Escitalopram vs. Fluoxetine for Depression: Important Differences and Potential Risks.

Escitalopram

(Lexapro)

Fluoxetine

(Prozac)

Summary for Escitalopram

Prescription only

Escitalopram, also known by its brand name, Lexapro, is a selective serotonin reuptake inhibitor (SSRI). It's a first-choice antidepressant to treat depression and anxiety in adults and children. The medication is available as a tablet and oral solution, in both brand and generic forms. A dose is typically taken by mouth once per day. Some common side effects include nausea, trouble sleeping (insomnia), and dizziness.

Indications for Escitalopram

Depression in people ages 12 years and older
Generalized anxiety disorder (GAD) in people ages 7 years and older

Pros and Cons for Escitalopram

Pros

First-choice medication for anxiety and depression
Only need to take it once a day
Generally has fewer side effects compared to other antidepressants
Can be taken with or without food

Cons

Can take up to 2 months before you feel the the full benefits
Risk of certain sexual problems
Can raise your risk for bleeds
Can cause withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Escitalopram

Headache (24%)
Nausea (15-18%)
Ejaculation problems (9-14%)
Sleepiness (6-13%)
Trouble sleeping (9-12%)
Dry mouth (6-9%)
Diarrhea (8%)
Tiredness (5-8%)

Warnings for Escitalopram

Worsening depression, suicidal thoughts, and unusual behavior
Serotonin syndrome
Stopping escitalopram (Lexapro) too suddenly
Risk of bleeding
Not for use alone in bipolar disorder
Glaucoma
Life-threatening abnormal heart rhythm (QT prolongation)
Low blood sodium levels
Sexual problems

Summary for Fluoxetine

Prescription only

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI). It's used to treat several mental health conditions, including depression and panic disorder. The immediate-release pill and liquid are taken by mouth, typically once or twice daily. The delayed-release capsule is taken weekly, but it's approved only for depression. Some common side effects of fluoxetine (Prozac) include headaches, difficulty sleeping, and tiredness. Don't suddenly stop this medication if you've been taking it for a while; doing so can lead to symptoms of withdrawal.

Indications for Fluoxetine

Pros and Cons for Fluoxetine

Pros

Good choice for treating depression, OCD, and panic disorder
Less likely to make you sleepy compared to some other antidepressants, such as paroxetine (Paxil)
Taken by mouth, typically once daily (IR capsules and liquid) or once weekly (DR capsules, for depression only)
Can be taken with or without food

Cons

Can take up to 2 months for you to feel the full effects of the medication
Can raise the risk of suicidal thoughts and/or behavior in those age 24 or younger
Can interact with other medications, especially those affecting serotonin levels
Can cause withdrawal symptoms if you suddenly stop taking it