Compare Lexapro vs. Prozac

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Lexapro
(Escitalopram)

Prozac
(Fluoxetine)

Improves mood and helps you relax. Lexapro (Escitalopram) is good for treating depression and anxiety. Might be less likely to cause side effects than some antidepressants, but not the best choice for people with heart or liver problems.Improves mood and helps you relax. Prozac (Fluoxetine) is good for treating depression and anxiety. It's more energizing than other antidepressants, but may not be the best choice for people who have trouble sleeping.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.832985386221294Lexapro
Reviews for Lexapro (Escitalopram)
59%
of people say Lexapro (Escitalopram) is worth it
46%
say it works well
15%
say it's a big hassle
Reviews for Prozac (Fluoxetine)
61%
+2% vs. Lexapro (Escitalopram)
40%
6% vs. Lexapro (Escitalopram)
16%
1% vs. Lexapro (Escitalopram)
Side effects
LexaproProzac
  • Ejaculation disorder 12%
  • Ejaculation disorder (primarily ejaculatory delay) 11%
  • Sleep difficulty 10%
  • Nausea 10%
  • Diarrhea 9%
  • Headache 7%
  • Drowsiness 6%
  • Fatigue 6%
  • Dizziness 5%
  • Lower sex drive 5%
More Lexapro side effects »
  • Rash 57%
  • Sleep difficulty 20%
  • Nausea 18%
  • Muscle weakness 12%
  • Drowsiness 10%
  • Tremor 9%
  • Dry mouth 9%
  • Lower sex drive 9%
  • Loss of appetite 7%
  • Anxiety 7%
More Prozac side effects »
How it works
LexaproProzac
Lexapro (Escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.Prozac (Fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.
Type of medication
LexaproProzac
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Available as
LexaproProzac
  • Pill
  • Liquid
  • Pill
  • Delayed release capsule
  • Liquid
Used for (click to learn more)
LexaproProzac
How well it works for depression
The free Iodine Start program helps people track how well they are improving, and find the right antidepressant faster.

After 4 weeks using Start and Lexapro (Escitalopram), here’s how much better people feel.

After 4 weeks using Start and Prozac (Fluoxetine), here’s how much better people feel.

Risk factors for serious side effects
LexaproProzac
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Lexapro (Escitalopram) suddenly
  • Higher dose
  • History of heart problems
  • History of liver problems
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Lexapro (Escitalopram) risks & warnings »
    • Age 24 years or younger
    • Using other medications that affect serotonin
    • Stopping Prozac (Fluoxetine) suddenly
    • History of heart problems
    • History of liver problems
    • Drug interactions
    • Taking other blood-thinning drugs
      • History of bipolar disorder
      • At risk for bipolar disorder
      Detailed Prozac (Fluoxetine) risks & warnings »
      Pregnancy category
      LexaproProzac
      CFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      CFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      Alcohol
      No specific alcohol-related info.No specific alcohol-related info.
      Food
      • Take with food to avoid upset stomach.
      • Take in the morning with food to avoid side effects.
      Kidneys and liver
      No specific kidneys and liver-related info.No specific kidneys and liver-related info.
      Sex
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Lexapro (Escitalopram) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Prozac (Fluoxetine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      Sleep
      • Stopping Lexapro (Escitalopram) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      • Stopping Prozac (Fluoxetine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      Weight
      • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
      No specific weight-related info.
      Upsides and benefits
      LexaproProzac
      • Lowers relapse rates of depression.
      • Causes less sleepiness than some other antidepressants.
      • Effective at relieving depression and anxiety symptoms.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      • Lowers relapse rates of depression and bulimia nervosa.
      • Causes less sleepiness than other antidepressants.
      • It's more energizing than other antidepressants, so it's good for people who have low energy.
      • It has been used to treat depression for a long time, so there's a lot of information available about how it works and how safe it is.
      • Effective at relieving depression and anxiety symptoms.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      Downsides and risks
      LexaproProzac
      • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
      • Can cause an irregular heartbeat if you take a high dose (20 mg a day, or more).
      • Not a good option for you if you have heart or liver problems.
      • The first antidepressant you try doesn't always work, and might have side effects you really don't like. You might need to try a few different medicines until you find one that works for you and that you can tolerate.
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than 24.
      • Can increase feelings of anxiety or cause headaches during the first few weeks of taking it. These effects should go away over time.
      • More likely than other antidepressants to interact with other medications you're taking.
      • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than 24.
      Tips from our pharmacists for people taking the medication
      LexaproProzac
      • Take with food to avoid upset stomach.
      • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
      • Stop taking it slowly to avoid getting withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      • Take in the morning with food to avoid side effects.
      • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
      • Stop taking it slowly to avoid getting withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      Learn more
      More about LexaproSide effectsReviews & ratingsAlternativesFDA package insert
      More about ProzacSide effectsReviews & ratingsAlternativesFDA package insert