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Prozac vs Lexapro: What's The Difference?

Vicky Davis

Medically reviewed by Vicky Davis, FNP

Written by Our Editorial Team

Last updated 8/31/2022

If you are dealing with major depression or anxiety, an antidepressant medication is a common treatment option. 

There are a number of different types of medications that can be taken to address symptoms of depression. Two medications that are sometimes used are Prozac and Lexapro. 

Both of these medications need to be prescribed by a healthcare provider for the treatment of depression or anxiety. Curious about them? Keep reading to learn more.

Learning About Prozac

Prozac — which is also sold as a generic called fluoxetine — is approved to treat major depressive disorder, obsessive compulsive disorder (OCD), panic disorder, bulimia and premenstrual dysphoric disorder (PMDD).

It is in a class of antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs). This type of antidepressant works by preventing the reabsorption of the neurotransmitter serotonin. Because of this, there is more serotonin in your brain.

Wondering how this can help with depression or anxiety? Serotonin plays a big role in your mood and behavior and it’s thought that issues with levels of serotonin could lead to depression.

Fluoxetine is available in tablets, liquid oral solution, capsules and delayed-release capsules. The first three forms are taken daily, while the delayed-release capsules are taken weekly.

It is possible you will be started on a lower dose, which may be increased as time goes on. This can help determine the right dosage for you and also prevent short-term side effects. 

You may need to take fluoxetine for four to five weeks before you notice a difference. You should not stop taking this medication suddenly — if you do, you may notice your original symptoms come back, and you could experience withdrawal symptoms. If you need to come off this medication for any reason, you should do so under the guidance of a healthcare professional. 

The most important thing to know is that research shows that fluoxetine can be an effective treatment for depression. A review of 87 different randomized clinical trials that looked at over 9,000 patients concluded that this medication is safe and works to treat depression — it’s even okay for elderly people and pregnant women.

Side Effects

Before you start taking fluoxetine, it’s helpful to understand the side effects that you may experience. Often, these side effects go away once your body gets used to taking fluoxetine.

Here are some of the most common side effects:

Along with the adverse effects listed above, there are some more serious side effects you should be aware of. While these rare, contact a healthcare professional for medical attention immediately if you notice any: 

  • Rash

  • Hives or itching

  • Blisters 

  • Fever

  • Joint pain

  • Swelling

  • Difficulty breathing or swallowing

  • Shortness of breath

  • Fainting

  • Seizures

  • Irregular heart beat 

  • Abnormal breathing

Whenever you start taking a new medication, you should let your healthcare provider know if you’ve had an allergic reaction to medication in the past. You should also let them know if you have any other medical conditions. This information can help your healthcare provider determine the right antidepressant treatment for you and you might have any medication interactions. 

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Learning About Lexapro

Lexapro — commonly referred to by its generic name escitalopram — is approved to treat major depressive disorder and generalized anxiety disorder (GAD). It is also sometimes prescribed off-label to treat OCD, bulimia nervosa, panic disorder and premenstrual dysphoric disorder (PMDD). In other words, there’s a lot of crossover with fluoxetine in terms of what it treats. Also like fluoxetine, escitalopram is a SSRI.   

Escitalopram can be taken as a tablet or a liquid oral solution and comes in doses from 1mg to 20 mg. The liquid comes in 1 mg doses and tablets come in 5 mg, 10 mg and 20 mg. Your healthcare provider will determine the right dosage for you — it’s possible you’ll be started on a lower dose before you work your way up to a higher dose

Side Effects

Because fluoxetine and escitalopram are both selective serotonin reuptake inhibitors, the side effects are similar. 

Common side effects of escitalopram include:

  • Nausea

  • Dizziness 

  • Low libido 

  • Trouble falling asleep

  • Heartburn

  • Constipation

  • Drowsiness and yawning

  • Trouble falling or styling asleep

  • Dry mouth

  • Flu-like symptoms 

  • Sore throat

  • Decreased appetite or weight loss

  • Runny nose and sneezing

Often, you may experience these side effects when you first start taking the medication and they’ll taper off as you get used to it. 

Along with these, there are some more serious potential side effects you should be on the lookout for. If you experience any of the following, contact a healthcare professional for medical advice as soon as possible:

  • Unusual excitement

  • Hives or blisters

  • Rash

  • Itching

  • Fever

  • Difficulty breathing or swallowing

  • Swelling of the face, tongue or throat

  • Seizures

  • Difficult or painful urination

  • Abnormal bleeding 

The Difference Between Prozac and Lexapro 

Both Prozac and Lexapro are used to treat major depressive disorder. Along with that, each one is sometimes used to treat other mental health conditions and anxiety disorders, like panic disorder, generalized anxiety disorder and obsessive compulsive disorder. These medications can also be used to treat bulimia nervosa and PMDD. 

Both medications require a prescription and fall under a type of antidepressant known as selective serotonin reuptake inhibitors, which help increase or stabilize your serotonin levels. 

But even though these drugs are in the same class of antidepressants — which means they work in the same way and have similar common side effects — some people may prefer one or be better able to tolerate one over the other. For some people, one SSRI may not treat their depression, while another will.

It’s also possible to have bad side effects from one SSRI but not from another. 

Even though SSRIs all have the same general mechanism of action, they work on slightly different enzymes. That means you may metabolize — or break down — one better than the other, which can cause different effects, especially when it comes to drug interactions.

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Treating Depression with Prozac or Lexapro

Both Lexapro and Prozac are effective treatments for depression and other mental health conditions. If you have noticed depression symptoms, you don’t need to try to make it through alone or without treatment.

Reach out to a healthcare provider as soon as possible to discuss your options. Hers offers an easy online consultation with a mental health professional for depression medication online. You can discuss your symptoms and what you may be looking for with treatment for depression, and get the help you need for major depression or anxiety.

10 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Fluoxetine. National Alliance on Mental Illness Retreived from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Fluoxetine-(Prozac)
  2. Chu, A., Wadhwa, R., (2021). Selective Serotonin Reuptake Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/
  3. Berger, M., Gray, J., Roth, B., (2018, March). The Expanded Biology of Serotonin. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864293/
  4. Fluoxetine. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a689006.html
  5. Rossi, A., Barraco, A., Donda, P., (2004). Fluoxetine: A Review on Evidence Based Medicine. Ann Gen Hosp Psychiatry. Retrieved from https://pubmed.ncbi.nlm.nih.gov/14962351/
  6. Escitalopram (Lexapro). National Alliance of Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro)
  7. Escitalopram. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a603005.html
  8. Keks, N., Hope, J., Keogh, S. (2016). Switching and stopping antidepressants. Aust Prescr 39(3). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919171/
  9. Chu, A., Wadhwa,R. (Updated 2022, May 8). Selective Serotonin Reuptake Inhibitors.. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/
  10. Preskorn, S.H. (1997). Clinically relevant pharmacology of selective serotonin reuptake inhibitors. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism. Clin Pharmacokinet, Suppl 1:1-21. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9068931/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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