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≡ main menu home supplements products about comments lexapro (escitalopram) vs. prozac (fluoxetine) lexapro (escitalopram) and prozac (fluoxetine) are two medications within the selective-serotonin reuptake inhibitors (ssri) classification that are commonly administered for the treatment of neuropsychiatric disorders. the development of lexapro (escitalopram) was initiated in 1997 by lundbeck and forest laboratories – whereas the development of prozac (fluoxetine) was initiated in the 1970s by chemists (bryan molloy and robert rathbun) at eli lilly. more specifically, lexapro (escitalopram) was intended to be an upgraded version of the medication celexa (citalopram) – whereas prozac (fluoxetine) was intended to be a diphenhydramine derivative that enhanced mood via inhibiting serotonin reuptake. in december 1987, prozac became the first ssri ever to receive u.s. fda approval for medical use – whereas lexapro received u.s. fda approval in 2002. both lexapro and prozac are approved by the u.s. fda for the treatment of major depressive disorder (mdd). however, lexapro is also approved as a treatment for generalized anxiety disorder (prozac is not) – and prozac is also approved as a treatment for obsessive compulsive disorder (ocd), bulimia nervosa, and panic disorder (lexapro is not). lexapro (escitalopram) vs. prozac (fluoxetine) included below is a chart highlighting general attributes of the serotonergic medications lexapro (escitalopram) and prozac (fluoxetine). assessing this chart should help patients understand some general similarities and differences between these selective-serotonin reuptake inhibitors. lexapro prozac ingredient escitalopram oxalate fluoxetine hydrochloride drug classification ssri (selective-serotonin reuptake inhibitor) ssri (selective-serotonin reuptake inhibitor) approved medical uses major depressive disorder (mdd). generalized anxiety disorder (gad). major depressive disorder (mdd). obsessive compulsive disorder (ocd). bulimia nervosa. panic disorder. off-label uses body dysmorphic disorder. hot flashes. obsessive-compulsive disorder (ocd). panic disorder. post-traumatic stress disorder (ptsd). premature ejaculation. premenstrual dysphoric disorder (pmdd). social anxiety disorder. alcohol dependence. autism spectrum disorder. binge eating disorder. body dysmorphic disorder. cataplexy. obesity. post-traumatic stress disorder (ptsd). premature ejaculation. premenstrual dysphoric disorder. social anxiety disorder. trichotillomania. bioavailability ~80% (oral) ~72% (oral) formats tablet. oral solution. capsule. tablet. oral solution. delayed-release (dr) capsule. dosages tablet: 5 mg, 10 mg, 20 mg oral solution: 5 mg/5 ml capsule: 10 mg, 20 mg, 40 mg tablet: 10 mg, 20 mg, 60 mg oral solution: 20 mg/5 ml delayed-release capsule: 90 mg developers lundbeck & forest laboratories eli lilly legal status rx (prescription)-only (u.s.) rx (prescription)-only (u.s.) mechanism of action selective-serotonin reuptake inhibitor. interacts with the serotonin transporter (sert) to prevent reabsorption of serotonin into the presynaptic neuron. modestly agonizes sigma-1 and sigma-2 receptors. selective-serotonin reuptake inhibitor. interacts with the serotonin transporter (sert) to prevent reabsorption of serotonin into the presynaptic neuron. additional actions: -5-ht2c receptor antagonist. -sigma-1 receptor agonist. -anoctamin-1 channel blocker. -acid sphingomyelinase inhibitor. -5-ht2a receptor modulator. -increases allopregnanolone concentrations (which modulates gabaa receptors). -may interact with the norepinephrine transporter (net) and muscarinic acetylcholine receptors (m1, m3, m2, m5) at high doses. -may increase synaptic norepinephrine and dopamine at high doses. -may interact with 5-ht3 receptors, nicotinic acetylcholine receptors (nachrs), and various ion channels. (norfluoxetine, the primary metabolite of fluoxetine, may interact with the dopamine transprter (dat) at high doses). generic version (?) yes. yes. half-life 27 to 33 hours (~35 hours) 96 to 144 hours common side effects insomnia. ejaculation disorder. nausea. sweating. fatigue. somnolence. decreased libido. anorgasmia. abnormal dreams. abnormal ejaculation. anorexia. anxiety. asthenia. diarrhea. dry mouth. dyspepsia. flu syndrome. impotence. insomnia. libido reduction. nausea. nervousness. pharyngitis. rash. sinusitis. somnolence. sweating. tremor. vasodilation. yawning. date approved (u.s.) 2002 (august) 1987 (december) duration of effect 24 hours 24 hours (standard) 1-week (delayed-release) metabolism hepatic: cyp2c19 (36%), cyp3a4 (34%), cyp2d6 (30%) hepatic: cyp2d6 (primary) + cyp1a2, cyp2b6, cyp2c19, cyp2c9, cyp3a4, cyp3a5 (secondary) onset of action 4 to 8 weeks (on average) 4 to 8 weeks (on average) dosage equivalence (approximation) 10 mg 20 mg note : the information documented within the above chart could be subject to inaccuracies and/or outdated. if you have specific questions about lexapro and/or prozac – contact a licensed medical doctor and/or pharmacist. lexapro vs. prozac: what are general differences? despite the fact that both lexapro and prozac are classified as selective-serotonin reuptake inhibitors (ssris), the agents differ in numerous ways. general differences between lexapro and prozac include: date of release; official medical uses; off-label uses; mechanism of action; formatting; bioavailability; route of metabolism; half-life; and common side effects . as was previously stated, in december 1987, prozac (fluoxetine) became the first ssri (selective-serotonin reuptake inhibitor) to receive fda-approval for medical use in the united states. nearly 15 years after the release of prozac, lexapro received fda approval for medical use in august 2002 . though lexapro and prozac are both indicated for the treatment of major depressive disorder (mdd), only lexapro is approved to treat generalized anxiety disorder (prozac is not) – and only prozac is approved to treat obsessive-compulsive disorder, bulimia nervosa, and panic disorder (lexapro is not). furthermore, while both lexapro and prozac are regularly prescribed off-label (to treat conditions for which they haven’t been fda approved), there may be slight differences in their respective rates of off-label use for certain conditions. there also appear to be differences between lexapro and prozac in pharmacodynamics – or the specific neurochemical targets with which each medication interacts. lexapro is the most selective ssri medication on the market – interacting primarily with the serotonin transporter (sert), and to a lesser extent, sigma-1 and sigma-2 receptors . prozac is significantly less selective than lexapro – interacting with a variety of neurochemical targets beyond its primary interaction with the serotonin transporter (sert) . secondary neurochemical targets for prozac include: 5-ht2c receptors, sigma-1 receptors, anoctamin-1 channels, acid sphingomyelinase enzymes, 5-ht2a receptors, gabaa receptors, the norepinephrine transporter (net), acetylcholine receptors (muscarinic and nicotinic), 5-ht3 receptors, the dopamine transporter (dat), and various ion channels. moreover, while lexapro and prozac are both manufactured in tablet and oral solution formats – only prozac is manufactured in standard (~24-hour) capsules and delayed-release (7-day) capsules . the specific routes of metabolism for lexapro and prozac are similar, but differ slightly in that prozac is metabolized by 2 additional hepatic enzymes . specifically, lexapro is metabolized hepatically by the enzymes cyp2c19, cyp2d6 and cyp3a4 – whereas prozac is metabolized hepatically by the enzymes cyp2d6, cyp2c19, cyp2c9, cyp3a4, cyp3a5, cyp1a2, and cyp2b6. in terms of elimination half-life, the elimination half-life of lexapro ranges from 27 to 33 hours and is shorter than the elimination half-life of prozac which ranges from 96 to 144 hours . there are also differences between lexapro and prozac in common side effects. comm

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