Two medicines, side by side

Escitalopram vs trazodone

Escitalopram and trazodone are both labeled for depression. Drugs@FDA records approvals of escitalopram since 2002 and of trazodone since 1981. Pharmacies paid $0.0632 per escitalopram 20 mg tablet and $0.0307 per trazodone 50 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Trazodone's other strengths are brand-only: $2.00 per mL (Raldesy 10 mg/mL solution). 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) …”; Trazodone, “The mechanism of trazodone's antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS.”

Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023); the trazodone FDA label on DailyMed (effective January 22, 2026).

Highlights of the escitalopram record

Escitalopram (Lexapro) · label of October 1, 2023

Boxed warning

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: indications
Lexapro 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 trazodone record

Trazodone (Desyrel) · label of January 22, 2026

Boxed warning

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 )]. Trazodone is not approved for use in pediatric patients [see Use in Specific Populations ( 8.4 )].

Used for

From the label: indications
Trazodone is a selective serotonin reuptake inhibitor indicated for the treatment of major depressive disorder (MDD) ( 1 ). Trazodone hydrochloride tablets are indicated for the treatment of major depressive disorder (MDD) in adults.

On the market

Earliest approval on file: December 24, 1981
Generic labelers: 38 labelers
Pharmacy cost: $0.0307 per tablet

Supply and safety

Shortage: No current entry
Recalls: 5

Source: FDA drug labels via openFDA (Escitalopram label of October 1, 2023, Trazodone label of January 22, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do escitalopram and trazodone 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) …”; Trazodone, “The mechanism of trazodone's antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS.”

Both are in FDA's class serotonin reuptake inhibitors.

Both labels carry a boxed warning; the records quote them.

Generics: escitalopram since 2007; trazodone since 1986 (Drugs@FDA).

	Escitalopram	Trazodone
Labeled for	Depression, Anxiety	Depression
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 …	The mechanism of trazodone's antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS.
Half-life (label)	Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.	n/a
Earliest approval on file (Drugs@FDA)	August 14, 2002	December 24, 1981
First generic approved	July 31, 2007	October 10, 1986
Generic labelers (NDC)	43 labelers	38 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)	$0.0632 per tablet (Escitalopram 20 mg tablet)	$0.0307 per tablet (Trazodone 50 mg tablet)
12-month price change	-12%	-10%
Boxed warning	Yes	Yes
Shortage now	No current entry	No current entry
Recalls recorded	1	5
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)	139,519	15,550
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 interactions
Concomitant 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.

Trazodone label, drug interactions
Examples isocarboxazid, moclobemide, phenelzine, selegiline, tranylcypromine Other Serotonergic Drugs Clinical Impact The concomitant use of serotonergic drugs including trazodone and other serotonergic drugs increases the risk of serotonin syndrome.

Source: FDA drug labels via openFDA

What next?

Escitalopram: the full record
Trazodone: the full record
Alternatives to escitalopram: every medicine labeled for the same conditions