Two medicines, side by side
Escitalopram vs sertraline
Escitalopram and sertraline are both labeled for depression and anxiety. Drugs@FDA records approvals of escitalopram since 2002 and of sertraline since 1991. Pharmacies paid $0.0632 per escitalopram 20 mg tablet and $0.0507 per sertraline HCl 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: 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) …”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”
Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023); the sertraline FDA label on DailyMed (effective August 8, 2023).
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
Highlights of the sertraline record
Sertraline (Zoloft) · label of August 8, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior 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) ]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZOLOFT is indicated for the treatment of the following [See Clinical Studies (14) ]: • Major depressive disorder (MDD) • Obsessive-compulsive disorder (OCD) • Panic disorder (PD) • Posttraumatic stress disorder (PTSD) • Social anxiety disorder (SAD) • Premenstrual dysphoric disorder (PMDD) ZOLOFT is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of ( 1 ): • Major depressive disorder […]
On the market
- Earliest approval on file
- December 30, 1991
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0507 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Escitalopram label of October 1, 2023, Sertraline label of August 8, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do escitalopram and sertraline differ on the record?
How each works, in its label's words: 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) …”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”
Both are in FDA's class serotonin reuptake inhibitors.
Half-life, in each label's words: Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”; Sertraline, “The average terminal elimination half-life of plasma sertraline is about 26 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: escitalopram since 2007; sertraline since 2006 (Drugs@FDA).
| Escitalopram | Sertraline | |
|---|---|---|
| Labeled for | Depression, Anxiety | Depression, Anxiety |
| Pharmacologic class | Serotonin Reuptake Inhibitor | Serotonin Reuptake Inhibitor |
| How it works (label) | 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 … | Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT). |
| Half-life (label) | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. | The average terminal elimination half-life of plasma sertraline is about 26 hours. |
| Earliest approval on file (Drugs@FDA) | August 14, 2002 | December 30, 1991 |
| First generic approved | July 31, 2007 | June 30, 2006 |
| Generic labelers (NDC) | 43 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0632 per tablet (Escitalopram 20 mg tablet) | $0.0507 per tablet (Sertraline HCl 100 mg tablet) |
| 12-month price change | -12% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 139,519 | 218,311 |
| DEA schedule | none | 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?
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.
Sertraline label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to escitalopram
- every medicine labeled for the same conditions