Two medicines, side by side
Alprazolam vs escitalopram
Alprazolam and escitalopram are both labeled for anxiety. Drugs@FDA records approvals of alprazolam since 1981 and of escitalopram since 2002. Pharmacies paid $0.0236 per alprazolam 0.25 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, alprazolam is a benzodiazepine and escitalopram a serotonin reuptake inhibitor.
Check it at the source: the alprazolam FDA label on DailyMed (effective January 18, 2023); the escitalopram FDA label on DailyMed (effective October 1, 2023).
Highlights of the alprazolam record
Alprazolam (Xanax) · label of January 18, 2023
RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
Used for
From the label: indicationsXANAX is indicated for the: • acute treatment of generalized anxiety disorder (GAD) in adults. • treatment of panic disorder (PD), with or without agoraphobia in adults. XANAX is a benzodiazepine indicated for the: • Acute treatment of generalized anxiety disorder in adults. ( 1 ) • Treatment of panic disorder with or without agoraphobia in adults.
On the market
- Earliest approval on file
- October 16, 1981
- Generic labelers
- 30 labelers
- Pharmacy cost
- $0.0236 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 23
Highlights of the escitalopram record
Escitalopram (Lexapro) · label of October 1, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsLexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]
On the market
- Earliest approval on file
- August 14, 2002
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0632 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Source: FDA drug labels via openFDA (Alprazolam label of January 18, 2023, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do alprazolam and escitalopram differ on the record?
In FDA's classes, alprazolam is a benzodiazepine and escitalopram a serotonin reuptake inhibitor.
How each works, in its label's words: Alprazolam, “Alprazolam is a 1,4 benzodiazepine.”; Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”
Half-life, in each label's words: Alprazolam, “Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to …”; Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: alprazolam since 1993; escitalopram since 2007 (Drugs@FDA).
DEA schedule: alprazolam CIV; escitalopram none.
| Alprazolam | Escitalopram | |
|---|---|---|
| Labeled for | Anxiety | Depression, Anxiety |
| Pharmacologic class | Benzodiazepine | Serotonin Reuptake Inhibitor |
| How it works (label) | Alprazolam is a 1,4 benzodiazepine. | The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS … |
| Half-life (label) | Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to 26.9 hours) in healthy adults. | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. |
| Earliest approval on file (Drugs@FDA) | October 16, 1981 | August 14, 2002 |
| First generic approved | October 19, 1993 | July 31, 2007 |
| Generic labelers (NDC) | 30 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0236 per tablet (Alprazolam 0.25 mg tablet) | $0.0632 per tablet (Escitalopram 20 mg tablet) |
| 12-month price change | -1% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 23 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 204,916 | 139,519 |
| DEA schedule | CIV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Alprazolam label, drug interactionsCNS Depressants Clinical implication The benzodiazepines, including alprazolam, produce additive CNS depressant effects when coadministered with other CNS depressants.
Escitalopram label, drug interactionsConcomitant use of Lexapro and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Source: FDA drug labels via openFDA
What next?
- Alternatives to alprazolam
- every medicine labeled for the same conditions