Compare common side effects, interactions, warnings, and more.
Lexapro
*image for illustrative purpose only
Xanax
*image for illustrative purpose only
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.
Xanax® (alprazolam) is a benzodiazepine medication used to treat anxiety and panic disorders by enhancing the activity of GABA, a neurotransmitter that calms the nervous system. Its FDA-approved indications include the treatment of generalized anxiety disorder (GAD) and panic disorder with or without agoraphobia. Xanax is available in tablet, extended-release tablet, and oral solution forms, typically taken once to multiple times daily depending on the dose. Common side effects include impaired coordination, low blood pressure, difficulty speaking, and increased libido. Serious risks include dependence, withdrawal, and respiratory depression, especially when combined with opioids or alcohol. Xanax carries a boxed warning for the risk of abuse, dependence, and potentially fatal respiratory depression when used with other central nervous system (CNS) depressants.
Selective serotonin reuptake inhibitor (SSRI)
Benzodiazepine
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
Xanax (alprazolam) is indicated for the:
Acute treatment of generalized anxiety disorder in adults
Treatment of panic disorder with or without agoraphobia in adults
Typically taken orally once daily
Comes in 5 mg, 10 mg (scored), and 20 mg (scored) tablets
Typically taken orally three times daily
Comes in 0.25 mg, 0.5 mg, 1 mg, and 2 mg tablets
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
The most common adverse reactions reported in clinical trials for generalized anxiety disorder and panic disorder (incidence >5% and at least twice that of placebo) include:
Impaired coordination
Low blood pressure
Difficulty forming or pronouncing words
Increased libido
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)
Known hypersensitivity to alprazolam or other benzodiazepines
Concomitant use with strong cytochrome P450 3A (CYP3A) inhibitors, except ritonavir
Drug interactions: Opioids, other central nervous system (CNS) depressants, digoxin, CYP3A inhibitors (except ritonavir), CYP3A inducers
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
Effects on driving and operating machinery
Patients with depression: Exercise caution in patients with signs or symptoms of depression
Neonatal sedation and withdrawal syndrome
Breastfeeding: Breastfeeding not recommended
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: RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.
The use of benzodiazepines, including Xanax, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Before prescribing Xanax and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.
Abrupt discontinuation or rapid dosage reduction of Xanax after continued use may precipitate acute withdrawal reactions, which can be life-threatening. To reduce the risk of withdrawal reactions, use a gradual taper to discontinue Xanax or reduce the dosage.
*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 Xanax®. See the Full Prescribing Information for more complete information. Alprazolam, the active ingredient in Xanax, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient alprazolam.
The information provided here is NOT MEDICAL ADVICE and is for informational and educational purposes only. The drug comparison tool does not determine eligibility for medications or treatments provided via the Hims/Hers platform. Consultation with a healthcare provider is required to assess suitability for any medical treatment based on individual health and medical history. All product names and associated trademarks are the property of their respective owners.