Lexapro Vs. Prozac: Drug Comparison

Lexapro^® (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults and adolescents. Off-label uses may include treating panic disorder, obsessive-compulsive disorder (OCD), and social anxiety disorder. Lexapro is available in tablet and oral solution forms, taken once daily. Common side effects include nausea, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial stages of treatment.

Prozac^® (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD). Off-label uses may include managing post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and borderline personality disorder. Prozac is available in capsule, tablet, and liquid form, typically taken once daily. Common side effects include nausea, insomnia, headache, and sexual dysfunction. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults during the early stages of treatment.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Lexapro (escitalopram) is indicated for the:

• Treatment of major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older

• Treatment of generalized anxiety disorder (GAD) in adults and pediatric patients 7 years and older

Prozac (fluoxetine hydrochloride) is a indicated for:

• Acute and maintenance treatment of major depressive disorder (MDD)

• Acute and maintenance treatment of obsessive compulsive disorder (OCD)

• Acute and maintenance treatment of bulimia nervosa

• Acute treatment of panic disorder, with or without agoraphobia

Prozac and olanzapine in combination for treatment of:

• Acute depressive episodes associated with bipolar I disorder

• Treatment resistant depression

• Typically taken orally once daily

• Comes in 5 mg, 10 mg (scored), and 20 mg (scored) tablets

• Typically taken orally once daily

• Comes in 10 mg, 20 mg, and 40 mg Pulvules^®

Most commonly observed adverse reactions (incidence ≥ 5% and at least twice the incidence of placebo patients) are:

• Insomnia

• Ejaculation disorder (primarily ejaculatory delay),

• Nausea

• Sweating increased

• Fatigue and sleepiness

• Decreased libido

• Inability to orgasm

Most common adverse reactions (≥5% and at least twice that for placebo) associated with:

Major depressive disorder, obsessive compulsive disorder, bulimia, and panic disorder:

• Abnormal dreams

• Abnormal ejaculation

• Anorexia

• Anxiety

• Weakness

• Diarrhea

• Dry mouth

• Indigestion

• Flu syndrome

• Impotence

• Insomnia

• Libido decreased

• Nausea

• Nervousness

• Inflammation of the throat

• Rash

• Inflammation of the sinuses

• Sleepiness

• Sweating

• Tremor

• Vasodilatation

• Yawn

Prozac and olanzapine in combination:

• Also refer to the adverse reactions section of the package insert for Symbyax

• Do not use MAOIs intended to treat psychiatric disorders with Lexapro or within 14 days of stopping treatment with Lexapro. Do not use Lexapro within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start Lexapro in a patient who is being treated with linezolid or intravenous methylene blue

• Concomitant use of pimozide

• Known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients

• Drug interactions: SSRIs, SNRIs, tryptophan, drugs that affect hemostasis (NSAIDs, aspirin, warfarin)

• Serotonin syndrome and MAOIs

• Pimozide

• Thioridazine

• When using Prozac and olanzapine in combination, also refer to the contraindications section of the package insert for Symbyax

• Drug interactions: monoamine oxidase inhibitors (MAOIs), drugs metabolized by CYP2D6, tricyclic antidepressants (TCAs), CNS acting drugs, benzodiazepines, antipsychotics, anticonvulsants, serotonergic drugs, drugs that interfere with hemostasis (e.g., NSAIDs, aspirin, warfarin), drugs tightly bound to plasma proteins, olanzapine, drugs that prolong the QT interval

• Serotonin syndrome

• Discontinuation syndrome

• Seizures

• Activation of mania/hypomania

• Low blood sodium: Can occur in association with syndrome of inappropriate antidiuretic hormone secretion

• Increased risk of bleeding

• Interference with cognitive and motor performance

• Angle closure glaucoma

• Use in patients with concomitant illness

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase the risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulties, hypotonia, tremor, irritability) in the neonate

• Suicidal thoughts and behaviors in children, adolescents, and young adults

• Serotonin syndrome

• Allergic reactions and rash

• Activation of mania/hypomania

• Seizures

• Altered appetite and weight

• Increased risk of bleeding

• Angle-closure glaucoma

• Low blood sodium

• Anxiety and insomnia

• QT prolongation

• Potential for cognitive and motor impairment

• Long half-life

• Prozac and olanzapine in combination: When using Prozac and olanzapine in combination, also refer to the warnings and precautions section of the package insert for Symbyax

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors. Lexapro is not approved for use in pediatric patients less than 7 years of age.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants.

Monitor for worsening and emergence of suicidal thoughts and behaviors.

When using Prozac and olanzapine in combination, also refer to Boxed Warning section of the package insert for Symbyax.

*This information is from the label for brand name Lexapro^®. See the Full Prescribing Information for more complete information. Escitalopram, the active ingredient in Lexapro, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient escitalopram.

*This information is from the label for brand name Prozac^®. See the Full Prescribing Information for more complete information. Fluoxetine, the active ingredient in Prozac, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient fluoxetine.