Prozac vs. Lexapro: What’s the Difference?

Published on: 18 Oct 2023
Clinically Reviewed by Karmen Smith LCSW, DD 
Prozac vs. Lexapro

More than 13% of adults in the United States take an antidepressant medication, according to CDC research. Selective serotonin reuptake inhibitors (SSRIs) are a popular class of drugs for treating depression, anxiety disorder, obsessive-compulsive disorder, and other conditions. Two commonly prescribed SSRIs are Lexapro (escitalopram) and Prozac (fluoxetine). 

Both of these selective serotonin reuptake inhibitor drugs are considered first-line treatment antidepressants, and conveniently, you can get a prescription for Lexapro or Prozac online. Both antidepressant medications have been FDA-approved to treat depression, and Lexapro is also approved for treating generalized anxiety disorder (GAD). Prozac is also approved to treat certain anxiety disorders, like social anxiety disorder and panic disorders. 

“Lexapro and Prozac are both in the category of SSRIs (serotonin selective reuptake inhibitors). SSRIs increase the amount of serotonin in the brain. Both Prozac and Lexapro are FDA-approved to treat depression and anxiety. Both have the same side effects of stomach upset and decreased sexual drive. SSRIs such as Lexapro and Prozac are considered the safer and better-tolerated class of antidepressants.”

Talkspace psychiatrist Dr. Dion Metzger

Despite some of their overlaps, Prozac and Lexapro have differences that are essential to understand so you can make an informed decision about your treatment plan.

Differences Between Prozac vs Lexapro

A significant difference between Lexapro and Prozac is how these two SSRIs work. Prozac has an extended half-life, so it stays in your system longer than Lexapro. This might make it a better choice for people who occasionally miss their medication because skipping a dose won’t lead to withdrawal symptoms due to the drug’s long-lasting effect.

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Conditions they treat

In addition to treating depression, Lexapro and Prozac are sometimes used for other mental health conditions.  

Prozac is approved for the treatment of:

Prozac can also be combined with Zyprexa to treat bipolar one disorder depression. 

Prozac off-label uses:

Lexapro is approved by the FDA to treat:

Lexapro off-label uses:

Dosage amount

Dosage amounts and forms also differ between Prozac vs Lexapro.

Prozac is available in the following doses and forms: 

  • Tablet — 10, 20, 60 mgs
  • Capsule — 10, 20, 40 mgs; or 90 mg delayed-release
  • Liquid — 20 mg per 5mL

Lexapro is available in the following doses and forms:

  • Tablets — 5, 10, 20 mgs
  • Liquid — 5 mg per 5 mL

Is Prozac milder than Lexapro?

In studies, Lexapro and Prozac have about the same effect. However, for some people, the side effects caused by Lexapro might be milder. 

Side effects

Prozac (fluoxetine) and Lexapro do have side effects in common, but there are also some differences. Lexapro can have fewer side effects, but it’s more likely to cause sexual dysfunction in men. Prozac can be more prone to causing nausea, sleep disturbances, and changes in appetite for more people.

Other common side effects of Prozac can include:

  • Headache
  • Dizziness or drowsiness
  • Anxiety or nervousness
  • Difficulty sleeping
  • Decreasing sex drive
  • Nausea or diarrhea
  • Decreased appetite or weight loss
  • Dry mouth
  • Weakness or tremoring
  • Sweating

Other common side effects of Lexapro can include:

  • Dry mouth
  • Difficulty sleeping
  • Ejaculation problems
  • A decrease in sex drive
  • Nausea and diarrhea
  • Drowsiness or dizziness
  • Weakness
  • Sweating

Similarities Between Prozac vs. Lexapro

Similarities between Lexapro and Prozac include: 

  • Both are SSRIs
  • They can have similar effects
  • They work in similar ways
  • Treatment of depression

Side effects

Serious side effects of both Prozac and Lexapro can include:

  • Risk of experiencing withdrawal symptoms 
  • Abnormal heart rhythms — risk can be higher in Lexapro
  • Buildup of serotonin in the body (high serotonin level)
  • High risk of bleeding
  • Manic episodes in people with bipolar disorder
  • Low sodium levels

How they work

Antidepressant medications known as SSRIs function by altering serotonin levels in the brain. They slow down serotonin reuptake to help promote calmness and improve mood. Increasing your brain’s serotonin level can effectively treat major depressive disorder in some people. Some SSRIs are used to treat generalized anxiety disorder (GAD). 

Effective treatment for depression 

These medications both effectively treat depression in some people. That said, no medication is guaranteed to work the same for everyone. Talk to your doctor or a medical professional about your symptom types and condition to determine which medication is right for you. 

Is Lexapro better than Prozac for anxiety?

The decision to take Lexapro vs. Prozac for anxiety depends on several factors, including specific symptom experiences, overall health, and personal response to medication. While both might be effective in treating some types of anxiety, only Lexapro has been approved to treat generalized anxiety disorder. You should consult with a healthcare provider for personalized advice.

Do you gain weight on Prozac or Lexapro?

Weight change is possible when taking either Prozac or Lexapro, but whether you’ll gain or lose weight can differ for everyone. According to research, an estimated 41% of people on Lexapro might experience weight gain. While Lexapro weight gain can vary, one study found an average of 2.4 pounds gained over 9 months. For Prozac, some research shows people gain an average of 7 pounds.   

Conditions TreatedMajor depressive disorder
Generalized anxiety disorder
Major depressive disorder
Panic disorder
Bulimia nervosa
Common Side EffectsNausea
Dry mouth
Decreased libido 
Dry mouth
Loss of appetite
Excessive sweating
Key ConsiderationsHighly effective in treating GAD
Available in brand name or generic
More likely to have interactions with other drugs
Available in brand name or generic

Determine if Prozac or Lexapro Is Right for You 

Deciding which drug is best for you and your condition is easier when you know the difference between Lexapro and Prozac. People can have varying experiences with medications, and there’s no one-size-fits-all when treating mental health conditions like anxiety or depression. Talk to a medical professional, or contact Talkspace today to determine whether Prozac vs. Lexapro might be best for you. Our online psychiatrists can help you find the right treatment for you.


  1. Antidepressant Use Among Adults: United States, 2015-2018. Centers for Disease Control and Prevention. September 4, 2020. Accessed August 20, 2023.
  2. Cipriani A, Santilli C, Furukawa TA, et al. Escitalopram versus other antidepressive agents for depression. Cochrane Database of Systematic Reviews. 2009;2016(5). doi:10.1002/14651858.cd006532.pub2. Accessed August 22, 2023. 
  3. Anagha K, Shihabudheen P, Uvais NA. Side effect profiles of selective serotonin reuptake inhibitors. The Primary Care Companion For CNS Disorders. 2021;23(4). doi:10.4088/pcc.20m02747. Accessed August 22, 2023. 

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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