapro is FDA approved to treat anxiety, while Prozac is approved for a few other mental health conditions, including panic disorder. They also have slightly different side effects.  

Can you switch from Prozac to Lexapro?

Changing antidepressants can be a common part of treating depression and anxiety. Your body may react better to one medication than another, which is why it’s important to let your doctor know how you’re feeling. Don’t stop taking your medication on your own—your doctor will help you taper off your medication slowly and safely.

What are other antidepressants medications?

Other SSRIs include Luvox (fluvoxamine), Paxil (paroxetine), and Celexa (citalopram), while SNRIs include Effexor (venlafaxine). There are also atypical antidepressants like Viibryd (vilazodone), as well as MAOIs (monoamine oxidase inhibitors) and TCAs (tricyclic antidepressants).  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Does Talkiatry take my insurance?

We're in network with major insurers, including:

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For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.

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