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.

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:

Major depressive disorder (MDD) in children over the age of 8

Panic disorder

Social anxiety disorder 

Bulimia

Obsessive-compulsive disorder (OCD) in adults and children 7 years and older

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

Prozac off-label uses:

Post-traumatic stress disorder (PTSD)

Borderline personality disorder (BPD)

Lexapro is approved by the FDA to treat:

Major depressive disorder (MDD) in adults and children over 12

Generalized anxiety disorder (GAD) in adults

Lexapro off-label uses:

Obsessive-compulsive disorder (OCD)

Panic disorder

Premenstrual dysphoric disorder (PMDD)

Post-traumatic stress disorder (PTSD)

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.   

 Medication

Lexapro

Prozac

Conditions Treated

Major depressive disorder
Generalized anxiety disorder

Major depressive disorder
OCD
Panic disorder
Bulimia nervosa

Common Side Effects

Nausea
Dry mouth
Insomnia
Sweating 
Decreased libido 

Dry mouth
Loss of appetite
Excessive sweating
Nausea

Key Considerations

Highly 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.