Escitalopram vs Fluoxetine: Similarities and Differences

Medically Reviewed

Depression is a complex disorder that may need various treatment options to address it. Different kinds of psychotherapies can be beneficial for someone through depressive symptoms, and there is a wide range of pharmacological options to choose from.

Not every medication will work for every person, and not everyone with depression needs medication. Finding the right medication and dose for your needs may take some trial and error between you and your doctor. Escitalopram and fluoxetine are two predominant medications that are used to treat depression and related issues. How do they compare?

Similarities Between Escitalopram and Fluoxetine

Both escitalopram and fluoxetine are in a class of prescription drugs called selective serotonin reuptake inhibitors (SSRI). They work by influencing a process called reuptake, which is when a chemical in the brain is removed from the synapse, the area of communication between nerve cells. Removed chemicals are broken down and recycled to prevent an excessive buildup.

SSRIs prevent the reuptake of serotonin, major chemical messengers in the nervous system. Serotonin is one of your “feel-good chemicals,” which means it’s one of the neurotransmitters in the brain that’s tied to your mood. However, serotonin is also linked to various other functions in the brain, including the healing of wounds and triggering of nausea. It also regulates anxiety and limits depression.

Since both drugs work in similar ways in the brain, they have some of the same effects, such as improved mood and stabilize anxiety. They may also come with some of the same side effects like insomnia, nausea, decreased libido, loss of appetite, and dry mouth. They both may cause something called serotonin syndrome, which is a condition marked by fever, agitation, sweating, tremors, and sometimes seizures.

Both drugs are available in generic forms, and they may be prescribed for short- or long-term treatment. Neither drug comes with a significant addiction liability, but they both can cause withdrawal symptoms when you decide to quit.

Differences Between Escitalopram and Fluoxetine

Escitalopram is sold under the brand name Lexapro, which is used to treat major depressive disorder and generalized anxiety disorder. Fluoxetine is sold under the brand name Prozac. It’s also used to treat anxiety and depression.

Man comparing two pill bottlesHowever, if you have obsessive-compulsive disorder, panic disorder, bulimia, or depressive bipolar disorder, you are more likely to take Fluoxetine, which has shown to be more effective for those other mental health disorders.

Escitalopram and fluoxetine are available in oral tablet form and as oral solutions, but only fluoxetine is available in a delayed-release form. Both drugs are similar in their potency, but Prozac is slightly weaker than Lexapro, so equivalent doses of it are slightly smaller.

Fluoxetine has a longer half-life than escitalopram at one to four days to escitalopram’s 32 hours. That means fluoxetine lasts longer in your bloodstream and may be effective for longer.

Long-term use of fluoxetine can give it a longer half-life, which means you may have longer periods between doses if you use the drug for a long time.

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