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Lexapro Vs. Prozac

By Jennifer S. Wright ; Updated July 27, 2017

Both Lexapro and Prozac are similar prescription medications belonging to a class of drugs called select serotonin reuptake inhibitors, or SSRIs. This class of medication works by increasing a brain chemical called serotonin that regulates mood. The generic form of Lexapro is escitalopram oxalate, and the generic form of Prozac is fluoxetine hydrochloride.

Prozac was the first drug in this class of medications and was introduced in 1987 to the U.S. market. Since Prozac has been on the market longer it is generally cheaper than Lexapro.

Conditions Commonly Treated

Prozac is approved to treat more illnesses than Lexapro. Lexapro and Prozac can be prescribed to treat depression. Lexapro is also prescribed to treat generalized anxiety disorder.

Prozac can be prescribed to treat several more illnesses including obsessive-compulsive disorder (OCD), bulimia nervosa, obesity, sleep disorders, panic disorder, depression related to bipolar disorder, alcohol dependence, attention-deficit disorder, borderline personality disorder, headaches, post-traumatic stress disorder, Tourette's syndrome, premenstrual dysphoric disorder (PMDD), cataplexy, Raynaud's phenomenon and anorexia nervosa.

Directions for Use

Lexapro and Prozac are both available in liquid and tablet forms. Prozac is available in additional forms, such as capsules and delayed-release capsules.

Lexapro and Prozac are usually taken once daily, but Prozac delayed-release capsules are taken once a week, which may increase compliance in some patients who dislike taking a pill every day. Either medication can be taken with or without food. Prozac should be taken in the morning to avoid insomnia and nervousness.

Prozac takes longer, about four to five weeks, before full effects are felt. Full effects of Lexapro are felt in about one to four weeks.

Side Effects

Lexapro has fewer side effects. A common side effect of both Lexapro and Prozac is nausea. Prozac has additional common side effects such as generalized weakness, dizziness, headache, drowsiness, tremors, nervousness, dry mouth, diarrhea, anorexia, insomnia, changes in libido and anxiety.

Symptoms of an allergic reaction to either medication can include hives, rash, fever, joint pain, difficulty swallowing or breathing and swelling of the feet, legs, hands, arms, throat, tongue or face. These symptoms need to be evaluated by a medical professional immediately.


The risks with both medications are comparable. Both medications may increase suicidal behavior and thoughts in persons 18 to 24 years of age during the first two months of treatment. Call your physician if you experience worsening depression, extreme worry, hallucinations, impulsive actions, abnormal excitement, panic attacks, agitation, problems falling or staying asleep or if you have any thoughts or plans of harming yourself.

Lexapro and Prozac are Pregnancy Class C medications, which means the drugs have caused risks to fetuses in animal studies, but the benefit of the drugs may outweigh the risk in humans.


Neither medication should be used in conjunction with alcohol. Prozac should not be taken with the herb St. John’s wort.

Never stop taking Lexapro or Prozac without your physician’s guidance. Symptoms of withdrawal include mood changes, depression, abnormally excited or frenzied mood, anxiety, irritability, dizziness, confusion, tiredness, headache, unusual dreams, problems with falling or staying asleep, sweating, nausea and numbness or tingling in the feet, hands, legs or arms.

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